The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

Use of Spirometry in an Inner City School , to Enhance Awareness of Lung Function to Facilitate a Follow-Up with the Students Primary Care Physician

 Edward Conway, RRT, Roberta Taylor BS, Cindy Perry, RN, Lisa Green, MD, Tom Holbeck, MD,
Joan Berry, BA

Background: Asthma is the most common chronic childhood disease. Asthma is most prevalent among inner city children, and accounts for most of the absenteeism within the schools. Children in this situation that are diagnosed with asthma usually have poor adherence to their medication regiment, and follow up with their primary care physician. There are also children in this population that go un-diagnosed with asthma and miss most of their school year. A team effort between Winton Hills Medical Center in Cincinnati Ohio and the American Lung Association of Southwest Ohio, and Respiratory Therapist from Cincinnati Children's Hospital performed spirometry testing for Winton Hills Academy in Cincinnati Ohio . This school is located in the inner city of Cincinnati , with grades Pre-K through the 8th grade. The purpose for the spirometry screening was to identify children that are at risk of having asthma, and to identify children with asthma that are not well controlled.

Method: Winton Hills Academy total student enrollment is 432 children. It was decide to screen each child over the age of 6 at risk of having asthma. A consent form developed by physicians at Winton Hills Medical Center , along with an asthma quiz developed by, ANN Allergy, Asthma Immunology was sent home with each child. Answers to the asthma quiz generated a score that identified children at risk of having asthma. Nursing staff at the school reviewed the quiz to identify children for spirometry; out of the 432 children 55 were identified. These children had a score of at least one on the quiz and had a completed consent form. On the day of the screening 52 of the 55 were screened do to absenteeism. Therapist from Cincinnati Children's volunteered their time to do the screenings. The Spiromters were supplied by Jones Medical and compensated for height, age and race. Each student screened would complete at least 3 reproducible tests.

Results: The breakdown of students that participated by grades was as follows: Kng. n=9; 1st n=9; 2nd n=4; 3rd n=8;, 4th n=8; 5th n=5; 6th n=6; 7th n=1; and 8th n-1. Of the participants 16 were known asthmatics, with the rest having no history of asthma. Results of the PFT screening were as followed: Normal PFT 17, 6 of those were known asthmatics, slight obstruction; 17, 4 of those were known asthmatics, Mild obstruction; 9, 5 of those are known asthmatic, moderate obstruction; 4, severe obstruction; 1 which was a known asthmatic, invalid test; 4 these are children who were unable to have a reproducible test. All children in the mild, moderate, and severe categories had a referral letter sent to their primary physician, and a letter sent home for the recommendation for the child to be seen by their primary care physician.

Conclusion: By providing spirometry in an inner school we were able to identify children at risk of having asthma and children that were not being controlled with their current asthma management plan. The screening identified 24 children at risk of having asthma or being under managed. Fifteen of those children have had a follow up visit with their primary care physician. Eight of these children have had a follow up at Winton Hills Medical Center and are part of their "Fast Track Asthma Program"

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