effects of asthma 8.6% of children In the United States, children in high-burden areas such as urban and rural areas are disproportionately affected by barriers to care and environmental factors. Exacerbations of asthma miss more than 14 million days of school each year, affecting schoolwork and daily life. Health care costs for families can be enormous, and the long-term consequences are far-reaching, putting children’s lives at risk.
All 50 states now have laws allowing students to carry and self-administer their asthma medications in school. but, only 14% of children Personal inhalers are available while at school. This was attributed to a variety of factors, including undiagnosed asthma, asthma diagnosis but forgetting medication at home, and lack of parental cooperation in carrying medications for children with asthma. It will be considered. Therefore, it is imperative that schools stockpile and provide medication to children experiencing respiratory distress.
Despite continued support from national organizations such as the American Lung Association and the American Asthma and Allergy Foundation, only 17 states We have enacted laws and guidelines that allow schools to stockpile quick-acting medicines. Additionally, many school officials across the country are reluctant to administer drugs to children. This problem falls into her two main components: (1) the difficulty of understanding the feasibility of establishing a school stock albuterol program and (2) the lack of adequate training for school personnel.
Feasibility of Stock Albuterol in Schools
Ensuring the availability of albuterol sulfate in schools is critical to address emergencies and aligns directly with evidence-based asthma treatment. To address concerns about the feasibility of providing asthma medications in schools, we can look to states and schools with established programs to learn from their implementation strategies and leaders.
Arizona was one of the first states to successfully establish a school stock albuterol program. A pilot program was implemented in Pima County in 2012. Two years after the introduction, the number of her asthma-related 9-1-1 calls and her EMS transports decreased. 20% and 40% respectively. The study authors noted that this was not unexpected given the small sample size and rare occurrence of the event, although not statistically significant.
Most recently, in 2017-2018, 229 schools in Pima County launched a Countywide Equity Inhalation Program.there were 1,038 recorded cases where albuterol was administered. In 84% of these cases, students were able to return to class without being sent home or EMS to the emergency room. Both nurses and school staff reported that the intensive training gave them confidence in managing their respiratory status. As of 2023, the program has expanded to eight more county schools.
Expansion of education and training
Some licensed nurses and school staff remain hesitant to administer albuterol to students who are having trouble breathing from undiagnosed asthma. This is due to concerns among some staff about distinguishing between asthma and anaphylaxis (both of which can cause difficulty breathing). Although the symptoms overlap, anaphylaxis and asthma are distinct and distinct conditions that require different treatments.
a study Kevin Murphy, MD, and colleagues discuss the implementation of a program in schools in Omaha, Nebraska, to distinguish emergency responses for asthma and anaphylaxis. A specific emergency protocol was established, and school personnel were trained and tested on epipen and albuterol administration procedures according to the student’s symptoms.
Over the 5 years, 99 students were treated. Of these, 5 students (5%) were treated with epinephrine alone and 89 students (90%) were treated with albuterol alone. The high number of cases of suspected asthma attacks compared to suspected allergic reactions highlights the need to integrate albuterol training into school health policies.
Most recently, Maricopa County, Arizona’s largest county, introduced both stock albuterol and stock epinephrine. program To meet the separate treatment needs for asthma and anaphylaxis.
When considering state-specific legislation, it is important to insist that unlicensed personnel, such as school personnel, be trained to administer stock albuterol inhalers.School nurses play an important role, but some US schools are underfunded hire Full-time certified nurse. Thus, in the absence of school nurses, untrained and unqualified personnel can save lives by administering albuterol to children with asthma attacks.
Albuterol has a broad therapeutic index and a high safety profile. Therefore, complications are rare and trained school personnel can confidently administer medications to children with suspected but unconfirmed asthma without fear of harm. must. States with albuterol stock laws also protect individuals trained to faithfully administer albuterol in line with best practices for asthma management.
Our goal
A major barrier to the implementation of stock inhaler programs is sustainable funding. We definitely need more advocacy at the national, state and school board level to seek financial support. In Illinois, statewide funding has been made available to implement pilot programs as a result of advocacy by physicians, licensed school nurses, and the state board of education. Additionally, a coalition of Arizona’s academic, state, and community-based programs have united to support the introduction of albuterol in schools. Establishing a strong board of academics, health authorities and data infrastructure is key to progress in terms of both program implementation and funding.
As more states take steps toward stock albuterol laws, protocols need to be standardized to ensure consistency with drug administration. In addition, continuing education should be extended to local paramedics and paramedic teams to facilitate rapid communication in emergencies.
Children spend most of their time at school, but it is of utmost importance to protect their health during school hours. For children with diagnosed or suspected asthma, developing a comprehensive, school-based approach to utilizing albuterol could save lives.
Pranati Movva is a medical student at the University of Michigan College of Osteopathic Medicine.
