Dr. Chrishana Ogilvie-McDaniel of Via Christi Clinic discusses pediatric asthma and allergy: the Back-To-School Edition of pediatric allergy and immunology.

1. Asthma / Allergy 101:
The Back-To-School Edition
Chrishana Ogilvie-McDaniel, MD
Pediatric Allergy / Immunology

2. Allergy / Asthma 101
Overview:
 Asthma as it relates to school-aged children
 Role of environmental allergy
 Management of food allergy
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3. Back-To-School
Asthma

4. Back-To-School: Asthma
Statistics:
 In 2010, 7 million children were living with asthma (9.4
percent of children)
 In 2010, three out of five children who had asthma
had one or more asthma attacks in a 12 month period
 More than half (59 percent) of children who had an
asthma attack missed school or work because of
asthma in 2008. On average, children missed four
days of school because of asthma
 185 children died from asthma in 2007
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5. Back-To-School: Asthma
Does my child have asthma?
 Colds that “settle in the chest” or are followed by a
lingering cough
 Recurrent bronchitis
 Use of breathing treatments within the past year
 Trouble breathing/coughing with activity
 Complaints of “heart hurting” or chest tightness
 Nighttime cough or constant daytime cough
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6. Back-To-School: Asthma
My child has asthma, but is it controlled?
Controlled asthma:
 Asthma symptoms ≤ two days a week
 Quick relief inhaler ≤ two days a week
 Nighttime awakenings < one-two times a month
 Asthma does not interfere with normal activity
 Oral steroids < twice a year
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7. Back-To-School: Asthma
Asthma medications:
Daily controller therapy – **Do not stop!**
Quick relief inhaler
Holding chamber / spacer
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8. Back-To-School: Asthma
Asthma Action Plan:
 Categorizes severity,
triggers and exercise
modifications
 Color codes
 Define symptoms
 Outline treatment
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9. Back-To-School: Asthma
Prepare:
 Restart asthma medications if they have been
stopped over the summer
 School forms authorizing medication use
 Sports participation
 Beware of cold viruses
 Flu shots when available
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10. Back-To-School
Environmental Allergy
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11. Back-To-School: Environmental Allergy
Statistics:
 13 percent of U.S. children suffer from
allergic rhinitis
 Compromised health interfered with school
performance in 1 in 10 children with allergies
compared with only 1 in 10 non-allergic
children
 Parents report a nearly 30 percent decrease
in their children’s productivity when allergy
symptoms are at their worst
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12. Back-To-School: Environmental Allergy
Common indoor triggers:
 Pet dander
 Dust mites
 Cockroaches
 Indoor mold
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13. Back-To-School: Environmental Allergy
Common outdoor triggers:
 Outdoor mold
 Pollens – trees, grass, weeds
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14. Back-To-School: Environmental Allergy
Signs:
Does my child have environmental
allergies?
 Nose – sneezing, watery drainage, itching,
congestion
 Eyes – redness, itching, drainage
 Frequent sinus infections
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15. Back-To-School: Environmental Allergy
Signs:
allergy triggers
Things to consider:
 Fall allergy triggers
 Grass pollen, weed pollen, molds
 Indirect pet exposure in the classroom
 Impact of environmental allergy on child’s
quality of life
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16. Back-To-School: Environmental Allergy
Management:
 Avoidance
 Oral antihistamines
 Nasal sprays
 Eye drops
 Allergy shots
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17. Back-To-School
Food Allergies
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18. Back to School: Food Allergies
Statistics
 2009 to 2010 study of children (infant to 18
years) indicated eight percent have a food
allergy
 Food allergies result in 30,000 ER visits
annually
 Case series: Nine of 32 fatalities occurred in
school and were primarily associated with
delay in epinephrine administration
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19. Back-To-School: Food Allergy
Immediate:
 Skin – itching, hives,
redness, swelling
 Nose –– sneezing, stuffy
nose, runny nose
 Mouth – itching, swelling of
lips or tongue
 Throat – itching, tightness,
difficulty swallowing,
hoarseness
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20. Back-To-School: Food Allergy
Immediate, cont.
 Chest – shortness of breath, cough, wheeze,
chest pain / tightness
 Gastrointestinal (GI) tract – vomiting,
diarrhea, cramps
 Heart – weak pulse, passing out, shock
 Nervous system – dizziness or fainting
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21. Back-To-School: Food Allergy
Delayed Reactions**:
 Eczema
 Feeding difficulties
 Poor weight gain
 Others
**these do not require
epinephrine
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22. Back-To-School: Food Allergy
Common allergens:
 Milk
 Eggs
 Peanuts
 Soy
 Wheat
 Tree nuts
 Seafood
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23. Back-To-School: Food Allergy
: Milk
Management:
 Identify food triggers
 Avoidance
 Self-injectable epinephrine
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24. Back-To-School: Food Allergy
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25. Back-To-School: Food Allergy
Food Allergy Plan:
 Identifies the food-
allergic child
 Lists specific food
allergy
 Provides instructions
for medication dosing
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26. Back-To-School: Food Allergy
Treatment:
 Self-injectable
epinephrine
 Two injectors at
each location
 Use it!
 Antihistamine
 Albuterol inhaler
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27. Food Allergy: Fast Facts
 Skin contact and inhalation of peanut butter
vapors do not usually cause generalized
reactions
 Foods vaporized through heating can cause
reactions (primarily respiratory)
 Non-ingestion exposures to peanut usually
cause mild reactions
 Peanut residue can be cleaned from the hands
using soap and water or commercial wipes, but
not antibacterial gels
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28. Summary
Prepare:
Prepare:
 Review asthma medications / symptoms with your
child and the doctor regularly
 Take medications as prescribed
 Recognize and treat environmental allergy
symptoms
 Ensure that your child has adequate numbers of
unexpired epinephrine auto-injectors readily
available
 Action Plans are essential
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