Emergency asthma, allergy management in schools inadequate

Alice Hoyt

Physician input may improve the care of asthma exacerbations and anaphylaxis in the school setting because emergency action plans are maintained by only approximately 41% of children with allergies and 21% of children with asthma, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology in Orlando.

“Emergency medical plans help bridge the clinic-to-classroom gap,” Alice Hoyt, MD, director of Code Ana and assistant professor at the division of allergy, pulmonary and critical care at Vanderbilt University Medical Center, told Infectious Diseases in Children. “When I, as a physician, see a patient with a chronic medical condition and the patient, family and I discuss and agree on a treatment plan as a team, that plan includes how to manage that chronic medical condition should it urgently worsen, such as in an asthma exacerbation or allergic reaction.”

“Because medical emergencies often occur when a child is away from his or her family, like when they are at school, it is imperative that the school also have access to that plan so the emergency can be identified promptly and managed effectively for the best possible outcome of the child,” she continued.

To examine how asthma and allergies are managed within the school setting, Hoyt and colleagues analyzed food allergy and asthma data provided by 34 schools in two school systems. Excel spreadsheets were used to complete this assessment for the first school system, whereas a refined and adapted analysis was conducted using Qualtrics software for the second system.

All information was provided by school nurses, who received information on asthma and allergy through paper- and electronic-based health information from parents.

Of the 34 schools invited to provide information for the study, 31 schools participated. Of the 15,191 students included in the analysis, 4.3% had reported food allergies, and 5.5% had reported asthma.

Approximately half of students with reported food allergies (50.1%) carried epinephrine autoinjectors, and 40.8% had action plans for anaphylactic events related to food or venom allergies. A similar number of children with asthma owned an inhaler (46.8%), but only 20.9% had action plans for an asthma-related emergency.

The ownership of epinephrine autoinjectors, inhalers or emergency action plans in the school setting were unrelated to socioeconomic demographics.

“Pediatricians play a critical role in managing chronic diseases in children, and part of that management includes completing medical emergency plans for schools,” Hoyt said. “We have found that growing collaborations with local schools can ease this process, and our program Code Ana provides a rode map for physicians, schools and families to work together to optimize the health of all children at the school.” – by Katherine Bortz

Reference:

Hoyt AE, et al. Abstract 679. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 2-5, 2017; Orlando.

Disclosure: Infectious Diseases in Children was unable to confirm relevant financial disclosures prior to publication.