Visiting a Van    

Mobile C.A.R.E. currently has three mobile clinics: the Asthma Vans.

Each van is staffed by a pediatric asthma doctor, an asthma nurse educator and a clinical assistant.

What to Expect at a Mobile C.A.R.E. Foundation Asthma Van Visit

At Mobile C.A.R.E., we're proud of our staff. They stay up-to-date on asthma medications and equipment. They follow nationally approved asthma guidelines.

They also make every visit to the van a friendly and helpful experience!

A first visit to the van typically lasts about 45 minutes, so the doctor and nurse can work one-on-one with the child and the parent or guardian.

Based on the child's medical history, physical exam and lung function tests, the doctor develops a treatment plan, then explains how each prescribed medication works. The child learns how to take the medication. The family receives a written plan to follow at home, along with any equipment, medications or prescriptions that are needed.

Mobile C.A.R.E. schedules follow-up visits to the Asthma Van, so the doctor can adjust the treatment and families can discuss any new concerns. Families can also call Mobile C.A.R.E.'s 24-hour emergency phone number for advice.

Mobile C.A.R.E.'s ongoing services are completely free and confidential, and are provided in English or Spanish.

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Scheduling an Asthma Van Visit

Mobile C.A.R.E. works with Chicago schools, using a survey to find out which students may need asthma care. If a student has had asthma symptoms recently and the parents would like to use Mobile C.A.R.E., then we schedule an appointment for the next van visit.

Another option is to contact Mobile C.A.R.E. directly for help. If you live in Chicago and you think your child has asthma, or you already know your child has asthma but you need more help, you can send e-mail to asthma@mobilecarefoundation.org or call 773-247-9736.

It's a good idea to check for asthma if your child has experienced these symptoms during the last 12 months:

• Episodes of wheezing (whistling in the chest).
• Wheeze or cough during or after active play.
• A dry, prolonged cough at night that is not part of a cold.
• Visit to a doctor, emergency room or hospital for wheezing.

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The First Visit to the Van

Many children are excited about going to the Mobile C.A.R.E. van, but the first visit can be scary. Will it hurt? Is the doctor nice? The answers are: no it doesn't hurt (there are no needles), and yes the doctor is nice!

Here's what happens during a typical first visit:

1.	Arrive with Parent/Guardian A parent or guardian signs the child out of class, then they go to the Mobile C.A.R.E. Asthma Van parked at the school.
2.	Check In Our Mobile C.A.R.E. driver, who is also a trained clinical assistant, greets everyone at the door.
3.	Consent Forms As with any medical treatment, a parent or guardian signs Consent Forms to show they agree to the visit.
4.	Health History The clinical assistant measures the child's height and weight. The nurse asks the family about the child's asthma symptoms and asthma triggers.
5.	Initial Lung Tests The child blows into a peak flow meter to measure the maximum amount of air the lungs can expel. The child also blows into a tube connected to a computer to measure lung function. The computer system is a spirometer, and the test is spirometry.
6.	Repeat Test The spirometry is repeated after the child uses a bronchodilator to open up the airways, using an inhaler with a spacer to pump the medicine to the lungs.
7.	Immediate Results The doctor analyzes the spirometry to see if the child's lungs are working normally, or if less air is flowing in and out, due to constriction or inflammation.
8.	Physical Checkup The doctor uses a stethoscope to listen for wheezing or constriction in the child's lungs. (The child and parents can listen too!) The doctor also checks for related health problems.
9.	Education and Medication If the child does have asthma, the family immediately receives training:
	Basics: The doctor and nurse explain what happens during an asthma attack and how asthma medications help.
	Practice: The family learns when and how the child should use each medication. The child practices using any required equipment.
	Triggers: The family learns about ways to avoid asthma triggers, for example, by making sure no one smokes in the home.
10.	Leave with a Plan The family leaves with an asthma plan that explains when to take each medication and lists phone numbers for the van and for 24-hour emergency advice. Supplies:The family receives everything they need to start treatment, including equipment, prescriptions, samples of medications, and pamphlets.

Note that if a child is not found to have asthma, Mobile C.A.R.E. may offer other treatments or referrals. And the child can be reevaluated later if symptoms worsen.

Contacting the Primary Care Physician

Using information provided by the family, Mobile C.A.R.E. contacts the child's primary care physician to make sure the Mobile C.A.R.E. visit, diagnosis, spirometry results and prescriptions are recorded on the patient's permanent chart.

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Follow-Up Visits to the Van

Follow-up visits to the van take less time (typically only 20-30 minutes), and are used to evaluate the child's asthma symptoms, and to adjust the child's asthma management plan if necessary.

Here's what happens during a typical follow-up visit:

1.	Update Health History The clinical assistant records the child's height and weight. Spirometry is repeated. And the nurse finds out if the child's asthma symptoms have changed or stayed the same.
2.	Review Home Treatment The doctor and nurse watch the child take the prescribed medication, and make sure the child has been taking each prescribed medication at the right times. They also find out if the medication fits the child's lifestyle.
3.	Discuss Asthma Triggers The doctor and nurse discuss possible asthma triggers in more detail, making sure that common triggers, such as cigarette smoke, are not allowed in the home.
4.	Allergy Skin Test If allergens are continuing to trigger asthma attacks, the doctor may do an allergy skin test. Allergens commonly included in the test are mold, animal fur, plant pollen, feathers, dust mites and cockroach. The skin test does not use needles and does not hurt, although it may itch a little. The skin test is only done once. (Food allergies are not tested on the van.)
5.	Adjust Plan Based on all the new information, the doctor may need to adjust the child's asthma plan. For example, if symptoms improved, it might be possible to reduce medication. (But remember, it's never okay for a child with asthma to stop taking medicine without the doctor's advice!)
6.	Review and Follow-Up Before leaving, the family gets a chance to review the new plan and make sure they know how to use any new equipment or medications. The doctor writes any new prescriptions, and sets a schedule for follow-up. Home Visit: If necessary, a home visit may be scheduled by a health educator from the University of Illinois School of Public Health (a Mobile C.A.R.E. partner), to help the family find and eliminate triggers in the home.

Note: Mobile C.A.R.E. does not replace the primary medical care that children are already receiving and does not displace existing medical care providers. Mobile C.A.R.E. is a community-based treatment option that provides specialized care for asthma only.

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Web site created by Karleen Stevens McAllester
Photography by Deno J. Andrews