This article first appeared in the St. Louis Beacon, Oct. 15, 2012 - A student visiting the Meramec Valley School District in Pacific last year for a song-and-dance performance fell ill from an asthma attack. She had neglected to bring along her medication to cope with any unexpected breathing incident. But Barbara Heger, the district’s health coordinator and a school nurse, was able to contact the student’s parents and provide treatment.
Heger uses that example to call attention to the value of Missouri House Bill 1188, introduced by state Rep. Sue Allen, R-Town and Country. Approved last spring, the legislation addresses the gray areas under which a school nurse might be hesitant to administer asthma-related medications. Heger was able to intervene and help mainly because she had established that the visiting student was suffering an asthma attack.
Had Heger not known about the student’s medical condition and couldn’t reach her parents, intervention might have been problematic. But the new law says a school nurse or an employee trained and supervised by the nurse must have the discretion to administer medicine to any student whom the nurse or employee believes is having a life-threatening asthma attack.
“This law is important because asthma is the largest diagnosis in my school,” she says. “When parents send students to us, they expect us to take care of them.”
The law also authorizes a licensed nurse employee to maintain a supply of medication for asthma and recommend to the school board the quantity of medication that should be maintained. Heger says this approach means that kids might not have to be taken to an emergency room for treatment for asthma attacks.
Among those who pushed for the legislation was the St. Louis unit of the Asthma and Allergy Foundation of America.
“The law states that any child, whether diagnosed or not, can have albuterol nebulizer treatment,” says Joy Krieger, executive director of the local AAFA chapter.
Albuterol is a common medication for treating wheezing, breathing difficulty and chest tightness from asthma or other lung diseases. The nebulizer transforms liquid medicine into a mist, which is then inhaled directly into the lungs.
The law is a huge benefit to the state’s childhood asthma problem, Krieger says, noting that 1 in 15 children has asthma nationwide, compared to 1 in 5 in parts of St. Louis, especially in poor communities.
“The issue can be life-threatening if a child is in need of treatment while in school. Asthma is the No. 1 (health) problem for school-age kids, and it’s the No. 1 reason kids go to the emergency room.”
While praising the law, Krieger says more education is needed to help parents and the public understand that asthma need not be regarded as a health crisis but as a condition that can be treated and managed.
“Our state doesn’t have a protocol program set up to help parents manage” the asthma, Krieger says.
Dr. William Kincaid, head of the St. Louis Regional Asthma Consortium, is also a proponent for more education, among other approaches, to controlling asthma. He has pointed out that asthmatics receive poor outpatient medical care. Only 10 percent of those going to an ER for asthma follow up with a visit to a doctor in the next three months, he says.
He adds that asthma is frequently under-treated because patients may not fill prescriptions for controller inhalers because of the cost. In addition, Kincaid would like to see more “asthma friendly” pharmacists, meaning they have special training to assist customers with questions about asthma medications and treatment.
The AAFA’s Krieger says her group intends to do more work with Medicaid providers about managing asthma. In addition, she says her group and a local pharmacy are working to provide schools with medications and educational material about the disease.
Special grant for Normandy district
The Environmental Protection Agency has announced a $30,000 education grant to the St. Louis County Health Department for an asthma-care program in the Normandy School District. Nearly 20 percent of the district’s students suffer from asthma, according to school nurses.
County health officials say the money will provide information for sufferers, caregivers and health professionals, including school nurses. The goal is to help people manage indoor pollutants that can trigger asthma, county health officials say. The EPA notes that the pollutants can cause a range of health problems, including sore eyes and headaches, as well as respiratory illnesses, such as asthma, and cancer as well.
