Preventing Asthma Deaths at School

by Jennifer Mitchell Wilson B.S. Dietetics, Dietitian, Health Professional

According to the Asthma and Allergy Foundation of America, nine Americans die from Asthma every day. While adults are seven times more likely to die from asthma than children, asthma is still the third leading cause for children landing in the hospital and therefore should not be taken lightly.

There are always going to be issues when children with asthma attend school. However, there are several things that can make navigating school with asthma safer and easier. Check out these tips to keep your asthmatic as healthy as possible while they are at school.

Attend a school that has a full time school nurse.
Twelve year old Laporshia Massey was an asthmatic who attended a school that only had a part time school nurse. On the day of her fatal asthma attack the school nurse was not present and there was no one else available who could asses the seriousness of her breathing difficulties. Though Massey complained of breathing issues no one called an ambulance. Instead she remained at school and, after being driven home after school, died later that day.

This heartbreaking story is a prime example of why a school nurse is a necessity if you have an asthmatic child. School nurses play a huge role in monitoring the health of their asthmatic students, providing medications as needed or calling an ambulance if warranted. They also educate other faculty and staff about each child's medical issues to insure that any adult your child comes into contact with will also know about their asthma.

Have an asthma action plan in place.
As we have discussed in several other posts on HealthCentral's asthma site - an asthma action plan is essential to insure the health of your asthmatic child. An asthma action plan provides detailed information from your child's physician about when to use the rescue inhaler, how much medication to use, normal peak flow levels for the student and when to call for emergency assistance. The asthma action plan also includes a list of your child's triggers and can help school staff keep those things away from your child as much as possible.

Insure that teachers and staff understand the seriousness of asthma.
Asthma is one of those conditions that can vary in severity from person to person. One person may have very few attacks and be well controlled while the next could have frequent attacks and numerous emergency room visits. That is why it is important for your child's teachers and staff to know how your child's breathing is doing. If anything changes with regard to their asthma control it is important to let them know immediately.

Sadly, 11 year old Sam Ford's asthma was not taken seriously by his teacher. The teacher, who was in a meeting, made Sam wait in the hallway until she was done. Ford's mother ended up taking him to the ER after picking him up at school but by then it was too late. Dr Charlotte Doughty, who treated Sam said he would likely have survived had an ambulance been called sooner. Dr. Doughty went on to say: "The people I have seen die from asthma attacks are the people who have delayed their attendance to hospital." Asthma should always be taken seriously no matter what the child's previous history entails. It is always better to be safe than sorry!

Leave a rescue inhaler with the nurse and student.
Another contributing factor to asthma deaths at school is the lack of quick access to a rescue inhaler. At our school my daughters' rescue inhalers are in the school nurses office. So far, that has worked out okay for them but what if the nurse steps out to run an errand, deal with another child or use the restroom? Then what?

According to the most recent study of asthma attacks in U.S. schools, 42 percent occurred while the children were participating in a physically active event and 31 percent of children died while waiting for medical assistance.

To help prevent asthma attacks or deaths related to participating in physically active events pre-medication with albuterol may be worth discussing with your child's physician. You can add the pre-medication routine to the asthma action plan as well. Our daughters both use their ProAir (albuterol) before they had P.E.

One way to address the issue of delayed care is to teach your child to be able to use their rescue inhaler on their own. Once they have mastered that skill your child's physician can sign a note that allows your child to carry their inhaler with them. All 50 states have laws that allow students to carry their inhalers as long as their physician approves it. That quick access to a rescue inhaler can help to prevent any delay in treatment.

Push for good IAQ.
IAQ or indoor air quality is essential in keeping your child breathing well at school. There are many things that can lead to poor air quality in the classroom like perfume, candles, chalk dust, second hand smoke on other children's clothing and many other things.

The Environmental Protection Agency has many tips on improving a school's IAQ. Some of these tips include:

  • Remove scented lotions, candles, sprays or perfumes from the classroom.

  • Be careful with the use of chemicals in the classroom. This includes bleach, Lysol or other cleaners that can be irritating to an asthmatics' lungs. Save the deep cleaning for after school whenever possible.

  • Spray for bugs or pests AFTER school hours to prevent students from breathing in those poisonous fumes.

  • Plan any construction for times when students will not be in the building as the dust, paint fumes, new carpet fumes and other debris can be a huge trigger for any asthmatic.

  • Keep HVAC system properly maintained and cleaned.

  • Monitor the rooms for any signs of leaks or water damage that could indicate mold.

  • Don't air out the classroom by opening windows if it's a high pollen or mold day.

  • Consider an air purifier if any of the above guidelines are unable to be met.

Keep your child home or head to the doctor when breathing is bad.
In most schools an absence due to a medical problem like asthma is excused as long as you contact the school and/or have a note from your child's physician. If your asthmatic isn't breathing well then there may very well be days where they are better off at home. We instituted a 504 plan for one of our asthma chicks because she was missing more school than she was attending. The 504 plan provided some accommodations and guidelines for us and her teachers to keep her caught up when she is not in the classroom.

Asthma can be a scary disease. Sending your child to school with asthma is even scarier. Hopefully these tips can help make you and your child safer and more comfortable dealing with their asthma at school.

Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years. Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).

Jennifer Mitchell Wilson
Meet Our Writer
Jennifer Mitchell Wilson

Jennifer Mitchell Wilson is a dietitian and mother of three girls. Two of her children have dealt with acid reflux disease, food allergies, migraines, and asthma. She has a Bachelor of Science in dietetics from Harding University and has done graduate work in public health and nutrition through Eastern Kentucky University. In addition to writing for HealthCentral, she does patient consults and serves on the Board of Directors for the Pediatric Adolescent Gastroesophageal Reflux Association.