Breathe easier

Friday, Sept. 7, started out as a typical day for Beatrice High School student Hannah Duncan.

But then things changed for the worse.

“I was in band playing my instrument and I had trouble breathing, it kept getting worse,” she said.

It was an asthma attack.

“Hannah was having a severe asthma attack,” BHS Nurse Heather Cullison said. “She actually almost didn't make it to my door. She passed out in the hallway and a para helped her in.”

Cullison said as a result of the constriction in Duncan's lungs caused by the asthma attack, the amount of air that was getting into her body was only enough for her to go on for another 30 seconds.

“She just wasn't getting enough air, because of her asthma her lungs were constricted,” she said.

Cullison said she laid Duncan down right away and got out the asthma emergency kit, a kit all schools are required to have as a result of a state law that went into effect in 2004.

She pulled the EpiPen out of the kit and asked Duncan if she was ready.

“I shoved it into her leg,” Cullison said.

After that, she said she was calling 911 and getting the nebulizer machine, used to deliver medication to deep parts of the respiratory tract, ready at the same time.

“I couldn't take the time to call anybody else to help,” she said.

It was a rare emergency situation, but one that could be handled immediately because Duncan's parents took the time to fill out and return an asthma action plan.

“It's amazing, she was one of my first students to get her asthma plan back,” Cullison said.

She said of the 70-75 students at the high school who have asthma, only 23 have returned their asthma action plan.

“It's scary that parents of students who have this lung disease don't take this seriously,” Cullison said of the importance of having the plan at school. “You have to have oxygen in your lungs to be able to breathe, to be able to live.”

Duncan also attests to the importance returning the plan.

“Having this plan is a really, really good thing,” she said.

Cullison said she would not have been able to administer the EpiPen to Duncan without the action plan from her parents. An EpiPen is an injection kit containing epinephrine, a hormone produced by the body that can help turn lung constriction around.

If not for the action plan, which spells out what to do if Duncan has an asthma attack, Cullison said she would have been giving resuscitation breaths instead, which would have taken a lot longer to reduce the restriction in Duncan's lungs.

She said, as far as she knows, this is the first time anybody in Beatrice schools has had a major asthma attack like that.

But this incident just illustrates the importance of filling out and returning the asthma attack plan to the school, Cullison said.

“Parents do need to fill it out because anything can trigger it (an asthma attack) and cause a problem,” she said, adding that a student can go from no problems for a couple years to a major problem in no time.

The asthma attack plans are part of Rule 59, passed by the state Legislature, that went into effect in 2004. Cullison said the law was created as a result of two asthma attack-related deaths at Omaha Public Schools in 2002.

In addition to the plans to be filled out by parents, the law also requires schools to have an asthma attack kit with supplies that can be used to treat an attack, she said.

Cullison said she also has to certify staff members who make up the school's asthma response team, so they know what to look for, what to do in case of an attack and who can help if Cullison is not on site.

What is asthma?

n Asthma is a lung disease caused by increased reaction of airways to stimuli, and can be life threatening. It is a chronic disease, with symptoms that may come and go and is often related to allergies. Symptoms occur when the airways become inflamed, mucous production obstructs the airways and muscles around the airways become constricted. The most dangerous symptoms may include marked chest tightness, wheezing, persistent coughing, shortness of breath, difficulty speaking, changes in mental status, chest retractions and cyanosis (blue color).

n Asthma is the most common chronic childhood disease.

n Nearly one in 13 school-aged children has asthma.

n Asthma is one of the leading causes of school absenteeism and hospitalizations for children.

n Asthma affects academic performance. Missed sleep due to nighttime asthma can cause poor memory recall, lack of concentration and mood swings.

n Asthma cannot be cured, but it can be controlled.

n Triggers that can worsen a person's asthma, potentially leading to an asthma episode, include tobacco smoke; mold and mildew; pollutants resulting from poor ventilation; pets with fur or feathers; cockroach or mouse droppings; strong odors such as perfumes, air fresheners, cleaning chemicals, hair spray, aerosol sprays, candles, clay, paints, solvents, chemicals and fumes from soldering or welding; cold and damp weather; exercise; extreme emotional expression; prolonged sneezing; hypertension; yelling or laughing; common cold, influenza, or other respiratory illnesses; and certain foods such as peanuts, milk, soy, shellfish, and eggs.

Source: www.attackonasthma.org