Asthmatic Child & School

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Question:

My twelve year old son has asthma. Occasionally, it’s quite severe. His school will not allow the children to keep their inhalers with them and so all inhalers are kept in the nurse’s office. I worry about this because I know how quickly an attack can hit. We live in Arkansas. I don’t really know what I can do to change school policy. I know that all schools are concerned with drugs … but asthmatics need their medication immediately (I know, I have asthma, too). Any suggestions on what I can do? The solution I’ve been using (which now has us in trouble with the school and the state) is to keep my son home with me if he’s having any asthma related problems. This way I can keep a close eye on him and make certain that medication is immediately available. It’s also a way for me to make the decision on weather to rush to the asthma specialist’s office for a breathing treatment. I don’t think the school personnel would know what to look for … not even the nurse. But as I said, we’re in trouble because of too many absences. And yet, I can’t take the risk of sending him to school on borer-line days. What do you recommend?

Response:

- Hide quoted text — Show quoted text – > My twelve year old son has asthma. Occasionally, it’s quite severe. His > school will not allow the children to keep their inhalers with them and so > all inhalers are kept in the nurse’s office. I worry about this because I > know how quickly an attack can hit. We live in Arkansas. I don’t really know > what I can do to change school policy. I know that all schools are concerned > with drugs … but asthmatics need their medication immediately (I know, I > have asthma, too). Any suggestions on what I can do? The solution I’ve been > using (which now has us in trouble with the school and the state) is to keep > my son home with me if he’s having any asthma related problems. This way I > can keep a close eye on him and make certain that medication is immediately > available. It’s also a way for me to make the decision on weather to rush to > the asthma specialist’s office for a breathing treatment. I don’t think the > school personnel would know what to look for … not even the nurse. But as > I said, we’re in trouble because of too many absences. And yet, I can’t take > the risk of sending him to school on borer-line days. What do you recommend?

Certainly a 12-yr old asthmatic should have the right to carry his inhaler with him to school. Here is a link to ASTHMA AND THE SCHOOLCHILD from AAAAI: http://www.aaaai.org/patpub/resource/publicat/tips/tip19.html Excerpt: "Medications at School Taking medications at school may be very difficult, since most children with asthma want to hide their need for medication. Also, poorly informed school authorities sometimes make it impossible for children to take their medication. In other cases, some children refuse to go to another part of the school building (nurse’s or secretary’s office) to take their medication. School officials and parents must create an environment that shows the child with asthma that it is okay to take medication in school. With physician and parental approval, an asthmatic child should be allowed to carry metered-dose inhalers (MDI) with him/her at all times and use them as appropriate. The individual needs of each child with asthma must be addressed." Here is a link to the 1997 Expert Panel Report on Asthma: http://www.ama-assn.org/special/asthma/treatmnt/guide/guidelin/comp3/… "School Issues The clinician should prepare a written asthma management plan for the student’s school (see figure 4-7) that includes the following information: an action plan for handling exacerbations (including the clinician’s recommendation regarding self-administration of medication and plans to ensure prompt, reliable access to medications); recommendations for long-term-control medications and prevention of exercise-induced bronchospasm (EIB), if appropriate; and identification of those factors that make the student’s asthma worse so the school may help the student avoid exposure. It is preferable to schedule daily, long-term medications so that they are not taken at school, even if this results in unequal dosing intervals throughout the day. However, in school districts that have more comprehensive school nurse coverage, children who would benefit from close supervision to promote adherence may be given medications at school. In this way, daily medication can be administered and patient education can be supplemented most days of the week. Students with asthma often require medication during school to treat acute symptoms or to prevent EIB that may develop during physical education class, school recess, or organized sports. Reliable, prompt access to medication is essential, but it may be difficult because of school rules that preclude the child from carrying medications. The National Asthma Education and Prevention Program and several member organizations have adopted resolutions that endorse allowing students to carry and self-administer medications when the physician and parent consider this appropriate. It may be helpful for some children to have a compressor-driven nebulizer available at the school. " You might try contacting Mothers of Asthmatics for advice. See http://www.podi.com/health/aanma/ Phone 800-878-4403 Other thoughts are to contact other parents in your school with children with asthma, contact the PTA, find out if a note from your doctor would let your child keep his inhaler with him. A last resort would be legal action, but I don’t think this should be necessary. There is a question of child endangerment; also the ADA, Americans with Disabilites Act may apply which requires appropriate accomodation. But make sure your child’s asthma is well controlled. He should be using a Peak Flow Meter to monitor lung function, and adjusting meds per Action Plan if he doesn’t stay in green (>80% PB) The rescue inhaler (albuterol) should rarely be needed, but never the less should be carried on his person just in case. Ellis

Response:

> My twelve year old son has asthma. Occasionally, it’s quite severe. His > school will not allow the children to keep their inhalers with them and so > all inhalers are kept in the nurse’s office. I worry about this because I > know how quickly an attack can hit. We live in Arkansas. I don’t really know > what I can do to change school policy. I know that all schools are concerned > with drugs … but asthmatics need their medication immediately (I know, I > have asthma, too). Any suggestions on what I can do?

Contact your local American Lung Association office and ask about the ‘Open Airways for Schools’ program. More information on this can be found at:http://www.lungusa.org/noframes/learn/asthma/astopen.html

Response:

What I did: 1. Gave my ward her inhaler, and told her if she was having trouble breathing to excuse herself to the bathroom and use it . . . otherwise to keep it out of sight. If the inhaler didn’t work, she was to call 911, and get an ambulance to transport her to the hospital, where they had my permanent treatment permission on file. 2. Filed suit against the school board for endangering my ward’s health. We never went to court, as they figured out that they would lose. 3. Made an appointment with my ward’s teacher at the beginning of every school year for the express purpose of discussing asthma, it’s causes, treatment, etc., and making sure we were all on the same track. If the teacher wasn’t willing to cooperate, we got a change of teachers. Basically, you beat the school system with a persistent stick. Good luck. Chris Owens

Response:

Well, I had similar problems iwth my daughters but our current school system is much better. 1. Make an appointment with your school facilitator or counselor to have your child evaluated and a 501accommodation plan done. This can include carrying of the inhaler or a plan such as the teacher keeping it in her desk. You may have to have an inhaler for every teacher and every class you child attends. This will also give you flexiblility with the absencetism policy. 2. get educated with concerns of educating the handicapped or chronicly ill child. Try you local Parents educating parents group…this wil educated you on all the laws and regulations about what you can and can not do. Will, make you look very good when you go in with your demads if you know the law. 3. Hold you school responsible for you child’s health and put in in writing. Explain to them the current plan you have for your child and denial of access to any part of this plan will result in legal action. 4. Have you doctor write up a plan of action for you child. 5. Talk to the child’s teachers and make them responsible also. Most teachers don’t want to take the responsiblility for your childs health so will let the child have his inhaler. 6. Last resort is the press…talk to your local newspaper or radio and TV stations and bring you case to the public light. Especially if the child gets ill at school once and requires ambulance transport. Good luck. The first approach worked for me. We are fortunate to have a good school system. I even keep tylenol and pepto bismal in the office for my daughter at my request along with her asthma meds. She has a good teachers and health aide. They have been very sensitive to her needs. So far this year we have had to problems.

Response:

Hi, My personal experience was some time ago (about 12 years), my youngest daughter has asthma. She had a bad attack one day and mentioned her problems to her Gym teacher. Well the teacher did not take the incident seriously and told my daughter she would have to continue until the period was over. Well things got worse but fortunately the nurse was not far from the gym. BTW, the administration, nurse and all the teachers(including this gym teacher) had been informed of her asthma condition. After this incident, I requested a formal meeting with the superintendent and principle. We met and I informed them that my daughter understands her asthma and when was having a problem, she would inform the teacher then the drugs were to be administered by her or the nurse. I did document my instructions to be placed in my child’s files. I then requested a monitored meeting with the gym teacher, superintendent and principle. At this meeting I requested that the teacher be made aware of the asthma situation and she was not to make a medical decision with regard to my child. She attempted to state that My daughter was using the asthma as an excuse. I remember telling her that my daughter knew when she was having an attack and that if indeed she was attempting to get out of something because she was having a breathing problem then by all means make certain she is taken to see the nurse. I told them all that I was to be called whenever an incident occurred! The administration was very understanding and followed my instructions to the letter. I did have few problems with the gym teacher but a few meetings with the principle took care of these. I found that the more you educate the better it will be for the child. Educators are not medically trained, so if you go to the school administration with all the necessary information to answer any questions. If not just to provide details of what should be done in case of a major event/attack. Sorry to get so winded but after reading your post, it brought back some rather unpleasant memories! Remember one thing, most teachers are concerned about the well being of their charges, not just educating them. — Regards and God Speed, Gary W. Sandvik : My twelve year old son has asthma. Occasionally, it’s quite severe. His : school will not allow the children to keep their inhalers with them and so : all inhalers are kept in the nurse’s office. I worry about this because I : know how quickly an attack can hit. We live in Arkansas. I don’t really know : what I can do to change school policy. I know that all schools are concerned : with drugs … but asthmatics need their medication immediately (I know, I : have asthma, too). Any suggestions on what I can do? The solution I’ve been : using (which now has us in trouble with the school and the state) is to keep : my son home with me if he’s having any asthma related problems. This way I : can keep a close eye on him and make certain that medication is immediately : available. It’s also a way for me to make the decision on weather to rush to : the asthma specialist’s office for a breathing treatment. I don’t think the : school personnel would know what to look for … not even the nurse. But as : I said, we’re in trouble because of too many absences. And yet, I can’t take : the risk of sending him to school on borer-line days. What do you recommend? : : :

Response:

I second the suggestion to send the inhaler to school, tell the child to excuse themselves to the restroom, and use it there. If He doesn’t feel well within a reasonable amount of time, have him call home. My daughter did this and it worked. She had an over-reactive teacher who would make a big fuss every time she needed the inhaler. This was when we were first learning about controlling episodes, etc. A twelve year old should be able to use their own discretion and know when they do and don’t need to use their inhalers. good luck. A Mom Who’s been there

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