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"