MANAGING MANAGING

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ASTHMA IN SCHOOLSASTHMA IN SCHOOLS

Asthma…

• Is the most common chronic disease of children

• Effects 1 in 5 children in Ontario

• Is the leading cause of school absenteeism and emergency room visits

• Can be life threatening if not properly controlled

• Is poorly controlled in >60% of cases

What’s the big deal?What’s the big deal?

ASTHMA IS…ASTHMA IS…Inflammation of the airways

(extra-sensitive or twitchy airways)

3 changes occur in airways:

muscles around airways tightenlining of the airways becomes swollenmucous production increases

SIGNS OF WORSENING SIGNS OF WORSENING ASTHMAASTHMA

Changes in airways can lead to:

• Coughing• Wheezing (not always heard)• Chest tightness• Shortness of breath

ASTHMA TRIGGERSASTHMA TRIGGERS• Airways are supersensitive and react to certain “triggers”

• A trigger is anything that makes asthma worse

• Triggers are unique to each child with asthma

Common triggers include:

• Colds/Respiratory Viruses• Exercise• Grass/pollen• Cold/Hot Weather• Dust & dust mites• Furry/feathered pets• Smoke• Air pollution• Strong smells

ASTHMAASTHMA MEDICATIONSMEDICATIONSControllers (orange, brown, purple, red) Long-acting, slow working (days to weeks) Usually taken at home every day to control

symptoms Will not help during an acute asthma “attack”

Relievers: (usually blue) Fast-acting (within 5-10 minutes)

Taken to relieve symptoms during an asthma “attack”

Taken before exercise, if needed, to prevent onset of symptoms

Need to be accessible at all times

A CHILD’S ASTHMA IS A CHILD’S ASTHMA IS GETTING WORSE …GETTING WORSE …

WHAT DO YOU DO?WHAT DO YOU DO?

1. RECOGNIZE THE SIGNS1. RECOGNIZE THE SIGNS

• Coughing (continual)Coughing (continual)• Increased breathing rateIncreased breathing rate• Complaining of chest tightnessComplaining of chest tightness• Increased use of reliever medicationIncreased use of reliever medication• Wheezing (not always heard)Wheezing (not always heard)• Increased restlessness and irritabilityIncreased restlessness and irritability• TirednessTiredness

2. RESPOND2. RESPOND

• Ensure fast-acting reliever

inhaler is given as soon as

possible. (Should improve breathing within 5-10 minutes)

• Tell the child to Tell the child to breathe slowly & breathe slowly & deeply. deeply. (Support privacy if child appears (Support privacy if child appears anxious)anxious)

• Stay calm!Stay calm! Remain with & reassure Remain with & reassure the child.the child.

3. FOLLOW-UP3. FOLLOW-UP

Minor episodes should not affect a Minor episodes should not affect a child’s involvement in schoolchild’s involvement in school

• When they feel better they can return to When they feel better they can return to normal activitiesnormal activities

• Medication use should be recordedMedication use should be recorded• Parent should be notified about the Parent should be notified about the

episodeepisode

Note: If the child requires the inhaler again in less then 4 Note: If the child requires the inhaler again in less then 4 hours the parent should be notified to seek medical hours the parent should be notified to seek medical attentionattention

SEVERE WARNING SIGNSSEVERE WARNING SIGNS

ANY of the following may be observed:ANY of the following may be observed:

• Lips or fingernails become blue or grayLips or fingernails become blue or gray• Breathing is difficult and fast (>25/min)Breathing is difficult and fast (>25/min)• Can only say 1-3 words between breathsCan only say 1-3 words between breaths• Breathing will involve the whole ribcageBreathing will involve the whole ribcage• Very agitatedVery agitated

ORORNo improvement within 5-10 minutes after No improvement within 5-10 minutes after

taking reliever inhaler taking reliever inhaler

THIS IS AN EMERGENCYTHIS IS AN EMERGENCY

1. Call 911 immediately.Tell them you have a child who is experiencing Tell them you have a child who is experiencing SHORTNESS OF BREATHSHORTNESS OF BREATH..

2.2. Give reliever inhaler immediately.Give reliever inhaler immediately.

3.3. Continue to give reliever inhaler every Continue to give reliever inhaler every few minutes until help arrives.few minutes until help arrives.

Never leave a child who is experiencing serious Never leave a child who is experiencing serious breathing problems alone.breathing problems alone.

Plan ahead…think ASTHMA !

Asthma: Know what it is and who has it.

Signs of worsening asthma: Be able to recognize & respond to them.

Triggers: Know what they are and how to reduce them.

Have a plan to manage asthma episodes.

Medications: Ensure easy access to fast-acting reliever.

Access resources.

THINGS TO CONSIDERTHINGS TO CONSIDERDOES YOUR SCHOOL HAVE…DOES YOUR SCHOOL HAVE…

A process to identify students with asthma? A process to identify students with asthma?

A process/protocol which allows students A process/protocol which allows students easy access to their (emergency) easy access to their (emergency) medication? medication?

A school-wide process for handling worsening A school-wide process for handling worsening asthma?asthma?

A process to identify & reduce triggers?A process to identify & reduce triggers?

A mechanism to communicate & collaborate with A mechanism to communicate & collaborate with families, and health care professionalsfamilies, and health care professionals??

ASTHMA RESOURCESASTHMA RESOURCES

• Ontario Lung Association www.on.lung.caOntario Lung Association www.on.lung.ca

Asthma Action Helpline Asthma Action Helpline 1-800-668-7682 1-800-668-7682

• Asthma Society www.asthma.caAsthma Society www.asthma.ca

1-866-787-4050 1-866-787-4050

• Creating Asthma Friendly SchoolsCreating Asthma Friendly Schools

www.asthmainschools.cawww.asthmainschools.ca