Working With Schools to Improve Pediatric Asthma Management

Abstract

Asthma morbidity in pediatric patients can be signifi cantly reduced through the coordinated efforts of asthma care clinicians, families, and schools. The efforts of asthma care clinicians and schools, both individually and collectively, should address the medical and psychosocial needs of the patient. The synergy created by each playing an active role in pediatric asthma management assists the patient in gaining adequate asthma control. In addition to writing asthma action plans for their patients, clinicians can work with schools more effectively by focusing their efforts on the following key actions: promoting asthma-friendly schools; identifying schoolaged children with asthma; educating patients and school staff about asthma; assisting patients, families, and schools in reducing exposure to environmental triggers; assisting the school staff in helping students manage their asthma at school; and playing an active role in monitoring and coordinating care with schools and families by working closely with care coordinators/case managers. School-based asthma management programs can assist families and asthma care clinicians in achieving good asthma control for school-aged patients. This article reviews recent research fi ndings and provides guidance for asthma care clinicians on how to enhance a full range of school-based asthma management for their patients.

El niño alérgico en la escuela. ¿Qué es lo que se necesita saber?

“…13 A esta enfermedad se atribuyen 13 millones de días perdidos de la escuela/año, lo que puede causar dificultades en el aprendizaje y en la integración escolar, así como en las metas académicas, además de ser una de las causas más importantes de hospitalización en menores de 15 años. 2,3,14,15 Los niños y adolescentes con asma, de acuerdo con su desarrollo y aprendizaje, deben tener conocimiento sobre su enfermedad, aprender cuáles son los principales factores de riesgo de exacerbaciones y comunicarlos a su familia y personal de la escuela, y aprender a usar el medicamento broncodilatador en una situación de emergencia. 8 Los padres de un escolar con asma deben informar a la coordinación de la escuela acerca de la gravedad del asma de su hijo y, siempre que sea posible, dar un plan de acción elaborado por escrito por el médico del niño.…”

“…Aunque hay mucha información sobre la gestión de las alergias, la evidencia sobre el cuidado de los niños alérgicos en la escuela es insuficiente. 3 Debido a que el niño alérgico permanece varias horas dentro de la escuela, es esencial que conozcamos el entorno al que está expuesto. Se sabe que la exposición a las micropartículas, entre ellas los aeroalérgenos en el aula, es alta.…”

Community Pediatrics: Navigating the Intersection of Medicine, Public Health, and Social Determinants of Children’s Health

“…19 Pediatricians should partner with local health departments and school districts and child welfare agencies to be aware of programs for children and families that address certain needs, such as injury prevention, child maltreatment prevention, lead poisoning, environmental tobacco smoke control, breastfeeding promotion, overweight/obesity prevention, asthma, perinatal care, trauma, child abuse prevention, and disaster preparedness. [20][21][22][23] One example of a pediatric/public health approach would be to ensure that children's issues are addressed in disaster planning/response.…”

“…Pediatricians should work together with public health departments, school districts, [21][22][23] child welfare agencies, community and children' s hospitals, and colleagues in related professions to identify and decrease barriers to the health and well-being of children in the communities they serve. 26,27 In addition, pediatricians should have access to information about community programs and resources that could affect the health and well-being of the children in their community.…”

Indoor air quality in primary schools

“…The IAQ in school buildings is expected to be a key role player in the assessment of the effects of the children personal exposure to air pollution as children spend at least a third of their time inside school buildings, that is, approximately seven or more hours a day in school EPA, 2010;Pegas et al, 2010;Wheeler et al, 2009;Ramachandran et al, 2005). Poor IAQ can affect scholarly performance and attendance (Daisey et al 2003;Godoi et al 2009).…”