When to Treat Asthmatic Children at School

When to Treat Asthmatic Children at School Male: I get a form constantly given to me. The school nurse wants to give a treatment in school. I don’t like it. I do it sometimes. I don’t like it and here’s why I don’t like it. She looks at a kid. She’s not trained really well in the treatment of asthma, maybe she assess the kid incorrectly and keeps the kid there to keep the kid in school and he maybe that shallow breather that’s going to get a lot of trouble and maybe we’re going to have a disaster. So, I asked this question of many people who treat asthma. Is it a good idea or a bad idea that you give the school nurse the ability to become an emergency room for kids that’s in the middle of school. I don’t like giving medicine if it’s maintenance. It’s the actual treatment, should she have -- Alfin G. Vicencio: Honestly, I actually think that children with asthma need to have their medications accessible at all times. Male: We’re not saying that. We’re saying if she’s going to have the right to make a decision the kid that’s wheezing, out of control like a mini emergency room. She’s dispensing psychotropic medicine like a pharmacy. She’s overwhelmed. Some of the kids come in and he’s coughing and wheezing and she’s going to be into it a little bit to make that rational decision. That’s my concern. Alfin G. Vicencio: Okay, I think it’s a legitimate concern. I do believe I have taken care of enough children with very, very severe -- you have to remember. My practice is usually filled with children who have very, very severe disease. Male: You don’t get the easy ones. Alfin G. Vicencio: Yeah, so my concern is that most of the children that I follow with my asthma clinic are the ones that are very poorly controlled that require rescue therapy, multiple times per day and -- Male: Here’s the word “rescue therapies”, so what would you say the kid could be treated in school relatively safely and the one that we have great concern that that kid should not be treated there, should be treated in the emergency room. What would be the things that you would suggest, put in that little slip so we could keep our self in a good safe situation. Alfin G. Vicencio: I think that any mild symptoms for example, cough, shortness of breath, certainly can be treated at school. When it starts progressing too wheezing or when it starts to progress to the point where a child is requiring multiple therapies at school and they need to go to the emergency room. Male: And if it is really using tremendous effect to breathe red sign. Alfin G. Vicencio: Yeah, it should never get -- in my opinion it should never get to that point at school. Male: So basically, at a mild uncontrolled situation, it gets controlled easily without arguing. My concern is that one kid that one time that is really out of control. I don’t know who want to waste their time in school that kids should be brought to the emergency room. Alfin G. Vicencio: No, I think that that’s going to answer --. Male: So that’s what our concern is about. So every time I read that form, I give my cell phone number. I said, “Call me first if you’re going to do it in school. Let’s work it out together.” But I don’t like it when they’re totally like they’re going to make a decision without a back up situation. Alfin G. Vicencio: Sure, sure.