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Asthma at School

Role of the Teacher

Identify the high-risk students with asthma:

  • Previous life-threatening episodes
  • Three or more emergency room visits in one year
  • Prior hospitalizations within one year
  • History of non-adherence to asthma treatment regimen
  • Recurrent nighttime asthma requiring medications
  • Know the early warning signs
  • Have a copy of the students Asthma Action Plan in your classroom
  • Understand the student may feel tired, different from other students, anxious
    about easy access to medications, embarrassed about asthma, worried about
    activities that induce asthma

Asthma Facts

  • Asthma is the most common chronic disease of children
  • There are approximately 22 million people in the USA diagnosed with asthma
  • Asthma is the leading cause of school absenteeism in the United States
  • Children with uncontrolled asthma miss approximately 14 days of school per year
  • Asthma education is a vital component of asthma management
  • Asthma specialists (Allergist, Pulmonologist) are needed to care for mild
    persistent, moderate persistent and severe persistent asthma
  • If properly managed, people with asthma can live a happy, healthy, active life

Early Warning Signs

  • Low peak flows
  • Chronic cough (especially at night)
  • itchy, scratchy, sore throat
  • headache, stopped up head, sneezing
  • shortness of breath with exertion restlessness, more irritable,
    or at even rest
  • dark circles under the eyes
  • restlessness, more irritable
  • increased fatigue
  • tired, itchy watery, glassy eyes

Asthma Action Plan

An action plan is a treatment plan for worsening asthma. The action plan adjusts to the severity of symptoms so that students can control their asthma. People with asthma should have a treatment and management plan developed by their health care team. An Asthma Action Plan is a special road map to know how to take care of asthma each day.

When peak flow rates are:

Green Zone
  • Everything is all "go"
  • 80% or more of what your peak flow rate should be
Yellow Zone
  • Caution
  • 60 to 80% of what your peak flow rate should be
Red Zone
  • Medical emergency - peak flow rates are less than 50% of what it should be

Peak Flow Monitoring

A peak flow meter is a device that measures how well air moves in and out of the lungs. During an asthma episode, the airways become inflamed and narrowed. Many people who take asthma medicine daily use a peak flow meter several times a day.

How to Use the Peak Flow Meter

  • Set the marker to the bottom of the numeric scale.
  • Take a deep breath. Be sure you are standing up.
  • Place your lips tight around the mouthpiece.
  • Talk a big deep breath in.
  • Blow as hard and fast as possible. Blast the air out fast!
  • Note the final position of the marker. This is your peak flow rate.

Inhalers

Metered dose inhaler:

This is a small canister that contains the medication you need to control your asthma or relieve bronchospasms during an asthma episode (Advair HFA, Symbicort, ProAir HFA, Xopenex HFA, Albuterol HFA, Flovent HFA, Q-Var HFA, etc.). Proper inhaler technique must be performed to efficiently receive the medicine.

  1. Shake inhaler and place in your spacer. You may need to remove the inhaler from the canister if your spacer requires no case.
  2. Take 2 or 3 slow and deep warm up breaths.
  3. Sit up straight and be sure you are holding your head looking straight ahead.
  4. Slowly exhale.
  5. Place inhaler in your mouth, and then spray one spray.
  6. Slowly breathe in and hold your breath at least 10 seconds.
  7. Remove the spacer from your mouth and slowly exhale.
  8. Properly place spacer back into your mouth and slowly breathe in again.
  9. Hold your breath at least 10 seconds then slowly exhale.
  10. Wait 1 to 3 minutes and repeat as ordered by your doctor. (Be sure to shake your inhaler again!) Rinse your mouth after using anti-inflammatory medications.

Dry powdered inhalers:

This is medication that is in powder form. (Advair Diskus, Pulmicort Flexhaler, Asmanex, etc.)

  1. Breathe out slowly.
  2. Put your mouth on the mouthpiece.
  3. Take a big deep breath in real fast.
  4. Hold your breath for 10 seconds.
  5. Blow out slowly.

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Grass Pollen Allergy

If the smells of freshly cut lawns make you sneeze, you may have a grass pollen allergy. Grass pollen is a common cause of allergy. Every spring and summer, plants release tiny pollen grains to fertilize same species plants. Grass pollen can trigger allergic reactions.

If you are experiencing these symptoms, grass pollen may be the trigger:

  • Runny nose
  • Sneezing
  • Itchy nose, eyes, ears and mouth
  • Stuffy nose (nasal congestion)
  • Red and watery eyes
  • Swelling round the eyes

 Since grass pollen grains may not be visible to the eye, your body may react even to tiny amounts of pollen in the air. With Oklahoma’s strong winds, pollen is distributed across the state.

Also known as hay fever, allergists refer to pollen allergy as seasonal allergic rhinitis.

What grasses cause allergy symptoms?

Fortunately, only a few grasses cause allergic symptoms. Where you live also plays a factor in grass allergy.

The most common grasses causing allergies are:

  • Bermuda
  • Johnson
  • Kentucky
  • Orchard
  • Rye
  • Sweet Vernal
  • Timothy

Living in Oklahoma, grass can pollinate through most of the year. Tiny, light and dry – grass pollen grains can travel for hundreds of miles.

“The first step is to get tested and diagnosed,” said OAAC Allergist Dr. Bret Haymore. “Once your allergist knows what specific allergens causing your symptoms, then we can work with you to create a treatment plan.”

Options for treatment include over-the-counter medicines, liquids or nasal sprays and prescription pills (also known as antihistamines, decongestants and nasal steroids). These can help reduce or prevent grass allergy symptoms.

“Grass allergy pollen medicines work best when you start taking them before pollen season begins,” said Dr. Haymore. “This will allow the medicines to prevent your body from releasing histamine and other chemicals that cause your symptoms.”

Another option if those medicines are no longer helping, may be immunotherapy or allergy shots. There are two types of grass allergy immunotherapy – allergy shots and allergy tablets. 

“Immunotherapy is a long-term course of treatment that can reduce or even prevent the severity of allergic reactions,” he said. “Allergy shots usually take a one-to-three-year commitment and can modify the body’s immune response to allergens.”

Allergy shots or subcutaneous immunotherapy (SCIT) are given at the OAAC clinics. Patients are monitored for any type of reaction to the shot. Most common side effects include local reactions at the injection site – redness, itching, swelling, tenderness, and pain. Less common reactions may include generalized redness, hives, itching, swelling, wheezing and low blood pressure.

Allergy tablets or sublingual immunotherapy (SLIT) can be done at home. This therapy involves placing a tablet containing the allergen under the tongue for one to two minutes and then swallowing it. Treatment must begin before grass allergy season and continues throughout grass allergy season. Taking the daily tablets may reduce grass allergy symptoms. There can be some side effects, and some can be serious. Please discuss with SLIT therapy with your OAAC provider about treatment options.

The post Grass Pollen Allergy appeared first on Oklahoma Allergy and Asthma Clinic.

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