Asthma in Schools A MacRobbie January 2008 What is Asthma ? Asthma is a problem with breathing - it affects the airways which are the small tubes which carry air in and out of the lungs
What is Asthma? When a person with asthma comes into contact with something that irritates their airways (a trigger), the muscles around the walls of the airways tighten so that the airways become narrower (bronchospasm), the lining of the airways start to swell
(inflammation) and sometimes sticky mucus or phlegm builds up. These cause the symptoms of asthma Common asthma symptoms
Cough Shortness of breath Wheeze Tight chest/chest pain Goals of treatment No cough or wheeze during the day or night - no missed school
physically active able to take part in sport Sleep through the night Prevent asthma flare-ups Use asthma medicines with few side-effects Avoid visits to A&E departments and hospital stays How common is asthma? 390,000
100,000 children (1in 9) 290,000 adults (1 in 15) 19,700 people severe asthma What does this mean for you? Prevention is better than cure Avoid Triggers
Ensure medicines are carried by pupil or there is easy access to medicines Anticipate medicine needs before planned exercise Triggers Cold air or hot humid weather
wear a scarf for cold transitions from hot to cold environments or vice versa air conditioning for hot environments Triggers Exercise with good asthma management you can and
should exercise regularly anticipate need and pre-medicate use warm-up and cool-down exercises monitor air quality Triggers Infections keep hands from face separate towels/disposable towels
wash hands Triggers Molds & pollens
fix water leaks close windows/exhaust fans bin raked leaves/grass in grounds minimise time outside Triggers Strong smells - avoid or limit use e.g. perfumes, cleaning materials, chemicals in science or technical sessions
Aerosols - avoid Candles - avoid Triggers Dust Mites/Pets - more of a problem in the home HEPA filter vacuums minimise soft furnishings dehumidifiers
avoid animals Asthma Management in schools Joint approach Hospital/clinic School
Pupil & parent School nurse &/or Community Paediatrician GP & primary care Etc.
Asthma Management Assessing asthma - peak flow meter Measure the pupils maximum ability to expel air from the lungs Readings are higher when pupils are well Asthma Medicines Usually medicines are inhaled
Two types of medicines used Preventers and Relievers Asthma Medicines - Preventers Take every day even when pupil feels well Decrease swelling in airways and mucus production
these inhalers are many colours often brown or dark red Examples - Becotide, QVAR, Flixotide, Pulmicort Asthma Medicines - Relievers Relax the airway muscles and open up the airway Take these inhalers when asthma symptoms
occur May be used before activity (e.g. PE) to prevent asthma which is triggered by exercise occurring Often inhalers are blue in colour - examples are ventolin (salbutamol), terbutaline Asthma Medicines Occasionally for severe asthma or flare ups, pupils may be prescribed steroid tablets to
reduce swelling in the lungs. An example is prednisolone. Inhaler Devices Pressurised meter dose inhalers (MDIs) Breath activated MDIs Dry Powder inhalers Nebulisers
Spacer Devices Asthma Management Green zone - no symptoms: breathing is good, no cough or wheeze, can work and play, sleeps
at night. Peak flow > 80% of best action - avoid triggers, pre-treat before exercise if needed Asthma Management Yellow zone - getting worse: some problems with
breathing, cough, wheeze or tight chest, problems working or playing, awake at night. Peak flow 50 - 80% of best Action - take quick relief inhaled medicines, repeat if necessary, call for help if no better
Asthma Management Red zone - Get help, call 999 Lots of problems breathing, cannot work or play, getting worse instead of better, medicine is not helping, peak flow <50% of best Action - take quick relief medicine, if lip or fingernails
blue or cannot talk in complete sentences call 999 immediately Summary Stop activity - do not lie down, sit and rest,Do you have asthma? Stay calm - relax shoulders, breathe out slowly through puckered lips, do you have a quick acting inhaler/reliever
Give treatment, repeat if doesnt work, contact parent or get help if no treatment available Call ambulance if breathing gets harder, trouble talking, or lips or fingertips blue Action Plan Knowing who the pupils are Having an individual healthcare plan for the
pupils Being familiar with the contents of the plan Knowing and being confident in what to do Have good communication systems which work Questions?
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