This webinar was recorded on Tuesday, August 16th

Join Allergy & Asthma Network for a look at asthma concerns as students return to school.  We’ll offer a unique perspective with a panel presentation from a high school student and school nurse as we look at useful tips and vital concerns.

Speakers:

  • Regan Lloyd
  • Sally Schoessler

Resource:

  • Download the presentation slides

Transcript: This transcript is automatically generated. While this transcript is believed to be accurate, errors sometimes occur. It remains your responsibility to evaluate the accuracy and completeness of the information in this transcript. This transcript is not intended to substitute for professional medical advice.

Speaker 2    00:02

It’s hard to believe it’s time for school again, but we’re busy with all of the preparations needed to start a new and exciting year. My name is Sally Schoessler and I’m director of education at Allergy and Asthma Network. It’s my pleasure to welcome you to today’s webinar. Allergy & Asthma Network is a grassroots organization that was begun over 35 years ago by a mom who knew that other mothers like her needed resources and support. Our mission is to end the needless death and suffering due to asthma, allergies and related conditions through outreach, education, advocacy and research. One of the things Allergy & Asthma Network is very interested in doing in every situation is bringing the voice of the patient, the voice of the person who’s dealing with allergies, asthma or related conditions to the discussions whether we’re having discussions with healthcare providers, leaders of in industry, other patient advocacy organizations. But we always really pride ourselves on making sure that people that are living with issues are heard. And so that’s one of the reasons I’m extremely excited about today’s webinar. Today, in a few minutes, you’re going to be hearing from Regan Lloyd and she is a student, she’s an asthma and allergy advocate. And I’ll tell you a little bit more about Regan in just a moment. For those of you that don’t know me, my name is Sally Schoessler. I’m director of education at Allergy & Asthma Network and talking about asthma at school. Is very near and dear to my heart. I spent most of my career as a school nurse. I’ve been a school nurse in the office. I know what it’s like to have 12 pairs of eyes looking at you needing things. I also was a school nurse teacher. I was a school state school nurse consultant for the state of New York, and I also worked as Director of Nursing Education at the National Association of School Nurses before I came to allergy and asthma network. So I joke that I identify as a school nurse. But I really do. It’s just that, you know, I think school nursing is a profession that really is, you know, it’s based on science, but it’s also based on heart. And I’ve loved every minute of that part of my professional career. So when we want to talk about taking care of students, so often we don’t hear from the students. And today we’re going to and I think that’s just a really exciting thing. So we have today with us Regan Lloyd and Regan is an active 17 year old who has severe asthma. Inspired by her own hospitalizations in 2018 she started her own Asthma and Allergy blog. She now serves as the teen Ambassador for Allergy and Asthma Network and in her spare time she,which I don’t think she has much spare time but she enjoys being a member of the varsity lacrosse team, student leadership societies, and she loves to hang out with her friends. So Regan, we’re so pleased that you’re here to bring that student voice to our thoughts on asthma care. Today’s program is going to have three parts to it. We’re going to do a little asthma overview 1st and then we’re going to hear from Reagan on the student perspective and then we’re going to talk about asthma issues at school and resources. To help care for students with asthma. So for our asthma overview, we’re going to start with a few statistics. And one of the most interesting statistics is that 1 in 10 children come to school with asthma. So if you have an average class size of 20 in every classroom in every school across our country, you’ll have two children that struggle with asthma in that class. This is one of the highest impact health issues for school aged children. But the other interesting statistic? That asthma is the number one reason the kids miss school, and that includes 13.8 million missed school days per year. Now we all want students in their seats and ready to learn, mostly for the altruistic reason that we want to make sure that children are getting a great education and are prepared for life. But also, in a lot of states, the state aid that the state gives the school is dependent on the number of children that are in their seats on a given day. So school administration also has a vested interest in having children healthy and at school. Another interesting statistic is that three in five students limit their physical activity with asthma. And so students that are in good asthma control should be told and should be able to do anything. They should not feel that they need to limit their physical activity. You know, Regan talks about playing varsity lacrosse. That’s amazing but you do have to be in great asthma control in order to be able to participate in physical activities, and that’s something we can really help students with. A few years ago there was a meeting of the American Academy of Allergy, Asthma and Immunology with the National Association of School Nurses and they work together to develop a school asthma management program. The short name for that is SAMPRO, They developed this graphic which was called circle of support. And I think that this is just a great way to think about that child with asthma and the student needs to be at the center. Of care within the community, the clinician, the school nurse and the family truly work together to support that student with asthma, no matter whether they’re at home, at school or at their medical home. We want to empower students to participate in their care and as they go through school, learn to self manage their asthma. Obviously you’re not going to ask a kindergartener on the first day of school to self manage their asthma, but if we think about all the years that a student  is in school every single year. We’re encouraging a student to take more of an active role in their asthma management and help teach them more and more. So if they truly understand what’s happening, then I think we’ve accomplished something pretty wonderful. So I guess that is a key thing is does the student understand what’s happening in their bodies? We really can’t take care of a student who doesn’t understand what’s going on. And certainly students and children feel like, Oh my gosh, I’m having trouble breathing, but they don’t necessarily know the pathophysiology of what’s going on. And again, you’re not going to explain to a first grader about bronchospasms, you’re going to make sure you’re teaching them at a developmentally appropriate age level for what they can understand, but it’s important that everyone understands that we’re no longer looking at asthma as a single disease but as a syndrome we’re looking at environmental and genetic factors which lead to inflammation and that inflammation makes our airways more hyper responsive but also creates reversible airway obstruction and those things create those clinical symptoms that you see. That cough, that wheezing and dyspnea, if you’re not a medical professional, dyspnea is labored breathing. But you know, so many of us are used to using the more clinical terms but you know, certainly students feel that burden of the difficulty in breathing. There are three phases to asthma. The early phase occurs in the 1st, 30 to 60 minutes of an asthma episode and those are inflammatory changes in the airway. It’s the bronchoconstriction, the bronchospasm and that’s treated with a quick relief inhaler. The later phase occurs 4 to 6 hours after that initial trigger and it’s continued inflammation with that airway hyper responsiveness and this can be treated with a more long acting inhaler for airway remodeling. That’s kind of the final stage when asthma has had a big impact on the airways and it’s the walls of the airway begin to thicken and that basement membrane of the epithelium thickens. And this is when we look more towards severe asthma treatments. Well, when we talk about respiratory treatments, I’ll tell you the reason I found Allergy & Asthma Network at first in my practice as a school nurse was this poster. At the time there were probably 6 to 12 items on it was not really busy because back in those days and I really don’t want to tell you how long I went to school and how long ago I started school nursing because that would certainly date me here. But we’re looking at, you know, all the different treatments and all the different. Inhalers that are available on the market now as practicing in a school setting, you’d be looking pretty much in the upper left hand corner at the short acting beta two agonist bronchodilators. Those are the ones you’re really going to be giving at school. But I did want you to see that we do have this poster available for you as a part of what Allergy & Asthma Network offers, and we update it about every six months when something new comes on the market or if something leaves the market. So one thing, excuse me, one thing you want to be thinking about too is that I could have a student come in and say, and they could say, well, I had my inhaler at home, but I’m still having trouble. Well, if you say, show me what inhaler you took at home and they show you either, you know, like an inhaled corticosteroid or long acting inhaler, then you can say, OK, so maybe you’d make a call to mom and say they’re telling me they had an inhaler. I’m thinking that from what they’re describing, that they have their long acting inhaler, I’d like to be able to give them the albuterol. Does that work with what they’ve had at home this morning? So the respiratory treatments, kids can’t always tell you what they take, but they can show you what they take and they can point to it and that’s some of the true value of this poster. I’d like you to encourage you to use terminology very carefully when discussing asthma medications with families. One of the things that we work really hard at the Network is talking about not calling those quick relief medications a rescue medication. Because in all honesty, that can be a life threatening misunderstanding. A lot of people will think, OK, when I need to and when I’m having an emergency and I need to be rescued, that’s when I’ll use my inhaler. Where really what they should be using it as is the first sign of symptoms. Use that quick relief medication because the earlier they use the medication, the less likely they are to need more and more medication. So really think about how you’re talking about medications. And how you can help families really learn how to go ahead and use their medications correctly. Another important tool is that asthma action plan. The Asthma action plan that you see on the right side here is the SAMPRO asthma action plan that was developed in that meeting that I discussed earlier. They had physicians in the room and school nurses and all sorts of different people and everyone kind of agreed. And one thing if you are a school health professional that you will like is that at the bottom of this the parents actually signed permission to give the medications. In school. So just some tips on using an asthma action plan. If you don’t have a plan, ask your healthcare provider or specialist to create one for you. And you know one thing you can do as a school health professional is make sure that you email a copy of this the same pro action plan you can find online. Just Google Sampro.cyproasthma if you Google SAMPRO asthma, it will bring you to this page. When you get to the point where you want to get the resources in the toolkit, it’ll ask you for an email address and that’s just so they can track who’s using it. They’re not going to send you emails, they’re not going to do anything with that information. But you’ll get all these, and you can even put your own logo on the asthma action plans for your school. They don’t mind if you take their if they have it, they actually have a copy that doesn’t have their logo on it. That you can put yours on. So I would actually email these in at the before the end of the school year to my students, to the parents of my students with asthma, so that I could try to get them to bring those in before the first day of school. Encourage families to keep the plan in a place that’s easy to find for the student and anyone that might care for the student, whether that’s a family noteboard, the refrigerator door, a bedside table, I think grandparents and daycare providers should have a copy of the asthma action plan. So the other thing too is you can keep a copy on your phone or your tablet and refer to it regularly, and that way everybody would know what to do and when to do it. Be sure you do check it regularly as or encourage your students to, because a lot of times you get in habits that aren’t really the right habits and the asthma action plan can bring people back to that high level of care. Also encourage families to take it to their medical appointments. Ask the healthcare provider to review it with them and update it whenever it’s needed. This is a great way to help parents and kids really take control of their asthma. Another important tool is the Rule of Twos . This is trademarked by Baylor Healthcare system and it really helps to answer is asthma in control? You know, you want to be thinking about, you know, when does someone need more than that quick relief inhaler? So the first four questions here I really think are just a great way to do a real quick you know, are you in control or aren’t you? If you take your inhaler more than two times a week, that quick relief inhaler. That’s a sign asthma is not in control. If you awaken at night with asthma more than two times a month, that’s a sign that asthma is not in control. How about the refill of your quick relief inhaler? If they’re filling more than two times per year, they may not be in control. Some people will say, oh, don’t worry, we would fill it every month when it runs out. And that’s kind of a great teachable moment. And then the question too is did you use Prednisone 2 or more times a year for asthma flares? So the providers will have asthma control tests they can use. But the rule of two is just a great, you know, quick and easy way to try to help families make that assessment of whether they need more? Well, at this time, it’s my pleasure to turn things over to our student for her perspectives on asthma care at school. Regan, we’d love to hear from you at this time.

Speaker 1    15:31

Hi, so. Throughout my years in school with asthma, I have certainly faced many different challenges. I’ve had school nurses or teachers listen to me breathe, then think that I should go to the hospital when I’m not nearly at that point for my own asthma. And I’ve had other teachers not treat my asthma seriously and ask me if I can wait untill after this assignment to go to the nurses or over encourage me to participate in an activity. So I’ve definitely faced situations on the polar opposite sides of the spectrum. And of course. There were never any poor intentions behind these actions. Nurses and teachers cannot always fully understand a student’s condition. However, because I knew my asthma plan and my own boundaries, I could self advocate and have the confidence to share what was best for me from a very young age and I think that has been very important. It’s very important to collaborate with teachers, nurses and school staff, and I think that really comes down to three points: preparation, see the doctor before school starts to complete any needed forms and make sure you are ready and healthy for a new school year plan. Have an asthma action plan in place and develop this with your teachers, your nurse, your doctor and student. Make sure it is accessible and easily understood, and make sure that the student understands the plan themselves so that they can advocate for themselves and share. Talk to your nurse and teacher about your asthma. Everyone is different and no case of asthma is exactly the same. So share your triggers, your plan and your boundaries. Students need to learn to advocate for themselves. A student can find confidence in their patient voice, express your needs, educate and share with those around you, and develop a relationship with your school nurse and teacher so that you feel comfortable.

Speaker 2    17:24

What school staff can do listen, encourage students to speak up, role play these difficult conversations and develop a trusting relationship with the student to empower them to speak for themselves. Be prepared with prescriptions and know your asthma action plan. Prepare and get ready in advance. Don’t wait for the first day of school to realize that you need medications if you’re going to need your inhaler and the nurse’s office. Make sure you have new prescriptions in the nurse’s office, have any needed forms signed and delivered, and know how to properly administer medication and know when to use it. Be sure your detailed asthma action plan is complete and delivered to school. Talking to peers about asthma. Be realistic about your asthma help. Peers understand that asthma can’t always be quickly fixed by just taking your inhaler. Each person’s experience is different, and what someone thinks asthma is may not be what it actually is for you. Kids with asthma can be stigmatized as being out of shape or weak. Educate your peers. Kids with asthma can be included, but they may need to take breaks. Discuss with peers what will happen if you have an asthma flare and need help, especially with COVID. Asthma symptoms can parallel those of a contagious illness. Explain to peers that you do not have anything that is contagious. Keep the conversation going. Keep it a no judgment zone empowers students with asthma. You can do anything when your asthma is control. Is in control. It can be a great school year.

Speaker 2    19:07

Regan, thank you so much. I think so many times again, we don’t always hear that student voice. And I just thank you so much for being with us and for sharing that. And I know you’ll be back when we get around to questions. So thank you so much.

Speaker 1    19:23

Of course.

Speaker 2    19:25

We’re just going to look at a few asthma issues at school and move some things ahead here. It’s really important, as you’re getting going with students with asthma, is that you obtain a health history. This is just so important, you know, what age, what was the age of onset for asthma symptoms for this student? What’s the impact on their daily life? And one question I always love to ask students is there something that you wish you could do that you have trouble with? And I think sometimes that really puts things in perspective. You know, one little guy one time said to me, I just want to play. I just want to go out and play. And I thought, oh, you know, every child should have that option. And so I think we, you know, if we can do what we can do to really help that happen for that student, I think that’s an amazing and wonderful thing. Find out what medications they’re on. And another thing that’s really helpful to ask parents about is their insurance status. You know, are they having trouble getting their medications? Can they afford them? You know, can you help with that? And I think that’s just a really important thing. Sometimes they actually need help getting some insurance so that they can get the best care for their child. So you want to make sure too that you’re being that connection between home and school and the medical home. This – What you see here, this resource is part of school Nurse Chat which stands for chronic health assessment tool and this is in our online store. Don’t let the word store bother you with this one. It’s a free download. It’s just the best place we can put it for you to download it. So but it but it is a free resource and you’ll see other pages from that resource as we go through this. But it really helps you just to have like a game plan for that phone call as you’re talking to a parent. About a health history. Next thing you want to do is make sure that you’re organizing care and medications that are ordered by the healthcare provider and doing that all important care planning. You want to be thinking, does this student need an emergency care plan? Some people call them emergency action plans, some call them emergency care plans. Or do you need an individualized healthcare plan or a 504 plan? Just as a quick overview, the emergency action plan is going to be written in lay language for school staff. Know what to do in the event of an asthma emergency. The Individualized Healthcare plan is going to be written in nursing language as a nursing tool to talk about what you know, detailed care equipment that’s needed medication administration and as well as that education plan to help that student get from dependent in their care to independent in their care. And some students really benefit from a 504 plan. I know that when we were. I was mostly an elementary school nurse, and in one district we did whatever the student needed, and we didn’t write a formalized 504 plan, which is a legally binding document for school accommodations. But whenever they went to the middle school, we wrote up the plan so that they would continue what we had done. So you don’t always need a 504 plan, but sometimes it’s a great tool for a student. Which I showed you the respiratory treatments poster earlier. We also have a respiratory tools poster and these are great in a school office to be able to point to things and show students things. And sometimes they’ll say, hey, I have one of those, but I never use it. What’s it for? A great moment to have a little education. So you want to make sure that you’re really talking to students about how to use what they have and what’s appropriate and these tools again they’re available from. Allergy and asthma network as a real help to you if you’re a school health professional. I just want to take a minute to talk about the September asthma peak. This is typically, excuse me, the third week of September, which this year turns out to being September 19-23.  This webinar is airing in 2022 so it would be September 19 through 23 in 2022 but what the September asthma peak is that every year in hospital and visits currently actually spike in mid-September and then decline again in mid-October And so a lot of people were thinking, well, why does this happen? But it’s a perfect storm of triggers with the return to school, a child’s being exposed to multiple allergens, indoor mold, animal dander and respiratory irritants including air pollutants. Idling school buses can be such a problem for children with asthma. There’s also high levels of ragweed and mold allergens in the outside air. Which can really make a difference to youth and teenagers who are outside doing sports. There are a lot of easy to catch cold germs and viruses, including the flu and of course, COVID-19 and then also allowed. Sometimes what happens is that in the summer, students stop using their medications regularly because summer is just a little looser. And so when children aren’t in their groove of using their asthma medications in the summer, they’re more at risk for asthma flares. September, when they’re exposed again to a bigger world, they’re not just in their own little Home group anymore, but also they’re anxiety and stress associated with the new school year, and that can often trigger an asthma episode. So what can you do? We’ve written out 10 steps. And again, this is a little poster. I took the middle part out because I wanted to get it all on one slide. But this is again, this is, I’ll tell you, a great spot to look for resources on our website in just a second, but be proactive and be preventative. You’re going to want to think about scheduling, scheduling an asthma checkup just like Reagan said with your doctor before the school year begins. And you want to make sure all asthma medications are refilled prior to the start of the school year. Take long acting asthma medications as prescribed and keep and carry medications at school, particularly a quick relief inhaler. Some people really love peak flow meters. I’m not necessarily one of them, but this certainly is a device that can help identify problems as they’re beginning. Encourage frequent hand washing to reduce the risk of a cold or virus, and also identify and avoid environmental triggers if Paul’s a problem. Talk with teachers about staying inside when pollen counts are really high. Get the flu vaccine, get the COVID-19 vaccine and follow your asthma action plan. Provide one to the school nurse with everybody’s on the same page. And also just make good team, good asthma control throughout the year, even as symptoms are well controlled during the summer. And that’s just a great way to avoid that September asthma peak. So if you’re looking at some of these resources and saying, boy, I’d love to have some of those for myself. One thing that we have done at allergy and asthma network is we have developed new pages on our website and it’s allergy asthma network dot org and we have new pages for managing asthma for parents, managing asthma for school staff. We have the same for allergies, both pages aimed at both groups. We also have a page on school health resources and that’s where you’re going to find a lot of these things. So look on the horizontal navigation bar on our website. Look for school and then you can find school health resources as a drop down under that. So at this point, we’re going to take your questions and we’ll get to as many as we can. So we’re going to have Regan come on the line again and we’re going to be able to ask some questions and get some answers. So Regan, the first question is something I think I’d like to hear from you on. And that question is what’s our slide doing here? It’s supposed to say questions. There we go. What advice would you give? A young child that’s struggling to learn how to speak for themselves and speak up.

Speaker 1    27:56

I think it’s really important to realize that your teachers and your nurses want to help you and they want to listen to you, and it’s OK to speak up. And you don’t have to be afraid that you’re not going to be listened to. And you don’t have to be afraid that you’re going to be stigmatized because not only does speaking up get you what you need, it’s really important for your own health.

Speaker 2    28:18

Do you think something like role play would work well with a younger child to really help empower them to speak up?

Speaker 1    28:25

Yes, definitely. I think it could help them find confidence in their own voice.

Speaker 2    28:29

I think you just hit it right there. Confidence . We have to help every child have confidence, but especially our children with asthma. Ok, so another question, Regan, that I’d like to have you answer. Is it OK if students tend to keep their inhaler in their backpack or do or do they need to leave it in the nurses office? What’s been your experience?

Speaker 1    28:52

I, when I was younger, always had to leave it in the nurse’s office, and it actually took me a little while until I was older, which made sense so that they knew I knew how to use my inhaler properly to get the accommodation, to have my inhaler with me. And I was given that accommodation, I think because I knew how to advocate for myself. I knew my asthma plan, I knew when I should take my inhaler so I was able to keep it accessible and close by. But I think it definitely depends on the kid.

Speaker 2    29:20

Oh, that’s so true. And it’s not, really, I don’t think, a chronological age. It’s a developmental age because I think there are some people who are very competent in 5th grade, and I think there’s some sophomores in high school I might worry about. But I think too what you want to make sure that you know what the laws are in your state and in your local school district. What’s your policy and stuff? So you know there is legally in all 50 states a child can carry their inhaler. But in a lot of states, the school nurse and the doctor and the parent all have to agree that the child’s ready to do that. So make sure you know what the policies and guidance is for your school district and your state. Ok, Regan, another question for you. Who would you, what would you want coaches to know about asthma?

Speaker 1    30:17

I think that sometimes you may need a break. And I know I’ve had lots of experiences with coaches because I’ve played travel sports my whole life, even with severe asthma. And I’ve had coaches definitely sometimes maybe think that when I need a break, it’s because I don’t want to run or I don’t want to work as hard. And that’s definitely not my nature. And when coaches get to know me, they realize that if I’m taking a break, it’s not because I want a break, it’s because I really need it. So I think it’s important for coaches to understand that. They need to accept if an athlete needs a break, and they also need to know that an athlete can be put in. They don’t need to be underestimated because On the contrary, I’ve had coaches or maybe hesitant to put me into a game as long, or if they know that I just missed a few practices because of my asthma, they want me to sit out longer. And of course their intentions are good but it can be hard when you’re being either underestimated or being told that oh, you’re fine, you can run more. So I think it’s. Really important to always listen to the athlete. And the athlete also needs to be honest and truthful because I know it can be easy to, you know, say you’re more OK than you are if you want to push it, or on the contrary, you know, say, oh, I need a break if you’re really tired. So I think it’s important that you have a relationship of trust between the athlete and the coach.

Speaker 2    31:34

Oh, absolutely. You know, I think that’s you’ve really hit on something that was always kind of a cornerstone of my school nursing practice was developing trusting relationships not only between nurses and students, but nurses and parents and just, you know, when everybody trusts everybody else, only good things can happen with that. So that’s great. Ok, I’ll take the next question. School nurse says that recently an asthma and allergy specialty office told them we don’t have asthma action plans but if you send us the school’s action plan we’ll fill it out and send it back to you and the and Rhonda asked shouldn’t they have plans to give parents and a lot of offices do have their preferred asthma action plan. But there are so many asthma action plans out there that you don’t always get the same one from the same group or they don’t necessarily have one they truly love. So I would say if you’re a school health professional, find an asthma action plan that you think is great for your school and send it with the parent for their appointments and see if you can get that back. And you might get one back that doesn’t look like the one you sent because you may have a district, an office, a physician’s office that has one that they prefer. Sometimes they’re actually in the electronic medical record and they can just type that out as a part of that. So is it standardized? Absolutely not. It’d be nice if it was, but it’s not. But I would take any asthma action plan over trying to wait for one that looked exactly the way I would prefer. Ok. I’m trying to look here at some more of our questions. When the Air Quality Index is elevated Reagan and the air is kind of hazy, do you ever have trouble when it’s time to go outside to either do physical education or when you were younger for recess?

Speaker 1    33:34

For me, my biggest air related trigger has always been pollen, so if it’s the fall or the spring, the air gives me a lot of trouble. But that’s the only time I really pinpoint as having more issues

All right, someone asked the question. This one’s a tough one. I probably shouldn’t even ask it, but I’m going to anyways. So last year the teacher took away my son’s inhaler. Can she do that? I would think that would be a very a fairly serious situation to address as school administration and school health, because I don’t think that if someone should indiscriminately ever take a child’s medication. But again, being really open and honest with faculty. The staff about what’s appropriate in your school and maybe what’s appropriate for individual children. Because again, if you have a child who at fourth grade self manages their inhaler beautifully, you can want to make sure the teacher knows they have permission to carry. They’ll be able to handle it well. If there’s any issues, certainly bring the school nurse in. However, there might be students that are older that you might say, you know, we prefer that they come to the school health office. So again. You know, can they legally do that? It’s a slippery slope and we certainly want to make sure that what we’re doing is ultimately what’s best for the student. ok umm how? And the next question from Jeanette was how do I help them get how do I help people get an asthma action plan that she’s a community health worker? I would work with the school, I would work with this child specialist and just do whatever you can. Again, maybe you provide the plan for this child to take to the doctor to get it filled out so. Regan, another thing is that children with food allergies often have a more severe reaction if they’ve had asthma as well. Have you ever seen that or know about any have any information about that?

Speaker 1    35:49

I actually don’t have any food allergies, so I don’t have any personal experiences with that.

Ok. I just thought I’d check. So I again to another question and I think this is the last one that we have time for is what if my son loses his inhaler at school and you know certainly things happen life happens and if a student were to lose their inhaler at school you obviously you’d want to make every effort to find it because you don’t want another child picking up an inhaler, but that brings up the topic a bit of stock albuterol at school. Many states have the option of having a stock of albuterol in the health office with cardboard spacers to use so that more than one student could use the same canister. And when you have that available that could certainly help a student who either you know, changed purses and doesn’t have their inhaler with them that day or lost it. Or you know, whatever the circumstance is, but we really want to. If your state and school district allows for staff albuterol, I strongly encourage you to create a plan to implement that because that can really help students that are in some distress. Well, Regan, I’m so glad you could join us today. I just think you shared with amazing information with us and I wish you the best with your senior year in high school and whatever lies beyond. So thanks so much for being with us today.

Speaker 1    37:25

Thank you so much.

Speaker 1    37:28

Well, I’d like to ask you. Thank you. And I’d like to thank our listeners for joining us today. And please join us for our next webinar on Biologic basics, the Type 2 connection with Doctor James Tracy on August 25th at 4 PM Eastern Time. You can register for this and all of our webinars at allergyasthmanetwork.org Scroll all the way down to the bottom of the home page to find our webinar recordings and links for registration. Thank you again for joining us. Please stay online for just two to three minutes to complete an evaluation survey. We use this information to plan for future webinars. This is Sally Schoessler for the staff at allergy and Asthma network. Join us as we work today and every day and every school day to help everyone breathe Better Together.