Every breath they take: helping children with asthma

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A guide to effective asthma management in the classroom

What is asthma?

Asthma is a condition that affects the airways – the small tubes that carry air in and out of the lungs. When a child with asthma comes into contact with something that irritates their airways (an asthma trigger) the muscles around the walls of the airways tighten so that the airways become narrower and their lining becomes inflamed and swollen. When this happens, a child will have asthma symptoms or, in serious cases, an asthma attack.

Asthma in the classroom

Children with asthma tell us that their asthma sometimes means they have problems joining in with lessons and going on school trips with the rest of the class. A third of such children say that asthma can result in being left out of sports activities at school.

A frequent worry they expressed was that teachers didn’t understand the condition and that, as a result, children were either placed in a “protective bubble”, with teachers banning them from certain activities, or, conversely, they were dismissed by teachers as being “melodramatic” or “over-reacting”.

Michelle Wallace, mother of Ellouisa, aged ten years, from Leicester says: “I have to keep Ellouisa off school when she is suffering badly with a chest infection, but her teachers aren’t very understanding. When Ellouisa was younger, the school would not let her carry her own inhaler, but I was very concerned and the teachers agreed she could carry it herself. I just don’t think the school realises the severity of asthma and that it can kill.”

Top Tips for handling asthma in the classroom

  • Make sure your school has an asthma policy
  • Many problems with asthma encountered in the classroom can be avoided if the school has an asthma policy. An asthma policy can be a stand alone policy or incorporated into a health and safety policy, first aid or general health policy. It sets out the school’s commitment to meeting the needs of children with asthma. A good asthma policy will ensure that staff receive training about asthma and are confident in dealing with medication and attacks.
  • Know which children in your class have asthma and talk with them and their parents about their triggers and their medicines
  • It is a good idea to try to talk to all the parents/carers of the children in your care who have asthma and find out what each child’s triggers are. Ask about which inhaler to use and when. Get them to write this down so that you have written consent to administer medication. If a child has an asthma attack or needs their inhaler while in your care, always inform the person collecting the child.
  • Ensure that they have access to their medicines at all times. Taking their reliever inhaler could make the difference between needing to go to hospital or not, so make sure they are always accessible.
  • Be aware of the possible triggers and signs of the condition getting worse
  • Asthma is a variable condition so make sure that you are aware of any changes in their medicines and speak with their parents to make sure you are both aware if their condition is getting worse.
  • Download Asthma UK’s free teaching resource for primary school aged children. To help all children have a better understanding of what asthma is, how it may affect their friends and family and what to do in an emergency, Asthma UK has produced a free online teaching resource for seven to eleven year olds that is designed to help fit asthma into the curriculum across the UK. There are lesson plans, activities and assembly guidance to help make learning about asthma as easy and as fun as possible.

Asthma attacks

A recent survey showed that three quarters of teachers are not completely confident about what to do if a child in their class has a potentially life-threatening asthma attack, even though asthma is one of the most common childhood long-term conditions in the UK. Indeed, there are, on average, two children with asthma in every classroom.

A comment from a primary school PSHE co-ordinator highlights the need for all teachers to understand who is asthmatic in each class: “Recently on a school journey I found out the hard way that a child in my class was very asthmatic. I had no clue about it before and had to rush him to the hospital”.

Sometimes, no matter how careful a child is about taking their asthma medicines and avoiding their triggers, they may still have an asthma attack. A child is having an asthma attack if:

  • their reliever does not help symptoms
  • their symptoms are getting worse (cough, breathlessness, wheeze or tight chest)
  • they are too breathless to speak, eat or sleep.

What to do if a child has an asthma attack:

  • help them to take their reliever inhaler (usually blue) immediately. Use a spacer device if one is available
  • sit them down and ensure that any tight clothing is loosened. Do not let them lie down
  • if there is no immediate improvement during an attack, make sure they take one puff of their reliever inhaler every minute for five minutes or until symptoms improve
  • if their symptoms do not improve in five minutes, or if you are in doubt, call 999 or a doctor urgently
  • make sure they continue to take one puff of their reliever inhaler every minute until help arrives.

Further information

Jenny Parry is Children & Young People’s Development Manager at Asthma UK.

Asthma UK provides a pocket-sized Asthma Attack Card with guidance on what to do during and after an attack. Cards can be ordered, and free teaching resources downloaded, at:
www.asthma.org.uk

Article first published in SEN Magazine issue 45: March/April 2010.

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