MANAGING ASTHMA AT HOME AND SCHOOL

Managing Asthma At Home And School

How can I prevent asthma at home?

The most important thing you can do is to control asthma triggers. The main asthma triggers that are in your home are dust mites, molds, pollens, pets, cockroaches, and household irritants. Secondhand tobacco smoke may also be a trigger in your home, especially for a child with asthma.

How can I protect myself against dust mites?

Encase pillows, mattresses, and box springs with allergen-proof, zippered covers.
Wash all bedding in hot water about once a week.
Non-carpeted flooring is best. If you cannot get rid of your carpeting, vacuum often with a multi-layer, allergen-proof vacuum bag. Wear a mask while vacuuming. If your child has asthma, do not vacuum while he or she is in the room. Products that eliminate dust mites from carpeting (such as Acarosan) can be purchased. Your asthma care provider can give you information about these products.
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Regularly change filters on heaters and air conditioners.
Replace heavy, lined curtains or drapes with washable window coverings. Wash window coverings in hot water. Use plain window shades instead of mini-blinds.
Dust all surfaces often, including lampshades and windowsills, with a damp cloth.
Keep clutter under control. Toys and books should be stored in enclosed bookshelves, drawers, or closets.
Replace traditional stuffed animals with washable stuffed animals.
Keep all clothing in drawers and closets. Keep drawers and closets closed.
Cover air ducts with filters or cheesecloth. Change these when soiled.
Pillows and bedding should not contain feathers.
Keep indoor humidity low (25-50 %). Use a dehumidifier.

How do I stop mold and mildew from growing in my home?

Air out damp, humid areas frequently. Run a dehumidifier to keep humidity between 25% and 50%.
Use air conditioners when possible.
Clean bathrooms regularly using products that kill and prevent mold. Use exhaust fans to vent steam. Do not carpet the bathroom.
Keep indoor plants out of bedrooms.
When painting, add mold inhibitor to paint to prevent mold from growing.
Avoid sources of outdoor molds, such as wet leaves or garden debris.

How do I control my home against insects?

Many homes and apartments have cockroaches and other insects. Some people with asthma are allergic to these. To control these allergens in your home:

Use roach baits or traps.
Insect sprays can be used but should only be sprayed when no one is at home.
Before you or your child returns home after spraying, make sure that your home has been aired out for a couple of hours.

How can I decrease my exposure to pollens?

Pollens are difficult to avoid, as they cannot be eliminated from the atmosphere. You can lessen your or your child's exposure to these by following these guidelines:

Pollen counts are highest early in the morning, especially on warm, dry days. Limit your or your child's outdoor activities during these times.
Keep windows closed during pollen seasons.
Use air conditioning if possible.

How do I protect myself against pets?

It is best not to own any pets if you or your child is highly allergic. Definitely avoid pets that have been shown to cause allergies.
Long visits to friends and family who own pets should be avoided. If you do visit, make sure you or your child takes asthma medicines before the visit. Exposure to the pets should be kept to a minimum when visiting.
If you must have a cat or dog in the home, restrict its living area. It should not be allowed in your or your child's bedroom at any time. If possible, keep the pet outside.
Wash the animal weekly.
Remove as much carpeting as possible. Animal dander deposits in the carpeting and stays there, even after the pet is gone from the home.

How do I avoid irritants in the air?

Avoid using aerosol sprays, paint, and cleaning agents with heavy odors when you are in the home. Make sure your home has proper ventilation. Wear a mask or handkerchief over your mouth when cleaning, dusting, vacuuming, sweeping, or working in the yard.
Do not use perfumes, scented lotions, or other highly scented products that may irritate your lungs.
Avoid wood smoke.
If you live in an area where air pollution is a problem, limit outdoor activities when the pollution counts are high.
Use an exhaust fan when cooking to remove smoke and odors.

How can I protect my child from secondhand tobacco smoke?

If you are the parent of a child with asthma, there are a number of steps you can take to protect your child from secondhand tobacco smoke:

If you smoke, quit -- if not for yourself, for your child. If your spouse or other family members smoke, help them understand the dangers of smoking and encourage them to quit.
Do not allow anyone to smoke in your home, car, or while having extended contact with your child.
Choose smoke-free places to go with your family. Avoid restaurants and public areas that allow smoking.

Managing Asthma at School

Children with asthma often have symptoms at school, and it is very important to get the school involved in caring for your child's asthma. This is true even if your child has only a mild case of asthma and even for children who do not need to take medicines when they are at school. Most schools have several students with asthma; so many teachers -- and certainly the school nurses -- are very familiar with helping children with asthma. Still, it is important to take steps to ensure that your child gets adequate attention and that all the relevant people at school are familiar with what is needed to help your child. You can look at this in two ways: There are things you need to do to prevent your child from getting asthma at school, and there are things you need to do to make sure that your child gets the right treatment for an asthma attack at school.

What should I do to prevent my child from getting asthma at school?

The most important thing is to talk to your child and, depending on how old he is, explain to him as much about the disease as he will understand. Ideally, your child should also keep track of when it's time to take his medicine, how to use the inhaler properly, how to use a peak flow meter, what the number on the peak flow means, and what to do if that number is too low. School officials should know about your child's asthma -- how severe it is, what the triggers are, what medications to use and how to properly give them, how to use the peak flow meter, and what to do in case of an asthma attack are all important issues to address. All of these things should be written up, and a list should be distributed to every school official who may be caring for your child. If possible, you should try to arrange a meeting with the school officials and explain the triggers, severity, symptoms, and treatment of your child's asthma. You should look at your child's classroom and other areas where he or she goes in school to see if there are any triggers. If you identify possible triggers for your child's asthma (dust mites and dust are common triggers in a classroom), you should work with the teacher to reduce your child's exposure to these triggers. It is very important to provide all the medicines that your child needs to the school nurse along with the proper instructions. Remember that for some medicines, like inhalers, there is often no way to tell whether the inhaler still has medicine or not. You need to keep track of this and replace the medicines at school on a regular basis. Finally, it is important to check every few months or so that the school is taking care of your child's asthma and that everybody is still on the same page.

It sounds like a lot of people at school -- not just the class teacher and the school nurse -- need to be involved. Is this necessary? Can you give me a more specific idea of who needs to be involved?

The more teachers and other adults at school who know about your child's asthma, the better. Your child could have asthma while in art or music class or when in the hallway -- these are places where the class teacher may not be present. Here is a list of people at school who must be involved:

Class teacher: This is the adult who is most likely to be around if your child has asthma at school. The more the class teacher knows and the more vigilant he/she is, the better the chances that your child will be properly helped. Sometimes, kids who have difficulty breathing do not perform as well in school even though they do not have asthma attacks. The class teacher should look out for this.
School nurse: You must talk to the school nurse and get an idea of what the school policies are. If your school shares a school nurse with other schools, make an appointment to see the nurse when she is in the school, and find out who will be in charge when the nurse is not around.
Art teacher, music teacher, or any other teacher who regularly spends time with your child.
Physical education teacher: The PE teacher has a special responsibility. In addition to spending time with your child like other teachers, the PE teacher should keep an extra eye on your kid when he/she is exercising, since exercise can trigger asthma. Also, you should make sure that your child is not being left out because he or she has asthma, and the PE teacher should encourage your child to participate as long as the asthma is under control.
Office staff, principal
Counselor: This is an important person to talk to, especially if your child has other problems, such as learning problems or problems dealing with other kids.
Substitute teachers: You should try to talk to substitute teachers yourself. The regular teachers should also know that substitute teachers need to be informed about your child's condition. This is where a written set of instructions from you can be particularly valuable.

What emergency instructions should I give the school?

You should give the school officials a peak flow meter, if possible. They should have a clear set of instructions (your doctor can help with this) about what is a low peak flow reading, what symptoms they should look out for, and what treatment they should give. The school should have a clear idea of when to call your doctor and when to call 911. You should make sure that the instruction sheet you hand out to all school officials has your doctor's phone number, your preferred hospital (emergency room), as well as contact numbers for you, other guardians for the child, and a trusted friend.