Doctor Calls for Nebulizers to Be Available to Student Athletes

Student athletes who suffer potentially deadly asthma attacks should be treated on the playing field with a lifesaving nebulizer, according to a Long Island doctor who is championing an effort he hopes mimics the success of portable cardiac defibrillators that have turned legions of people into Good Samaritans.

Dr. Harvey Miller, a specialist in asthma, says most people aren’t aware of the gravity of a severe attack so he aims to raise the public profile of asthma as he calls for widespread placement of nebulizers on athletic fields.

Nebulizers transform the potent drug albuterol into an inhalable mist. The drug relaxes the smooth muscles of the airways to restore normal respiration.

Miller’s pitch, however, doesn’t have universal support. A law passed in New York a year ago stipulated that nebulizers can be placed only in schools with a physician or nurse on staff.

Moreover, the American Academy of Allergy Asthma and Immunology, the professional organization of physicians who specialize in the condition, has never studied the use of nebulizers in public places.

Dr. Richard A. Nicklas, a member of the academy and a clinical professor of medicine at George Washington University, questioned whether widely placed nebulizers is a good idea.

“I think this is something worth thinking about,” Nicklas said yesterday, “but it seems like it would be overkill for many patients with asthma.”

He said the dose of albuterol in a nebulizer is substantially higher than that in the inhalers that most asthmatics keep handy.

Moreover, the dose must be calibrated for each patient, something he doubts a person without medical training would be able to do.

“This is something we usually use when someone comes into the emergency room or when their inhalers are not managing the asthma. This is something that is done in a setting with people who know how to administer it,” Nicklas said.

Miller, who lectures frequently to asthma support groups on Long Island, is noting the danger of exercise-induced asthma as he focuses on student athletes who play court and field sports.

“I am very passionate about this,” Miller said yesterday. “I first came up with the idea in 2003 because a Northwestern University football player … died, and he died because he only had an inhaler,” the small canister that dispenses a lower dose of albuterol.

An estimated 23 million people in the United States are asthmatics, but there are no statistics on how many student athletes experience debilitating attacks on athletic fields.

Miller wants to study the issue in more depth, the way automated external defibrillators _ AEDs _ were researched before they were placed on athletic fields and in other public venues.

Nicklas said the use of nebulizers cannot be compared with that of AEDs.

Still, Alan Van Cott, superintendent of Islip schools, sees merit in Miller’s pursuit and has strongly endorsed the doctor’s plan.

Van Cott said he has watched with interest as Miller “continues on his quest to have on-field access to nebulizers for student athletes throughout New York State.

“Advances in technology and the design of these devices have made them very portable and easy to use, thus increasing the attractiveness of this idea.”

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