Two years ago, Jasmine Ramirez was diagnosed with asthma.
Though she wasn't suffering from an asthma attack at the time, the doctor told her mom that allergies would trigger one. The family was given a machine to deliver medication as needed and some instruction, but didn't face any issues - until last week.
That's when Jasmine's mom, Norma, arrived at their Mesa home to find Jasmine, 10, struggling to breathe.
"Her stomach was sunken in. She was worried," her mom said. "This time, I don't know why, but it was different. We have a machine. She did the treatments. She was not feeling well, but when I got home from work it was awful. They were telling me she had a severe asthma attack."
Jasmine was admitted to Cardon Children's Medical Center. After she was stabilized, Jasmine and her mom participated in the hospital's asthma education program, GetWell Asthma Care Plan, designed to help keep Jasmine and other children like her from being readmitted any time soon.
With so many children coming to the hospital with asthma - more than 140 were admitted in the first four months of this year - pediatric asthma educator Kim Reiners, a registered nurse, is a busy teacher.
"My goal is a quality of life for the patient and family. I want to make sure the patient stays at home and in school," Reiners said. "It's a team approach at home - parents, coaches, teachers, other family members that hang out. It's a team approach to make sure that child is in control and everybody is watching out for him."
The program includes videos and hands-on instruction about how and when to use the various medications available, what may trigger an asthma attack and how to manage that, and when to get to a doctor. Reiners or another medical staff member also draws up a personal care plan for the patient.
"Even parents who have had a child with asthma say, ‘Oh, I forgot about that or I didn't know that,'" Reiners said.
Reiners took on the asthma education position about two years ago. She became an advocate for asthma education because her daughter, now 17, was diagnosed when she was younger.
"As a new mom and prior to becoming a nurse, I didn't know anything about asthma. I know what it can be like to be overwhelmed when the doctor comes in and says, ‘asthma.' It can be scary," she said. "If the parent or child isn't educated, they're not going to be safe or in control. They're going to just keep coming back to the emergency rooms."
Not one of the asthma patients who have gone through the education plan has returned to the emergency room within 30 days of being discharged this year, Cardon statistics show. The hospital is starting to share its education plan with other facilities.
Dr. Leno Thomas, a pediatric pulmonologist at Cardon Children's Medical Center, said patients admitted to the hospital are targeted for the education plan because of the time involved.
"Most asthma education can't be done in the pediatric office because of the time it takes. We spend half an hour daily on how to use an inhaler, how to use a spacer and when to call (the doctor)," Thomas said. "No matter how many medications I give, if you're not using them correctly it doesn't matter."
Asthma is seen in high numbers of children and adults in Arizona for a number of reasons, Thomas said. Typically, it's because allergy season is practically year-round.
"Here you have things blooming throughout the year. There's not a hard freeze like you see in other parts of the country. There's ragweed and various pollens that are fairly persistent nine, 10 months of the year," he said. Add the winds and the pollution because of the Phoenix area being in a valley, and there are a number of triggers people may face.
"A lot of people move to Arizona thinking their allergies get better. It doesn't. You just picked up and got new allergies," Thomas said.