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Children with asthma might need your help to ensure their school asthma management program is adequate, says Barbara Weintraub, RN, MPH, MSN, pediatric critical care nurse practitioner at Northwest Community Hospital in Arlington Heights, IL. "There have been cases of children who told their teacher that they needed to visit the nurse to use their inhalers," she says. "Unfortunately, the teachers felt that the child was trying to get out of class, so they did not allow them to go to the nurse." This type of scenario should not occur, stresses Weintraub. "Any child who feels they need their inhaler should be allowed access to it without question."
Weintraub offers the following list to use when contacting school health nurses to ensure appropriate asthma management is being done:
• School health nurses must be able to recognize a possible asthmatic emergency and have a written plan of action should one occur. "Although many asthmatics feel short of breath during an asthma attack, there is a small subset of asthmatics who do not experience this breathlessness," says Weintraub. "They are at the highest risk of death from asthma."
• All school personnel should learn to recognize the signs of respiratory distress and be prepared to initiate treatment once that is recognized.
• Schools should bring in appropriate personnel to teach the signs and symptoms of respiratory distress, some of which can be subtle in children.
• There should be a written policy that any child who asks to use their inhaler should be allowed to without question or judgment on the part of the teacher. "They should also have in their policy that any child who needs their inhaler more often than once in two hours is probably in need of more definitive care," says Weintraub.
• As part of their asthma education, schools should include information on the difference between rescue inhalers and maintenance inhalers, and the chronic nature of the disease. "This is especially important, as many schools have health aides rather than nurses," says Weintraub.