With the help of RTs, nurses, HME providers, and pharmaceutical representatives, parents of allergic/asthmatic children are helping families fight asthma.

It seems like asthma is everywhere. Although there are conflicting reasons as to why asthma is on the rise, experts agree we are in the midst of an asthma epidemic. Asthma varies widely in severity from one individual to the next, affecting a wide range of age, occupational, and income demographics—with annual direct health care costs of about $11.5 billion. It is the most common chronic disorder in childhood, affecting an estimated 6.2 million children under 18 years. And it is the number one cause of school absenteeism (attributable to a chronic condition) ac-counting for an estimated 14 million lost school days in 2004.

“So what’s a mother to do?” That is a question Cindy Coopersmith, RRT, AE-C, asked more than 10 years ago. Coopersmith is the program coordinator for the Taming the Tiger asthma education program at Poudre Valley Hospital, Fort Collins, Colo. “I have a child with asthma, and I had attended some of the Parents of Allergic/Asthmatic Children (PA/AC) meetings, and I knew some of the board members,” she says. “One day I received a call from a board member asking me to be the president of the group, because the founder of PA/AC was leaving the state.”

She has continued to provide leadership to the completely volunteer, nonprofit organization ever since. Their mission is providing education and support to families who are coping with asthma.

Unlike most nonprofit organizations, PA/AC has no physical address or the associated overhead; the community hospital provides a phone line and answering machine. It has no paid staff, no executive director, receptionist, fund-raising coordinator, or program coordinator. Consequently, PA/AC has minimal operating costs. The major expense comes from printing flyers and advertising in the local newspaper to promote each of its quarterly events.

The success of PA/AC has depended on Coopersmith’s leadership and a loyal band of respiratory therapists, nurses, HME providers, pharmaceutical representatives, and parents of asthmatics who volunteer their time because they see the difference PA/AC makes in their community. “I continue to be amazed at how many new people attend every meeting,” says Coopersmith. “Just one piece of practical information can be significant to a child’s life and breath.”

HME providers who have given their time have found they get back as much or more than they put in. PA/AC gives HME providers an opportunity to distinguish themselves from the competition in an increasingly crowded field—all while making a substantive difference in the community. Lee Ann Wilson, RRT, a respiratory care specialist with PVHS Home Medical Supply in Fort Collins, became involved with PA/AC after learning about its mission. “I have been asthmatic since childhood,” says Wilson. “I became an RRT for the same reason—I wanted to help others with breathing problems.”

One of the PA/AC’s keys to success, and a reason why its volunteers are so loyal, is that they see the benefits with every event. Another reason for their success is that they have clear and attainable goals, focused on each of four annual events. This also makes for a reasonable commitment on the part of volunteers. They typically attend four planning sessions and four events annually. They don’t get bogged down in monthly meetings and planning sessions.

How They Do It
Each of the PA/AC’s quarterly events could serve as a model for fledgling groups interested in getting their first asthma awareness event under way. “We repeat the themes from year to year, so we don’t have to reinvent the wheel every time we host an event. Our volunteers have learned their jobs, so they know what’s expected of them for each of our themes,” says Coopersmith. “We try to keep it simple. It is still a lot of work, but there is only about a 4-hour commitment required.”

Planning sessions are never held at a stuffy “bored” room—instead the volunteers meet at a local bar and grill or on a board member’s patio. There is ample time for socializing, and the networking opportunities are obvious.

In late September they focus on children returning to school with asthma. Fort Collins is a burgeoning community with new families moving in every month so Coopersmith tries to “capture” those new families by working closely with schools to promote the event. This year’s September event was called Hop Skip and Jump Back to School With Asthma, and featured a panel discussion in which parents could ask questions about asthma management and community resources. The panel included a physician specialist in asthma and allergy, a district school nurse, and a specialist in exercise-induced asthma.

A new law in Colorado (see sidebar, page 26) allows children to bring asthma medications with them to school and keep them handy (so they do not have to see a school nurse) when they need a treatment. Parents naturally had many questions about that, and the physicians who were on hand were especially helpful, since they had helped lobby for the law and were knowledgeable about the specifics.

One of the most enjoyable events is Surviving the Holidays With Asthma and Allergies. This event focuses more specifically on food allergies, which are also extremely common with asthmatics. One of the highlights is an allergen-free holiday feast, including a roasted turkey (or two). Side dishes are prepared by PA/AC board members, and each dish includes a stack of note cards specifying the allergens (peanut, gluten, dairy) that are avoided in its preparation, along with a stack of recipe cards. Parents bring their children, sample the dishes, and listen to an engaging presentation by a panel of experts. Question and answer time is critically important, and parents consistently report they learned as much from the answers to other people’s questions and concerns as they did from their own.

Midwinter is time for the Peak Flow Pizza Party. For this event, parents are seated in a lecture room where they have an adult-oriented lecture presented by an asthma and allergy specialist. Children are managed separately. They make the rounds to three small rooms, or learning stations. In one room, they learn about peak flow meters, nebulizers, and spacers. An exceptionally engaging and well-produced video presentation from DeVilbiss is especially popular. At another station they learn about respiratory anatomy and physiology, and a breathing lung exhibit from the American Lung Association provides a graphic and memorable example of the effects of smoking on lungs. And of course, there is free pizza, cookies, and drinks—typically provided by generous pharmaceutical firms.

In conjunction with World Asthma Day, a springtime event provides free asthma screening. But PA/AC has taken this commonplace type of event to a new level. Its screening fair features numerous “stations” where parents and their children have a variety of experiences. Once they check in and fill out a brief intake form, nurses and respiratory therapists perform simple spirometry tests.

They often require three machines to be running at once to handle the crowds. Participants are next referred to an on-site asthma and allergy specialist for follow-up. Each of the city’s three asthma and allergy practices mans a table where the tests are evaluated, and free consultations are provided. There is also an allergy-free petting zoo where children can make friends with iguanas, fish, and snakes. Meanwhile, the American Lung Association has a table for meeting families and recruiting children (age 7-14) for its  extremely popular summer “Champ Camp.”

The events are purposely in sync with the school year so they do not compete with holidays, and PA/AC does not have events in the summer. The summer break also provides a needed breather for volunteers, so they are fully recharged and eager to recommence for the upcoming school year. “I’m sensitive to burn-out, since I get there myself sometimes,” says Coopersmith. In addition to volunteers, she has found the continued support of several highly committed asthma and allergy specialists to be invaluable to the group’s success.

PA/AC fulfills an important function in the community, giving families access to information and support they can not always get from existing mainstream resources. “I continue to find the meetings well received and important to the community,” says Coopersmith. “On a personal level, I adore our board members and feel very supported and connected to them.”

John A. Wolfe, RRT, CPFT, is a clinical specialist at Poudre Valley Hospital, Fort Collins, Colo. He can be reached via e-mail: johnalfredwolfe@comcast.net.

Colorado Schools Says Yes to Self-Administering of Asthma Medications
By John James, MD
The Colorado Schoolchildren’s Asthma and Anaphylaxis Health Management Act allows students the right to self-administer asthma inhalers and epinephrine for anaphylactic symptoms. Many other states have passed similar legislation.

Children with symptoms of asthma and anaphylaxis frequently have increased health problems at school because of exercise and exposure to allergens. Colorado’s recent legislation authorizes public school students with asthma or severe allergies to possess and self-administer prescribed medications during school, while at school-sponsored activities, or while going to or from school or related activities. Passage of the bill improves continuity of care, reduces risk of morbidity and mortality, and further protects schools from associated legal responsibility.

A committee of school nurses developed a set of regulations to accompany the bill. A school’s health care provider can indicate that self-administration may be appropriate, and the school nurse should be involved in determining whether students are mature and competent enough to self-administer their medications.

Nebs for Kids
HME providers looking to boost pediatric nebulizer referrals may want to consider a youthful twist on industrial grey. Jaded physicians who have seen it all just may perk up when they see products such as the AIRIAL MQ7000 Pediatric Building Block compressor nebulizer system from Medquip, Hilton Head Island, SC. Meanwhile, parents who are weary of plopping their kids in front of the TV also may appreciate the interactive nature of the MQ7000. “I started thinking, what can we do to serve that 5-year-old-and-up age range and make it interactive,” says Craig Bright, president, Medquip. “So we took a compressor and made the top a platform for building blocks. From a physician’s standpoint, if a treatment isn’t as imposing or scary, then that can help with compliance.”

For HME providers, kid-friendly nebulizers can break the ice with a pediatrician who is looking for something new. “It is real difficult to walk into a pediatrician’s office with an adult nebulizer and ask for their respiratory business,” says Bright. “These types of products—whether it be the building block nebulizer, the panda- or penguin-theme nebulizer—give the doctor or nurse practitioner something different that maybe the competition is not offering. And it can help providers earn that physician’s referral business not only with respiratory, but wheelchairs and other ancillary products…because we are about building our dealers’ business.”