COD E R E D

Childhood ConditionsSchool-based Programmatic Recommendations■ Institute infection control and avoid overcrowding atdaycare settings and schools to reduce respiratoryinfections.■ Establish management and support systems for asthmafriendlyschools by: identifying school asthma needs;designating a person as asthma activities coordinator;identify all students with asthma using attendance records;developing system for communication among students,teachers, parents, nurses, and health care providers;evaluate programs and policies annually, and seek nationaland local funds to support asthma programs.Evidence-based RecommendationsPupil/student health education■ All students should be offered with asthma awarenessprograms to be peer-supportive and lung health educationincorporated into health education curricula.■ Provide and support smoking prevention and cessationprograms.■ Educate students with asthma in asthma basics, toimprove their self-management and emergency responseskills and adhere to a written asthma management plan.School personnel education■ School staff should be informed about asthma, symptomsand triggers recognition, and its implication on health,safety, academic performance.■ Staff should be aware of children with asthma(confidentiality must be preserved) and given a personalizedaction plan in case of emergencies. The plan will includeinformation such as: personal asthma triggers, symptoms,parent's signature, contact information, list of asthmaworsening factors, list of medications and a medicationsplan.■ A staff member needs to be appointed for coordinatingasthma management plan in school.■ School teachers have to develop a plan for handlingschoolwork missed during the absent days.■ Physical education instructors and coaches have to beinformed on asthma, have quick access on emergencymedication and follow the action plan for each studentaffected. They should encourage the children with asthmato participate in sports.School health services■ Train health aids and school nurses in asthma monitoringtechniques and treatment delivery, action and emergencyplans and also to train other teaching personnel. Schoolbasedasthma services be physician or nurse-directed witha full time nurse, all day and for every day at each school.Have a nurse-to-student ratio of at least 1:750.■ Ensure the availability of prescribed asthma medicationsfor children with asthma in the school setting and all timesimmediate access to the medication. Enable students tocarry and administer their own medications if theparent/guardian, health care provider, and school nurse soadvise.■ Provide appropriate school-based care and mental healthservices for students with asthma by: obtaining a writtenplan for all children with asthma; providing a casemanagement for students with frequent absences, healthvisits or hospitalizations.E-46