DECATUR – Cami White was diagnosed with asthma before she began kindergarten.
Now in third grade at Mount Zion Grade School, she carries her own inhaler, but must go to the school office to use it, said her mother, Denise White.
A new law went into effect in Illinois on Jan. 1 requiring schools to request an asthma action plan from parents of every student with asthma and to develop an emergency plan accordingly. Personnel who work directly with students are also required to take training every two years.
“It is my understanding that, due to insurance liabilities, any school-age child must be monitored with the administering of medication, prescription or otherwise,” White said. “When I was a student at MacArthur High School, the asthmatic students had to report to the nurse's office to use their inhaler. The steroids in inhaled albuterol can have serious side effects on anyone, but especially children.
"It is not unheard of to OD on inhaled steroids and cause your body to go into shock, heart failure, etc. The school has to be very careful with monitoring the use of these very necessary medications.”
Cami was last hospitalized in November and has been taking a preventive medication that has minimized her asthma episodes, White said, and has never had a life-threatening episode. Though White said some of her daughter's attacks have been frightening, the maintenance medication has made a big difference.
Mount Zion schools have an asthma response and asthma emergency plan, said Superintendent Travis Roundcount, both available on the district website. Both are recently updated, but have been in place for some time.
Episodes are categorized by green (can work and play normally); yellow (coughing or wheezing and chest is tight); and red (breathing is difficult, normal activity is slowed).
The emergency plan calls for school personnel to let the child use their inhaler and assist if necessary; call 911, the school nurse and the parent or guardian; and stay with the student until help arrives.
Decatur public schools allow students to carry and use their inhalers and EpiPens if parents sign off, said Angie Wetzel, health services coordinator.
“We have a form, and basically, we get the medication order from the child's physician, and if the child is old enough and responsible enough, they can carry it with them if the parent feels comfortable,” she said.
“With any emergency medication, they can carry it as long as they're responsible. It's not kept in the nurse's office or main office. We would prefer they carry it and know how to use it."
Wetzel has ordered training equipment with inhalers that she will use for training sessions with school personnel, but it's on back order due to high demand. Staff has written instructions on emergency protocol, and anyone can ask for further instruction.
Thomas Jefferson Middle School has a larger population of medically fragile students because that building is where special education students of that age are assigned, and school nurse Stacey Johansen said several of them have asthma. She is accustomed to helping them.
“The lucky thing at my school, I'm here all day,” Johansen said. “The majority of schools don't have a nurse full time. If (a student) has an issue in the classroom, I'm able to go and assess.
"With the asthma, we've created an attack list. It's for the lay person with no medical knowledge, (for example) if they came in and only the secretary was there, what the symptoms are and what was done for that student.”
Some of the students with special needs aren't able to verbalize what they're feeling, and staff at Thomas Jefferson and other schools are taught what to look and listen for to know when an attack is escalating, she said.
Some of the students can't use a typical inhaler, and for them, a device called a spacer allows someone to help them use it or make it easier for them to use it themselves. Johansen will sometimes call a parent to suggest they get one of those for a child who's having difficulty.
She also teaches students how to use their inhaler if they're doing it incorrectly.