Breathe Easy

 

A

 

 

Access- the problem of asthma specialty healthcare access is a big problem in the East Bay Area and Bayview Hunters Point. The Breathmobile takes away transportation problems and long waiting in lines, but provide direct access to the asthma care by being at the schools where children and parents are located.

 

Advocate- we go to the school nurse, we advocate with Healthy homes, we advocate FOR patients with our impact in the schools in the home environment in the community

 

AeroEclipse- this is the reservoir that medication is inserted into your nebulizer. There are many different types of nebulizer reservoirs, the Breathmobile uses the AeroEclipse

 

African American- Asthma rates have risen dramatically for this particular population’s children in the last 30 years. African Americans have higher asthma rates than Caucasians and are more likely to have fatal asthma attacks.

 

Alameda County- This is the County where the Breathmobile mostly operates. Asthma hospitalization rates for this county exceed California rates in every demographic group studied. The asthma hospitalization rates are second highest among California’s 58 counties.

 

Allergens- anything that you are child is allergic (pollen, dust, dogs, cockroach droppings). The Breathmobile performs allergy tests and provides medicine to keep allergies under control, since allergies can cause asthma attacks.

 

Appointment- the Breathmobile works on an appointment system. Appointments are always once a month, which is necessary for asthma management. Regular appointments have been proven to greatly decrease the chance of asthma attacks and asthma related school absences and asthma related hospitalizations. 

 

Assessment- when your child is on the Breathmobile, they get an assessment: weight, height, vital signs (blood pressure, Oxygen saturation, respiratory rate, heart rate, lung sounds)

 

Asthma- the disease that the Northern California Breathmobile works to manage. Asthma is prevalent in the certain parts of the Bay Area, namely the East Bay Area and Bayview Hunters Point. Despite years of education and intervention, children in certain parts of the Bay Area engage in episodic rescue patterns of healthcare patterns and experience a disproportionate level of morbidity

 

Asthma management- this is the goal of the Breathmobile. By providing a specialty asthma clinic that provides information, medicines and treatment we steer parents away from ER visits to proper, preventative disease management. By providing the Breathmobile to the community we can shift a population of children from acute episodic care to routine preventive care in accordance with national standards.

 

Asthma Trax- That is the asthma patient history, assessment, diagnosis, medical management system; software system, to document patient assessment history (in order to manage asthma- you need patient history, patient physical assessment, and PFT, you need those three to document, Asma Trax helps you do that) The AsmaTrax system serves as an electronic medical record (EMR) for the Breathmobile. All 17 operational Breathmobiles utilize the AsmaTrax system; in fact, many have integrated the AsmaTrax EMR into their hospital’s own EMR system. Demographic clinical and participation data is tracked carefully in this electronic medical record system

 

Auscultation- the act of listening to lungs (nurse, respiratory therapist medical assessment, or doctor listens to your lungs with his stethoscope)

 

 

B

 

 

Bayview Hunters Point- this is a neighborhood in San Francisco that has very high asthma rates amongst its population, children, and babies. The Breathmobile began serving this area in March of 2011.

 

Budget- The Breathmobile runs on a very specific budget. This is why grants and donations are very important to keep the Breathmobile functioning in the Bay Area.

 

 

C

 

 

Consistent- we are here EVERY month, appointment based, follow ups are scheduled monthly

 

 

D

 

 

Diagnostic- The Breathmobile provides diagnosis for allergies.

 

Diesel – a common irritant of asthma.  Its fumes are very prevalent in the air of the East Bay. Diesel fumes are a big problem in the East Bay Area where ports, freeways, plants, refineries, trucks, and factories are a common fixture in neighborhoods. The 580 and 880 freeways and Port of Oakland contribute a great amount of diesel fumes into the air that West Oakland children breathe.

 

 

E

 

 

Economics- poverty, urban living, poor housing, low-income households are common economic factors that are directly related to high asthma rates. Studies have shown that the prevalence of daily or weekly asthma symptoms are tied to low income households.

 

Education- lack of asthma education is a contributor to asthma rates. Social determinants of asthma include poverty and low literacy levels. Asthma medicine and treatment education is a huge factor in helping fight the prevalence of ER visits and missed school days due to asthma.

 

Emeryville- one of the schools that the Breathmobile serves in the East Bay Area

 

Environment

1. The environment on the Breathmobile helps patients and parents. The environment is intimate, interpersonal, friendly, and educational.

2. The environment of the areas the Breathmobile serves are similar, that is urban living, pollution, nearness to ports, highways, and plants, substandard housing, lack of access to healthcare, and low literacy.

 

Ethnicity- The Breathmobile keeps track of the ethnicities of the children it treats

 

 

F

 

 

Focused- The Breathmobile is focused on asthma and allergies, which sets it apart from a general practice, where the child might not get as tailored asthma treatment attention for the asthma

 

 

G

 

Granberg- Dr. Granberg is one of the doctors on the Breathmobile.

 

 

H

 

 

Healthy Homes- we give referrals to Healthy Homes if/when we find that the child is allergic to something like dust, cockroaches, or mold that can be found in the home, or if the parents comments that there may be indoor triggers. It is a free service that gives out free dust mite covers, cleaning advice, and tests for other household triggers.

 

Hispanics- Hispanics have higher rates of asthma than Caucasians and are more likely to have fatal asthma attacks.

 

HRA (health risk assessment) Survey- this part of our computerized asthma management system. This is a series of questions we ask every parent and child at the beginning of every appointment.  It’s a patient history of symptoms. It helps to determine asthma severity, trends in asthma severity, and it is also used to see if the child is improving. For more details take a look at our Treatment & Medicine’s page on the BreatheEasy blog. It provides structured systematic assessment of asthma control for each patient at each visit, along with individualized guideline-based recommendations for treatment, and a visual display of the patient’s pattern of asthma control over time.

 

 

I

 

 

Income- Many of the children we see on the Breathmobile live in low-income households. Low income areas often have little access to specialty asthma care and have lots of pollution. Income and asthma attacks have been linked in studies.

 

Insurance- we do not require for the patient to have insurance on the Breathmobile, but we do take many types of insurance.

 

Interpersonal- personalized care, very intimate, intimate settings

 

Irritants – These unlike allergens do not occur naturally, such as perfumes, air pollution, tobacco smoke, wet paint, and fumes from stoves, heaters, and fireplaces.

 

 

J

 

 

James Acuna- a regular fixture on the bus.  He is our patient services rep who does the HRA survey, paperwork, and drives the Breathmobile bus.

 

 

K

 

 

Kushnir- Dr. Kushnir is one of the doctors on the Breathmobile. She is an allergist/immunologist and is one of the co-medical directors on the Breathmobile.

 

 

L

 

 

Languages – we hear different languages on the Breathmobile. We provide Spanish translation on the Breathmobile.

 

Latino- Both Latinos and African Americans have higher asthma rates than Caucasians and are more likely to have fatal asthma attacks. Many of the children that the Breathmobile treats are Latino.

 

Lisa- the medical assistant on the Breathmobile

 

Liz Bellow- one of the Respiratory Therapists on the Breathmobile

 

 

M

 

 

Maintenance medication- another word for preventative medications, the Breathmobile gives these and write prescriptions for these. Maintenance medications when used correctly can prevent asthma attacks from starting. And example is Singulair, nasal sprays, and controller inhalers.

 

Marbin- Dr. Marbin is one of the doctors on the Breathmobile.

 

Mobile- The Breathmobile is a mobile clinic, “a clinic on wheels.” The Breathmobile’s ability to go to the patients is one of the reasons of its huge success. Patients do not lose care do to transportation issues or lack of accessible health facilities in their area.

 

 

N

 

 

O

 

 

Oakland- A few of the schools that the Breathmobile visits is in Oakland. Oakland has very high rates of asthma both in its adult and child population.

 

 

P

 

 

Patient Services Worker- James Acuna is the PSW on the Breathmobile. He performs the HRA and drives the Breathmobile.

 

Pulse oximeter- measures oxygen content in the blood

 

 

Q

 

 

R

 

 

Risk factor (and disparities)- There are a number of asthma risk factors and disparities such as environment, hereditary/genetic disposition, socio-economic factors, behavioral and cultural patterns, and access to routine care that make the Breathmobile necessary to the communities it serves.

 

 

S

 

 

San Leandro- The Breathmobile serves a school in this city

 

Spencer Weir- the RN on the Northern California Breathmobile

Spirometry- This is performed on the Breathmobile. Also known as Pulmonary Function Exam. Spirometry uses a spirometer. It is the most common of the pulmonary function tests, measuring lung function, specifically the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled.

Standardized care- the Breathmobile provides standardized care through a computerized asthma disease management program.

 

Stress levels- asthma sufferers in inner cities and urban areas often have higher stress levels, which may contribute to the rates of asthma, such as crime and low levels of employment. Physical and mental stress (exercise, crying, yelling) can trigger an asthma attack.

 

 

T

 

 

Transportation- lack of transportation to asthma clinics or to the doctor can contribute to a child missing school because of asthma or having to go to the ER or because of the lack of preventative asthma care. The Breathmobile eliminates this by coming to the parents and children.

 

Triggers- These are composed of allergens and irritants. Different things can trigger asthma attacks in different people. These irritants and allergens may not cause an immediate attack, but they build up in the system and when there are enough, can “trigger” an attack

 

 

U

 

 

V

 

 

Vital signs- these are always taken on the Breathmobile at the beginning of every appointment. Vital signs are height, weight, blood pressure, pulse oximeter (measures oxygen content in the blood), heart rate, and respiratory rate.

 

 

W

 

 

Waiting- unlike a standard medical clinic, there is no waiting on the Breathmobile. Many people would complain that is why they would not go to a clinic, because of the long lines. The Breathmobile eliminated this problem.

 

West Oakland- West Oakland is an area of the East Bay Area that the Breathmobile serves because of the high rate of asthma in this area. 20% f the children here have asthma. West Oakland children are 7 times more likely to be hospitalized for asthma than any other children in California.

 

Wet paint- common trigger for an asthma attack (glues and solvents are similar triggers to this)

 

 

X

 

 

Y

 

 

Z