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Bronchodilator pilot program aids lung health

Nashua schools benefit from legislation aimed to aid asthmatics

NASHUA – According to Breathe New Hampshire, a nonprofit organization with a primary focus on lung health, one in nine residents in New Hampshire have asthma.

In recent years, the state has worked to make accommodations for those suffering from the condition, especially students.

In May 2016, the New Hampshire Legislature passed Senate Bill 322, regarding the use of inhalers, spacers and nebulizers in school. Senate Bill 322 allows school nurses to maintain a bronchodilator for an emergency. The use of this is limited to students with a diagnosis of asthma, who have a current Asthma Action Plan and whose own inhaler is not available.

In fall 2017, the New Hampshire Asthma Control Program, in collaboration with the New Hampshire School Nurses Association, supported pilot implementation of the emergency inhaler legislation in 28 schools in 10 school districts (pilot schools) across New Hampshire over the 2017-2018 school year, according to the New Hampshire Emergency Bronchodilator School Pilot Project Evaluation Summary.

That summary was authored by New Hampshire School Nurses’ Association Liaison Martha Judson; School Nursing Coordinator in the Office of Student Wellness at the New Hampshire Department of Education Nancy Wells and consultant Karen Horsch.

An additional 10 schools participated as non-pilot schools.

School nurses at the 28 pilot schools received a one-hour training, along with educational materials. The evaluation summary noted that all pilot schools and non-pilot schools received an emergency inhaler and four spacers.

They found that during the 2017-2018 school year, 60 students in the pilot schools needed the

emergency inhaler, most often because students forgot their device at home.

“Over three quarters of these students were sent back to class after use of the inhaler, meaning they did not need to miss instruction time due to asthma, their parents largely did not need to miss work to attend to them and emergency medical care was avoided,” the evaluation summary noted.

The evaluation summary recommended that schools in New Hampshire have emergency inhalers, continue sharing training materials and continue emphasizing the importance of having written Asthma Action Plans.

The final report was completed in June 2018.

Judson said the study would not have been possible without the New Hampshire Asthma Control program, along with the New Hampshire Nursing School Association, who provided funding.

Multiple schools in Nashua, that could not be named for privacy reasons, participated as pilot schools. Jeanamarie Lopez-Carrasco, Nashua’s district-wide head school nurse said Judson came in and spoke about the project with the nurses in the school district as a group. They found out which schools had the most needs. Judson gave inhalers and educational posters for the pilot schools last year. Lopez-Carrasco said Judson has been checking in with the nurses throughout the year.

“It’s been a success,” Lopez-Carrasco said.

Lopez-Carrasco said Judson also presented an AAP, which is a similar representation to a stoplight. Green means the student is good to go, and has no trouble breathing. For yellow, which is consider as caution, a student might feel like their chest is tight or they have a mild wheeze. For red, which signifies danger, a student’s asthma is getting worse, they are having trouble speaking and their breathing is hard and fast.

Lopez-Carrasco said having an extra inhaler can really help students, especially students whose families don’t have access to healthcare.

“When a kid comes in with an asthma attack, we are able to help them out and hook them up to different agencies,” Lopez-Carrasco said.

In Nashua’s Elementary Student Handbook, it states that a student may carry an inhaler provided the licensed prescriber has given written permission.

“A. After the use of the inhaler the student will report to the nurse. B. A back-up inhaler to be kept with the nurse is recommended,” it states. So, while the school district does not require the school nurse to have a backup inhaler, it is recommended.

“I always explain that, to students and parents, that if they chose not to keep up a backup that that one time they’ll be in trouble,” Lopez-Carrasco said. “That’s why we like to have a backup in our office, just in case that happens one day, especially for the kids who play sports after school.”

Grace Pecci can be reached at 594-1243 or gpecci@nashuatelegraph.com.