Asthma is the most common cause of illness among children and adolescence, and the leading cause of absenteeism.

What is asthma?

Asthma is a condition affecting the lungs in which the airways narrow and swell and may produce extra mucus. This can make breathing difficult and cause repeated episodes of coughing, a whistling sound (wheezing) when you breathe out, chest tightness, shortness of breath, and nighttime or early morning coughing. 

What is the treatment for asthma?

If your child has been diagnosed with asthma, you and their doctor will come up with a treatment plan that involves a blend of medications and avoiding asthma triggers. It is also a good idea to develop an Asthma Action Plan to help manage the condition at home.

What are asthma triggers?

Asthma triggers are various allergens that can cause asthma flare ups. It is important to recognize and minimize these triggers in order to effectively manage your child’s asthma. Different people have different triggers. Here are a list of the most common asthma triggers:

• Tobacco Smoke – tobacco smoke is not good for anyone but can be especially dangerous for those with asthma. If your child has asthma you should make your home a “smoke-free” zone and avoid smoking around them in general. The best thing to do for both your child’s health and your own, is to quit smoking.
• Dust Mites – dust mites are microscopic bugs that can live in your home. To minimize their occurrence make sure you are vacuuming regularly, washing bedding weekly, avoiding down filled comforters/pillows/quilts, and  keep your home at a relatively low humidity level (around 30-50%).
• Outdoor Pollution – air pollution can come from many sources including factories, vehicles, wildfires, etc. Pay attention to air quality in your community when planning activities and be aware of when your child might be more susceptible to asthma exacerbations. Ideally, outdoor activities should be planned for when pollution levels will be low.
• Seasonal Allergies – The same substances that trigger your hay fever (allergic rhinitis) symptoms, such as pollen, dust mites and pet dander, may also cause asthma signs and symptoms. In some people, skin or food allergies can cause asthma symptoms. This is called allergic asthma or allergy-induced asthma.
• Pests (cockroaches, mice, etc.) – To control pests in your home: 

• Remove as many water and food sources as you can.
• Clean dishes, crumbs, and spills right away.
• Store food in airtight containers.
• Keep trash in a closed container.
• At least every 2 to 3 days, vacuum or sweep areas that might attract cockroaches or mice.
• Keep counters, sinks, tables, and floors clean and free of clutter.
• Seal cracks or openings in cabinets, walls, baseboards, and around plumbing.
• Use pesticide baits and traps in areas away from children and pets, following manufacturers’ instructions.
• Avoid using sprays and foggers as these can cause asthma attacks.

• Pets – Furry pets can trigger an asthma attack if you are allergic to them. If you can’t or don’t want to find a new home for the family pet, decrease your exposure by: keeping pets out of bedrooms, washing furry pets, using an air cleaner with HEPA filter, and using allergen-proof mattress and pillow covers.
• Molds – Breathing in mold can trigger an asthma attack whether or not you are allergic to mold. Indoor mold growth is often found in damp areas; bathrooms, basements, kitchens, and water damaged areas.
• Cleaning and disinfecting products – These products should always be used in well ventilated areas. Children with asthma should have limited exposure to these products.
• Scents/fragrances – certain scents and fragrances might trigger an asthma response, avoid exposure to these items to prevent exacerbations.
• Illnesses – certain illnesses that affect your respiratory system can make asthma worse. Make sure to avoid exposures and to get your child’s annual flu vaccine.
• Exercise – Exercise sometime triggers asthma. Exercising is an important aspect of healthy living. Please make sure your child’s action plan accounts for recess and gym activities if this is a trigger for your child.
• Emotions/Stress – strong emotions and stressful situations can lead to very fast breathing, called hyperventilation, that can also cause an asthma attack. 

What is an Asthma Action Plan?

An asthma action plan is an individualized plan that outlines how to manage your asthma. This plan will be developed by you and your child’s provider and shared with the school nurse. It will be important to make sure that this form is completed and returned to school as well as any medications that your child may need during the school day. The best way to prevent an asthma attack/complication is to follow the treatment plan. Many people live healthy lives with asthma if it’s managed well. Asthma Action Plans often contain the following information:

• A list of triggers 
• Symptom tracking
• A list of asthma medications and instructions on when and how to take them 
• When to call the healthcare provider or seek emergency medical care 
• Emergency phone numbers

Your child’s Asthma Action Plan will be renewed each school year.

https://www.cdc.gov/asthma/action-plan/documents/asthma-action-plan-508.pdf

Allergies and School

Managing allergies in schools is a collaborative effort between students, families, staff, administrators, and the school nurse. The goal for effective management is to reduce and/or eliminate potential allergens. The keys to meeting this goal is prevention, education, awareness, communication, and rapid emergency response. 

An allergy occurs when your immune system reacts to something – such as pollen, bee sting, pet dander, or food – that does not usually cause a reaction in most people. The severity of a reaction can range from mild irritations, such as rash/itching/swelling, to anaphylaxis.

Anaphylaxis is a severe and life threatening reaction which can occur within seconds or minutes after exposure to an allergen. The symptoms of anaphylaxis are as follows:

• Skin reactions, including hives and itching and flushed or pale skin
• Low blood pressure (hypotension)
• Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing
• A weak and rapid pulse
• Nausea, vomiting or diarrhea
• Dizziness or fainting

Food allergies, specifically, are a growing concern among school children. It is the most common trigger, accounting for 60% of the reactions is a school setting. The CDC estimates that approximately 1 in 13 children have a significant food allergy that may result in anaphylaxis. The most common food allergies in children are: milk, eggs, wheat, soy, peanuts, tree nuts.

Insect stings are another common allergy in school age children. Insects that can trigger allergic reactions include honeybees, yellowjackets, hornets, wasps, and fire ants. When they sting, they inject venom into the skin. Allergic reactions to stings usually don’t happen when a child is stung for the first time. Most happen when the child is stung for a second time, or even later.

If your child has an allergy please contact the school nurse so the appropriate accommodations can be made and documented. If your child has a history of an anaphylactic reaction the school nurse, in collaboration with you and your child’s doctor will create and Emergency Action Plan (EAP). An EAP is a plan that gives specific steps for school professionals to take if your child has a medical emergency. 

https://my.clevelandclinic.org/health/diseases/8610-allergies

https://kidshealth.org/en/parents/sting-allergy.html

https://downloads.aap.org/AAP/PDF/AAP_Allergy_and_Anaphylaxis_Emergency_Plan.pdf