Asthma

Facts on the Condition

General description including
types, causes, prevalence, signs and symptoms

Asthma affects up to one in four primary age children, one in seven teenagers and one in ten adults. It is important for school staff to be aware of asthma, its symptoms and triggers and most importantly, the management of asthma in the school environment.

Asthma is a condition that affects the airways of the lungs. In a person with asthma, the airways are more sensitive than normal. When they are exposed to a ‘trigger factor’ they overreact and narrow, resulting in an asthma attack. The narrowing is caused by:
• constriction of the muscle in the walls of the airways
• swelling of the lining layer of the airways
• excessive production of mucus in the airways.

A variety of trigger factors may lead to an asthma attack (for example, colds/flu, exercise, pollens, dust, dust mite, temperature change or cigarette smoke) and these triggers vary from person to person.

Symptoms of asthma commonly include:
• Difficulty in breathing or breathlessness
• Wheezing
• Cough
• Tightness in the chest
• Difficulty speaking.

Many children and adolescents have mild infrequent asthma with very occasional attacks. They require medication only during attacks. However, students with frequent episodic and persistent asthma need medication on a daily basis and frequently require additional medication at school (particularly before or after exercise). Most students with modetate to severe asthma can have their asthma controlled by taking regular medication.

*It is important to remember that anyone with asthma can have a severe attack, even people with mild asthma.

Treatments, including role of specialists,
effects of treatments, use of devices, daily routines

There are four types of asthma medications.

1. Reliever medications are used for immediate relief. They relax the muscles in the lining of the airways in the lungs, which constrict in an asthma attack. Reliever medication is the only medication to use in an asthma emergency (they include Asmol, Airomir, Bricanyl, Epaq and Ventolin and are all blue/grey in colour).
*Children should carry their reliever medications with them at all times.

2. Preventer medications are used for students with moderate to severe asthma to help reduce and prevent the inflammation of the lining of the airways and to reduce the production of mucous. They are taken morning and night. Preventer medications are usually taken long term, but it will be one to two weeks before they begin to reduce the inflammation in the lining of the lungs and improve asthma symptoms.

3. Symptom controller medications are long acting relievers that are used in conjunction with preventers.

4. Combination medications include a combination of preventer and symptom controller medication in one device.
Preventers, symptom controllers and combination medications should not be used to relieve an acute asthma attack and will not usually be seen at school (unless on school camp).

Asthma medications are generally taken by a hand-held inhaler device such as a ‘puffer’ (metered dose inhaler) or dry powder inhaler (turbuhaler, rotahaler, accuhaler, aerolizer). It is recommended that a puffer be used in conjunction with a ‘spacer’ to assist with fast and more effective delivery of a reliever medication in an emergency.

A spacer is an inexpensive device that assists in the effective administration of medication, ensuring that the inhaled medication (both relievers and preventers) gets where it is needed, deep into the airways.

Note: Schools should provide a reliever puffer (for example, Airomir, Asmol, Bricanyl, Epaq or Ventolin puffer) and a matching spacer device in the school’s first aid kit.

Schools are not required to provide a nebuliser pump for their students to use.

Each child with asthma should have their own Asthma Action Plan written in consultation with their doctor, outlining triggers of their asthma, the medication they require for day to day asthma management, what to do if their asthma deteriorates and how to carry out Asthma First Aid, including when to call an ambulance. (plans can be downloaded from the Asthma Victoria Website at www.asthma.org.au). Asthma Action Plans should be placed in a central location that is easily accessible to all staff caring for the child with asthma. If the child’s asthma treatment is changed the parent/guardian should notify the staff of a change in the child’s Asthma Action Plan.

For further information, Asthma Victoria provides brochures, information sheets as well as a telephone HelpLine from 9.30am to 5.00pm Mon, Tue and 9.30 to 3pm Wed to Friday.