Katie Swanson

Asthma is one of the most common chronic conditions of childhood. It affects about 6 million children and adolescents in the U.S. This condition causes the lungs and airways to become inflamed when exposed to certain triggers, such as environmental allergens, exercise, weather changes or catching a respiratory infection.

Childhood asthma can cause bothersome daily symptoms that interfere with play, sports, school and sleep. It is a primary reason why students miss days of school, and it can be dangerous if unmanaged.

If your child has asthma, the back to school season is a great time to develop an asthma action plan. You can’t be with your child all the time, so outlining a plan ensures that key adults in your child’s life understand the condition and what to do in an emergency. Preventing asthma symptoms is better than treating them after they begin, and symptoms are much easier to manage if you begin treatment early. With good asthma management, your child should be able to live a normal, active life.

Return to school brings changes

Many children experience more asthma episodes after returning to school in the fall. A few reasons that autumn can be difficult for kids with asthma include:

 Hard to avoid asthma triggers

Children can more easily avoid asthma triggers while at home during the summer. These are environmental, allergy or exercise situations that start an asthma episode. When they go back to school in the fall, children can’t control their environment as easily, and they could be exposed to more asthma triggers.

 More viral illnesses

More viral illnesses go around when children are around other people. especially in school. Viral illness can trigger exacerbations, and these illnesses are more common during the school year and in the winter.

 Seasonal allergies

Autumn brings seasonal allergies, specifically to mold and ragweed pollen. Allergies can trigger more asthma episodes for children.

 New activities and adults

Children may start new sports or have a new coach who does not know how to help a child avoid asthma triggers.

Asthma action plan

The Asthma and Allergy Foundation of America created the asthma action plan template to provide information and instruction on how to properly manage and respond to the condition. People with asthma should complete the plan with help from family members and their health care team.

For school children, an asthma action plan should include:

• Emergency contact name and telephone number.

• Health care provider name and telephone number.

• Peak flow values.

• Medication names, dosing and frequency.

• Steps to take during an asthma episode.

• Outline of when to seek emergency medical care.

An asthma action plan uses a traffic light format to categorize asthma symptoms.

• Green

When in this section, your child is not coughing or wheezing and able to sleep through the night and play without shortness of breath. You should continue to use preventive medications.

• Yellow

Your child enters this section if showing signs of a cold, experiencing some symptoms or was exposed to a known trigger. This section outlines additional medications, such as rescue inhalers, and when to call the child’s health care provider.

• Red

Your child is in this section when asthma symptoms are getting worse fast and immediate emergency medical care is required.

A thorough plan ensures that all adults in your child’s life, from the school nurse and bus driver to coach and grandparent, understand their unique experience with asthma and are on the same page with managing and responding to asthma episodes.

Each person’s experience with asthma is unique. Make sure that your child has his or her own

asthma action plan, rather than following someone else’s or only telling the school nurse that your child has an inhaler. Take steps to complete and distribute the plan so your child can minimize episodes and have the best learning experience possible this school year.

Katie Swanson, Family Medicine nurse practitioner, Mayo Clinic Health System in Waseca, Minnesota.

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