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In addition to the medical and health education challenges faced by pediatricians managing patients who have asthma, school-based asthma management is a concern. This article is a companion to the Pediatrics in Review article "Managing Patients with Asthma: The Pediatrician as Emergency Physician, Chronic Illness Specialist, and Teacher" (1992;13:213-215). School-based management has become necessary and more complex with the increased awareness of the school's responsibilities and increased emphasis on aggressive preventive care. Effective management of asthma at school is critical because it can: promote a supportive learning environment, promote optimal school performance by controlling symptoms and medication side effects, thereby reducing absences, provide the necessary support in the event of an emergency, and enable students to achieve full participation in physical activities. This article will review the steps used by practicing pediatricians to manage patients who have asthma in school effectively (Table). Evaluation of School Policies and Programs A complete asthma management plan includes a detailed evaluation of asthma management in the school. The evaluation determines whether appropriate school policies are in place for proper asthma management. Critical issues include environmental control, medication administration, asthma monitoring, emergency care, attendance, and physical and health education. Appropriate environmental control policies eliminate or minimize identified allergens and irritants from the school.
Managing Patients Who Have Asthma: The Pediatrician and the School
Lani Smith Majer MD, FAAP1
1 Director of School Health, Anne Arundel County Department of Health, Annapolis, MD.
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