ASTHMA IN SCHOOLSLynn Franklin RN, BScN

Halton Region Public Health Nurse

Sue Murphy RN, CAECredit Valley Hospital

Research Assistant , University of Toronto

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Managing Asthma in SchoolObjectives:• Understand asthma• Be able to recognize signs & symptoms of worsening asthma

• Know how to manage worsening asthma episodes

• Know where to access information and resources related to asthma

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What’s the big deal?

• 1 in 5 students have asthma• Leading cause of

– School absenteeism – Emergency department visits– Hospitalizations

• >50% have poor control of the disease• 80% of asthma deaths are preventable• Asthma and anaphylaxis commonly co-exist

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What is Asthma?

Asthma is a chronic inflammatory condition that occurs in the airways (or breathing tubes) of the lungs.

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Asthma Triggers• Triggers make asthma worse• Common triggers include

• Colds/Viruses • Physical activity• Weather (hot, cold and humid)• Pets• Dust and dust mites• Mould• Grasses, trees, pollen• Poor air quality

• Scents

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Trachea

Or Well Controlled Asthma

Open Airway

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Asthma Signs & Symptoms

•Coughing•Wheezing•Chest tightness•Shortness of breath•Difficulty breathing

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Exercise Induced Asthma (EIA)

• One of the most common triggers• Symptoms may occur during or after exercise

• All students need to be physically active• Avoidance of exercise is not a solution

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Prevention and Treatment of Exercise Induced Asthma

•Prevention is key– If student already having trouble with

asthma, don’t start activity– Use warm-up and cool down times– Allow students who have EIA, to use their

reliever/rescue blue inhaler 10-15 minutes prior to exercise

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Prevention and Treatment of Exercise Induced Asthma

•Treatment of EIA– STOP the activity, SIT and REST– Take reliever/rescue (blue) inhaler– Symptoms should improve within 5-10

minutes of taking the reliever– When symptoms are relieved, the student

can resume the activity

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The Signs of Worsening Asthma

• Coughing• Chest tightness or difficulty breathing • Wheezing (not always heard)• Increased restlessness and irritability • Increased use of reliever

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What to do

• Encourage the student to use reliever inhaler immediately

• Stay calm and reassure the student• Coach the student to slow down their breathing and to breathe in deeply

• Notify the parent of the episode• Student can resume normal activity once feeling better

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Dangerous Signs of Worsening Asthma

• No improvement within 5-10 minutes of taking the reliever/rescue inhaler

• Student is unable to catch a breath – breathing more than 25 breaths per minute

• Only able to talk 1-3 words before needing to take another breath

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Dangerous Signs of Worsening Asthma

•The neck muscles tighten •You may notice that the ribs are showing with each breath

•Lips and nails are blue or gray

These signs indicate an EMERGENCY.

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In an Emergency…•Call 911

•Encourage the student to continue using the blue reliever inhaler

•Stay calm, remain with the student

•Encourage the student to breath slowly and deeply

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Controller Medication•Controls asthma and prevents asthma symptoms

– Decreases and prevents swelling of the airways– Can take days to weeks of regular use to work

effectively

•Usually taken 2 times a day - before and after school at home

•Various colours (orange, purple, brown, red)

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Reliever/Rescue Medication

•A rescue medication – usually blue in colour- opens up the airways

•Provides quick relief, within minutes•Relaxes the muscles of the airways•Taken only when needed or prior to exercise if necessary

•Needs to be accessible at all times

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Demonstration

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Asthma is controlled when . . .Asthma is controlled when . . .

• No missed school because of asthma

• Physical activity is normal

• Appear well-rested because asthma symptoms have not caused nighttime awakenings

• Blue reliever inhaler is needed less than 4 times/week (does not include inhaler use for exercised induced asthma)

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For More Information…•Creating Asthma Friendly Schools

•www.asthmainschools.com

•Lung Association Asthma Action Helpline•1-800-668-7682 or www.on.lung.ca

•Asthma Society Helpline•1-800-787-3880 or www.asthma.ca

•Halton Asthma Project Coordinator•Lynn Franklin 905-825-6000 ext. 2547

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Credits• Lynn Franklin RN, BScN

Halton Public Health School Asthma Project Coordinator

• Sue Murphy RN, CAECredit Valley Hospital

• Rebecca Lewis, RN, BScNHalton Public Health School Asthma Project

• Boris Hofman, Media SpecialistHalton Catholic District School Board

• Bob Soroko, Halton Catholic District School Board