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Asthma Control Education (ACE): Back-to-School Safely During COVID

By: Erica Singer, PA, Asthma Educator (Allied Physicians Group, NY)

TOP TEN TRENDING TOPICS from the ‘ACE’ [Asthma Control Education] Webinar: The Back the School Edition

As summer vacation draws to a close, we all begin to feel excited and anxious for the new school year ahead. It is always tough to move on past great summer activities and memories we’ve created. This year is no different. However, 2020 has thrown some serious curveballs. From Tiger King and murder hornets to toilet paper shortages and complete lockdowns. This year has kept everyone on their toes. We are now faced with an unprecedented amount of uncertainty as we journey through unchartered territory. Drive-by nasal swabs, virtual learning, and mask-wearing has become the new norm. Many of us are facing tough decisions moving into the new school year and we are questioning how to properly go back in a safe and successful way. There is ambiguity in previously routine activities, and we feel a lack of control. But despite these chaotic times, there is one thing as a parent you can take control over now … that is your child’s asthma. Allied’s ACE (Asthma Control Education) team is here to help!

 

COVID-19 & Updated ASTHMA Guidelines

Now more than ever, knee-deep in the current pandemic, the emphasis on overall health is at an all-time high, with strong emphasis on those with underlying chronic respiratory illnesses such as asthma. Asthma is the most common chronic disease in children (8%). What we know about asthma and its correlation to COVID-19 is plentiful and the data continues to be analyzed by experts every day. According to our current understanding of the novel coronavirus, well-controlled asthmatics are NOT at greater risk for developing severe COVID-19 when compared to the general population. There are also no physiological difficulties associated with wearing a mask, in those with or without asthma. You may get sweaty, but the oxygen you are inhaling is still plentiful and you increase your level of protection in a drastic way! Wear a mask.

The 2020 asthma guideline updates now consider the use of low dose inhaled corticosteroids as mainstay therapy (previously albuterol). The guidelines encourage their use for more asthmatics to achieve better control and prevent future attacks. Are they safe? YES. Remember the overall goal of asthma treatment is to control symptoms AND avoid risk of future attacks. The information and knowledge we have for managing asthma is ever-changing, like much of medicine, and it is our job to make sure we keep you up to date.

 

ASTHMA CONTROL

As we begin to prepare for our return to school and work, COVID cases continue to make appearances in our community. Good asthma control has never been more important heading into this fall season. If your child’s asthma is well-controlled, their asthma should not be the diagnosis that holds them back from attending school or other activities.

 

The Asthma Action Plan

A well-controlled asthmatic knows what to do to control and manage their symptoms. In other words, they have an ASTHMA ACTION PLAN (AAP). Your written AAP can be filled out with your pediatrician, asthma educator, or a specialist with your help. Copies of the written AAP should be handy: at home, school, work, sports bag, etc.

 

 “Know the Difference”

Both the parent and the child should have some level of understanding when it comes to what to do should asthma symptoms occur. An asthmatic should know WHICH inhaler to use and WHEN! Does YOUR CHILD know the difference? Rescue versus controller… this could be lifesaving!

 

The Nebulizer vs. The Inhaler

During this ongoing pandemic, there has been much discussion about which modality is better to use, the nebulizer or inhaler. Both are EQUALLY as effective… if USED PROPERLY! The inhaler is the more preferential mode of medication delivery currently but remember any form of assistance to breathing is better than none! The use of nebulizer machines in offices, urgent care centers, and hospitals are not recommended at this time. This is due to contamination of aerosolized bacteria and viruses which can be spread to multiple users of the same device. We recommend you start inhaler education early for your child, so when they need medicine, they are ready to go! Inhalers are generally more sanitary, time-saving and easier to transport. Remember, be prepared BEFORE an attack occurs.

 

Proper Inhaler Use

Not only does an asthmatic need to know which inhaler to use when, but they must be able to effectively use it to get the medicine successfully into their lung space. There are various types of inhalers, most commonly meter dosed inhalers, aka puffers, and breath activated inhalers. It is recommended you arrange an appointment with your provider to learn how to use your inhalers properly. Here is a short video/link summarizing HOW TO USE YOUR INHALER(meter dosed inhaler demo) presented by the UCLA Children’s Hospital.

 

THE TEAM APPROACH: Recommended Asthma Well Care

Asthma is not a ‘one size fits all’ disease.  As it’s been stated, asthma varies from person to person, with a wide array of triggers. An asthma exacerbation can range from mild to severe and flare-ups can be intermittent or persistent. With these different asthma presentations, there is a requirement for individualized care. Your child’s asthma management should involve a TEAM. This team approach is the cornerstone of proper asthma well care. Diagnosis usually begins with the pediatrician and can continue with an asthma educator, a specialist, or both. The team should also include any parents, caregivers, babysitters, the school nurse, teachers, and coaches.

Within Allied, after the diagnosis of asthma is made, it is recommended that patients meet with an asthma educator to learn the ins-and-outs of the disease and how to best manage it. We cover topics including but not limited to:

  • Asthma Pathophysiology & Identifying Asthma Triggers
  • Formulating and adjusting Asthma Action Plans
  • Proper Inhaler and Nebulizer Techniques
  • Medication Adjustments & Refills
  • Assess Asthma Status and Control
  • Performing Breathing Tests
  • Assessing Seasonal Asthma Changes

 

Well-controlled asthmatics meet with their team every 3-6 months, with the goal of preventing exacerbation and need for more intense pharmacotherapy or hospitalization. At this time, it is HIGHLY RECOMMENDED each asthma patient has a BTS (back-to-school) Asthma Well Care Appointment– either in person or virtually. Poorly controlled asthmatics need more frequent assessments and have a greater risk of complications.

 

THE TEAM APPROACH: When to see a specialist?

For some asthmatics, there may be some great benefit to meeting with a specialist: allergist or pulmonologist. When asthma is poorly controlled, despite proper asthma well care with the pediatrician and/or the asthma educator, patients are referred for further workup and consultation with a specialist. Some patients are sent to see a specialist earlier than others. It is variable. Remember, asthma is unique for each individual and thus requires individualized care. If asthma symptoms cause patients to miss school or work often, interfere with activities or have a patient landed in the emergency room, it’s time to see a specialist.

 

BE PREPARED: VACCINATE!

We know the ongoing pandemic is scary, but we must not forget there are diseases, some which may be more serious for our children than COVID, which can be preventable with proper vaccination!  Remember to follow your child’s recommended routine vaccination schedule with your pediatrician and schedule an appointment to get the annual flu vaccine! Remember, vaccines are designed to protect and decrease your child’s chances of getting sick!

 

BE PREPARED: What to do now?

The Allied organization is here to help you and get your child’s asthma under control. We are focused on optimizing the care we provide for all our patients, especially those with asthma. We have a team of well-trained pediatricians who coordinate care with specialists and asthma educators, and we can bring you top-of-the-line care from the comfort of your own home with virtual visits!

  • SCHEDULE A VISIT: Telemedicine

To successfully accomplish all the above, it is recommended you schedule a visit!

  • Asthma Well Care/Routine Asthma Maintenance (q3-6 months)
    • Poor control or change in medications: visits recommended more frequently
  • *NEW*: Back-to-School Asthma Telemedicine Visit
    • Recommended end of August through September
    • Education/Inhaler Demo and Practice
    • Asthma Action Plan (required by school/copy must be given to school nurse)
    • Medications: Home, School, Sports bag, etc.
  • Asthma Questions/Concerns
  • Acute Asthma Care or Follow Up

 

  • CONSIDER A SPECIALIST: Further Workup
    • Allied Physicians Group: Strauss Asthma & Allergy: Dr. Strauss, Dr. Ahmad, and Dr. Kreiner

 

Click here to schedule a visit with an Allied Asthma Educator now!  Covered by most insurance plans!

Remember, take control of your asthma BEFORE the attack. Be prepared. Stay well and stay safe. We are here to help! Stay tuned for future webinars from your Allied ACE [Asthma Control Education] Team!