What is Asthma?
74. Asthmatics or people with asthma have airways which narrow as a reaction to various triggers. The triggers vary between individuals but common ones include viral infections, cold air, grass pollen, animal fur and house dust mites. Exercise and stress can also precipitate asthma attacks in susceptible people. The narrowing or obstruction of the airways causes difficulty in breathing and can be alleviated with treatment.
75. Asthma attacks are characterised by coughing, wheeziness and difficulty in breathing, especially breathing out. The affected person may be distressed and anxious and, in severe attacks, the pupil’s skin and lips may become blue.
76. About one in seven children have asthma diagnosed at some time and about one in twenty children have asthma which requires regular medical supervision.
Medication and Control
77. There are several medications used to treat asthma. Some are for long term prevention and are normally used out of school hours and others relieve symptoms when they occur (although these may also prevent symptoms if they are used in anticipation of a trigger, e.g. exercise).
78. Most pupils with asthma will relieve their symptoms with medication using an inhaler. It is good practice to allow children with asthma to take charge of and use their inhaler from an early age, and many do.
79. A small number of children, particularly the younger ones, may use a spacer device with their inhaler with which they may need help. In a few severe cases, children use an electrically powered nebulizer to deliver their asthma medication.
80. Each pupil’s needs and the amount of assistance they require will differ, eg the majority of children with asthma will manage their condition at school with little or no difficulty. Each will use the National Asthma Campaign card to record their medication and dosage. A very small number of children may require an Individual Health Care Plan to be drawn up. This would only occur following advice from the consultant at the Asthma Clinic, Dr Gray’s Hospital. Parents would be advised to approach the school with such requests
81. Children with asthma must have immediate access to their reliever inhalers when they need them. Pupils who are able to use their inhalers themselves should usually be allowed to carry them with them. If the child is too young or immature to take personal responsibility for their inhaler, staff should make sure that it is stored in a safe but readily accessible place, and clearly marked with the pupil’s name. Inhalers should also be available during physical education and sports activities or school trips.
82. It is helpful if parents provide schools with a spare inhaler for their child’s use in case the inhaler is left at home accidentally or runs out. Spare reliever inhalers must be clearly labelled with the pupil’s name and stored safely.
83. The medication of any individual pupil with asthma will not necessarily be the same as the medication of another pupil with the same condition. Although major side effects are extremely uncommon for the most frequently used asthma medications, they do exist and may sometimes be made more severe if the pupil is taking other medication.
84. Pupils should not take medication which has been prescribed for another pupil. If a pupil took a puff of another pupil’s inhaler there are unlikely to be serious adverse effects. However, schools should take appropriate disciplinary action if inhalers are misused by the owner or other pupils.
85. Pupils with asthma should be encouraged to participate as fully as possible in all aspects of school life, although special consideration may be needed before undertaking some activities. They must be allowed to take their reliever inhaler with them on all off-site activities. Physical activity will benefit pupils with asthma in the same way as other pupils. They may, however, need to take precautionary measures and use their reliever inhaler before any physical exertion. Pupils with asthma should be encouraged to undertake warm up exercises before rushing into sudden activity especially when the weather is cold. They should not be forced to take part if they feel unwell.
86. The IPP should identify the severity of a pupil’s asthma, individual symptoms and any particular triggers, such as exercise or cold air.
87. If a pupil is having an asthma attack, the person in charge should prompt them to use their reliever inhaler if they are not already doing so. It is also good practice to reassure and comfort them whilst, at the same time, encouraging them to breathe slowly and deeply. The person in charge should not put his/her arm around the pupil, as this may restrict breathing. The pupil should sit rather than lie down. If the medication has had no effect after 5 - 10 minutes, or if the pupil appears very distressed, is unable to talk and is becoming exhausted, then medical advice must be sought and/or an ambulance called.
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