Schools improve in managing asthma

Children's symptoms often worsen at the beginning of the school year.
MINNEAPOLIS-ST. PAUL STAR TRIBUNE
Every year, Kimberly Bouzguenda sends her 9-year-old daughter, Izzy, to school with a backpack and an inhaler. Izzy has had asthma since she was an infant.
"I'm always a little more concerned at the beginning of the school year, especially if there is a new teacher and you don't know how they will react and support your child," Bouzguenda said.
The start of each school year brings the annual peak in emergency-room visits and hospitalizations for children who have asthma. Experts say that when kids return to school in the fall they are exposed to many of the triggers that cause asthma attacks -- viruses, pollen, dust, chemical fumes and stress.
"We believe that if asthma is properly managed, it doesn't need to result in [hospitalizations]," said Janet Keysser, head of the Minnesota Department of Health's asthma program.
It's the management part that can be tricky. The American Lung Association last week released results of a national survey of parents who have children with asthma, showing that most don't take the minimum precautions. Fewer than half alert their child's teacher about their child's condition or make sure that the child has medications needed at school, the association said.
"We are doing better with asthma than we used to because we have safe, effective medicines," said Dr. Richard Sveum, an asthma and allergy specialist with Park Nicollet Clinic in St. Louis Park, Minn. "But improvement is needed in all areas," he said.
Percentages
Asthma afflicts about one child in 10 in Minnesota, with rates higher for black children and those who live in urban areas. In Minneapolis schools, for example, 12.5 percent of pupils have asthma, said Mary Heiman, nursing-services manager for Minneapolis schools.
Children with asthma have an overactive immune response to things such as viruses, allergens and pollutants. When exposed to an irritant, their airways become clogged with immune cells and mucus.
"Breathe through straw," said Bouzguenda, who also has asthma. "That's what it feels like to breathe if you are asthmatic."
Asthma can be controlled with medication. Most kids use a "rescue" inhaler -- a short-acting steroid that opens the bronchial tubes -- when they start to wheeze or before exercise. But many also take less concentrated forms of steroids daily to keep symptoms at bay.
In the past five years, many schools have gone on the offensive to make sure that their staffs are educated on how to recognize asthma, and to make sure that pupils have access to medications they need.
Improving
"Schools are getting really good," said Sveum. Those in Minneapolis and St. Paul, for example, have gotten a boost by being able to participate in a federally funded program aimed at reducing asthma in cities. It provides money to teach teachers and school nurses how to recognize asthma, and how to care for kids who have it.
One of the most important things they learn, according to experts, is how to reach out to parents of asthmatic children. Heiman said that school nurses keep track of all pupils with asthma. They ask parents to provide an Asthma Action Plan, an individualized medical form from a child's doctor that provides detailed information about each child's condition, medication and triggers.