June 6, 2023, Med Page Today: Schools Aren't Prepared to Treat Asthma Attacks https://www.medpagetoday.com/opinion/second-opinions/104868
Every school should have a stock albuterol program
Asthma affects 8.6% of children in the U.S. [ONE IN 12]
Children in high-burden areas, including inner-city and rural areas, are disproportionately affected due to barriers to care and environmental factors. Asthma exacerbations account for over 14 million missed school days per year, impacting school work and daily living. Healthcare expenses incurred by families can be staggering, and long-term effects are far-reaching, putting children's lives at risk.
Currently, all 50 states have laws permitting students to self-carry and self-administer asthma medication in schools. However, as few as 14% of children have access to a personal inhaler while at school. This could be due to various factors, including having undiagnosed asthma, having an asthma diagnosis but forgetting medication at home, or lack of cooperation from parents to allow children with asthma to self-carry medication. Thus, it is imperative for schools to stock and provide medication for any child experiencing respiratory distress….
Expanding Education and Training
Some licensed nurses and school staff remain hesitant to administer albuterol to students in respiratory distress with undiagnosed asthma. This, in part, stems from concerns among some staff regarding differentiating between asthma versus anaphylaxis, both of which can present with respiratory distress. While there are overlapping symptoms, anaphylaxis and asthma are separate conditions with clear distinctions, mandating different treatments. Medical News from Around the Web
A study from Kevin Murphy, MD, et al, discusses the implementation of a program in schools in Omaha, Nebraska, to distinguish between emergency responses for asthma and anaphylaxis. Specific emergency protocols were established, and school staff were trained and tested on steps for administering an EpiPen versus albuterol, depending on a student's symptoms.
Over a period of 5 years, 99 students were treated. Of these, five students (5%) were treated with epinephrine alone, and 89 students (90%) were treated with albuterol alone. The greater number of cases of suspected asthma attacks compared with suspected allergic reactions highlights the need for incorporating albuterol training into school health policies….
As more states take steps toward stock albuterol legislation, we must standardize protocols to ensure consistency with medication dosing. In addition, continuing education should be expanded to community paramedics and EMS teams, in order to facilitate quick communication during emergencies.
Children spend most of their time in school, and protecting the health of the child during the school day is of utmost importance. For children with diagnosed or suspected asthma, developing a comprehensive, school-based approach to albuterol access can save lives.