Asthma Action Plan

Asthma Action Plan?

How was the Asthma Care Plan Developed?

How is the Asthma Action Plan used?

Which Students Need the Plan?

What Medications and Procedures does it have on it?

Can a Student Carry his/her Meds and use them when Needed?

Metered Dose Inhalers (MDI)

How to Clean Equipment

Asthma Management Plan in your School

Share your Asthma Action Plan 

Stay in touch

 

  What is an Asthma Action Plan?

An Asthma Action Plan is an individualized management plan for any person with asthma. The plan will provide information on the severity of one’s asthma, triggers that cause flare-ups, asthma symptoms as they the episode worsens, daily medications and dosages, what to do, and who to call, in the case of an emergency.. Click here to see and print an Asthma Action Plan of your own!

 

  How was the Asthma Care Plan developed?

  • It, along with the Asthma Information Form, were developed in collaboration with the Colorado Department of Education Regional Nurse Specialists, Colorado Asthma Coalition, National Jewish Health, The Children’s Hospital and numerous health care providers from around the state. 
  • Both documents align with the Colorado Clinical Guidelines Collaborative and reflect current evidence-based asthma management practices.
  • Any suggestions for changes to the form can be submitted to a Regional Nurse Specialist for consideration for the next revisions.  The current form should be used without changes.

 

  How is the form used?

  • Information from the Asthma Information Form is used by the School Nurse to decide if a plan is needed.  The parent or the provider can also request that a plan is developed. 
  • It is a legal document with the health care provider, parent, and school nurse signatures.
  • School district policy can allow it to be the medication permission form.
  • Click HERE for more information and to print a sheet on how to use your Asthma Action Plan.

 

  Which students need the Colorado School Health Asthma Care Plan?

  • The parent/guardian of the student completes the Asthma Information Form.  The school nurse will review the information, decide if more information is needed, and determine if the care plan is indicated.
  • The best predictor to know if the student with asthma is going to have difficulty is to look at how their asthma has been over the last 12 months.  The following risk factors indicate the potential for trouble: 
    • Previous exacerbations
    • Use of oral steroids
    • Urgent care visits or hospitalization History of intubation.
  • The lack of asthma control can be determined by using the “Rule of 2’s’” ™
    • Has the student experienced daytime asthma symptoms more than 2 days/week?
    • Has the student experienced night time wakening asthma symptoms more than 2 nights/month?
    • Has the student needed quick relief medication more than 2 days/week?  (Pretreatment with quick relief medication does not count.)
    • Has the student not been able to participate in normal activities without interruption from asthma symptoms?
    • “ Yes” to one or more of above questions suggests asthma is not controlled as well as it could be. Notify the school nurse for further assessment and planning.

 

  What medications and procedures are on the plan?

  • Only asthma medication typically needed at school is a quick reliever bronchodilator (i.e. albuterol) Click HERE to learn more about using an inhaler for your asthma.
  • It is normally given via an inhaler with or without a spacer.  Research has shown that it is the preferred delivery method as compared to the nebulizer.
  • An provider may request that a peak flow reading be done, which is written in the “if you see this” section.

 

 Can a student carry the medication and use it when needed?

It depends on the state where you live. In Colorado, the state law allows kids to carry their own medications. However, certain districts within Colorado have stricter polices about self-carry. Make sure you check with your school nurse to find out the policies that are specific to your county and district. It’s always a good idea to inform the school nurse and administration about medicines that your child may be taking while at school. Creating a care plan that works for your child and ensures that the school has enough information in case of an emergency is another good way to help your child feel safe and empowered while managing his/her asthma. In Colorado kids are allowed to carry their own medications. Click HERE to learn more Senate Bill 12.

 

 Click HERE to learn more about using a Peak Flow Meter (PFM) 

  • Device:  the medication can be given through various devices.  The health care provider selects the type for the student depending on age and ability to coordinate.  If the student is able, the valved-holding chamber (VHC) with mouthpiece is used.  If not, a snug fitting mask that covers the mouth and nose is used.
  • Body position:   standing or sitting upright.  For a baby or small child, sit up straight in adult’s lap with one of adult’s arms wrapped around child’s arms if necessary.
  • Inhalation:  prolonged with greater time than exhalation if able.  The inhalation needs to be more forceful with dry powder devices  and with breath actuated devices.
  • Hold breath:  10 seconds at end of inhalation.  With the nebulizer, hold breath every few breaths, if able. If possible, keep babies and children calm - breathing pattern with crying decreases medication delivered.
  • Priming: Refer to attached “Priming Medications” table for specific manufacturer’s recommendations.

 

 What do I need to know about the metered dose inhalers?

  • It is recommended that the Metered Dose Inhalers (MDI) are used with a Valved Holding Chamber (VHC)  (a spacer with a valve).
  • If the VHC is new or has not been used in more than a week, waste priming puffs from the MDI into the chamber to decrease static charge.  Or you can dip the VHC in soapy water, rinse off the outside, and let air dry.  Do not rinse inside the chamber  as soap film decreases static charge in spacer
  • Inhaling the medication:
    • Remove mouthpiece and shake inhaler gently
    • Exhale fully prior to use
    • Inhale slowly - you will hear a “honk” sound from the spacer if inhaled too quickly
    • Hold breath for 10 seconds
    • For children less than 5 years or unable to perform mouthpiece maneuver, always use a mask with VHC.  Have the child take 5 breaths in.
  • Keep track of doses with hash marks or with counter that is attached if available
  • The MDI is just as effective as a nebulizer when used correctly.
  • Note:   The provider may indicate up to 8 doses of the MDI on this care plan.   Eight doses of Abuterol is equivalent to 720 mcgs and one nebulizer dose is 2500 mcgs.
  • If VHC is not available, HFA inhaler may be put directly in mouth using the same technique.
  • Click HERE to watch a video tutorial.                 

                                  

 How do I clean the equipment?

  • Metered Dose Inhaler:   Wash the small outlet hole inside of mouthpiece/boot with damp Q-tip once a week or as needed to avoid clogging.  Do not immerse in water.
  • Valved Holding Chamber (or spacer): 
    • Remove the end cap from the  VHC.  Wash all parts in warm water with mild liquid soap.  Rinse all parts with water, except chamber.  Allow parts to air dry.  Reassemble all parts. 
    • For Optichamber, make sure that one- way valve is seated correctly on the small clear posts on the end of the chamber.  Place mouthpiece over valve assembly and then turn clockwise until it snaps in place.  For Optichamber longevity, replace the one-way valve when it becomes dried out and starts to curl.       
    • Click HERE to learn more about using a spacer with your inhaler.

 

 Asthma Management Plan in Your School

Schools can play an important role in helping your child manage their asthma by providing support through an asthma action plan. Mesa County School District # 51, for example, has an asthma management plan which includes school policies on the use of inhalers and medications, actions or emergency procedures staff should take when a student has an asthma attack, and student asthma action plans. The student asthma action plan serves as an individual management plan for each student with asthma. It provides pertinent information to school officials on each student’s asthma condition. The asthma action plan should contain the student’s medical information, identified asthma triggers, actions to take, emergency procedures, and phone numbers. This action plan should be signed by the child’s physician.  Afterwards, the physician, parent or care-giver, and the school each keep a copy of the student’s action plan.

 Click here to download a booklet on how to better take control of your asthma.

 

 Share Your Asthma Action Plan

  • Share your asthma action plan with all the adults who regularly interact with your child at school.  These individuals might include:
  • Teachers, including music, art and physical education teachers
  • After-school caregivers
  • Bus drivers

These individuals need to know about your child’s asthma and how best to help keep your child’s symptoms under control. 

 

 Stay in touch

  • Has your action plan changed?  Keep your physician, school nurse/health assistant and teachers informed of:
  • Changes in your child’s asthma symptoms or overall condition
  • Medication changes
  • Revisions to your child’s asthma action plan, including your contact information
  • Recent asthma flare-ups or attacks
  • Specific times when asthma triggers may be a greater risk for your child, such as changes in seasons or during times of increased anxiety/stress or physical activity

Be proactive in managing your child’s asthma at school. A team approach is key to keeping his or her asthma under control.

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