ALL SAINTS’ CATHOLIC SCHOOL, Mansfield ASTHMA Asthma is a condition that affects the airways, and thus breathing. Asthma does not have a cure, but much can be done to prevent the disabling chronic symptoms. Asthma can cause life threatening acute symptoms, which can be averted by prompt recognition of symptoms and immediate effective treatment. Asthma is a significant illness
• Currently 1 in 10 children suffer asthma in the UK • The number of children with asthma is increasing. • Asthma is a life threatening condition, and still kills 40 children a year. 1
Symptoms of asthma
• Shortness of breath • Difficulty in breathing • Wheezing • Inability to talk • Chest tightness / chest pain • Increasing cough • Decreasing consciousness
Treatment Asthma treatments can be divided into 2 groups 1. Relievers - improve symptoms during an attack or exacerbation
Bricanyl (Terbutaline) blue inhaler Salbutamol (Ventolin) blue inhaler
2. Preventers - help stop symptoms arriving. The common ones include:
Beclomethasone (Clenil Modulite) brown inhaler Budesonide (Pulmicort) brown inhaler Fluticasone (Flixotide) green inhaler Monteleukast (Singulair) tablet or granules
Inhalers come in different types, these include
• Multi dose inhaler (MDI) - the traditional “puffer” • Accuhalers – round devices • Turbohalers – tubular devices
In urgent situations an MDI should be used, and this should be given through a “Spacer” to insure maximum effect. After each puff – allow the student to take 6-8 breaths in before delivering a further puff. In severe asthma an MDI into the mouth may not be effective. Policy
1. All asthmatic children within the school should be identified and each class teacher should be aware of who they are. 2. All teachers and support staff should be familiar with the symptoms of asthma and the inhaler devices used in the treatment of asthma. 3. Asthmatic children should have easy access to their inhalers and should be encouraged to use them when necessary. Ideally, all children who suffer regular symptoms or who have had severe asthmatic attacks should have an MDI Salbutamol (or Bricanyl) inhaler with a Spacer kept in the General Office. This should be clearly labelled with the child’s name and tutor group. 4. Sports activities should be encouraged as normal, but asthmatic children may need to use their reliever inhaler before, during, or after the event. If asthmatic children get symptoms during an activity, they should be allowed to rest, and should use their Salbutamol or Bricanyl inhaler. They should be checked to make sure they have not deteriorated. Management of an exacerbation
Mild Slight breathlessness or wheeze, or increased cough eg with sport Stop exercise and rest Promote use of the reliever 1- 2 puffs Reassess to make sure they have improved If not go to moderate If improved consider returning to activity
Moderate Difficulty breathing, chest tightness, increasing shortness of breath and or wheeze Sit student down Stay calm, calm student Send for 1st aider at the office, and for their inhaler/spacer Give 6 puffs of Salbutamol MDI via the Spacer device Contact parents Reassess after 10 minutes to make sure improving. If improved at 30 minutes consider returning to class If not improving go to severe/life threatening Severe/Life threatening Marked difficulty breathing, student unable to speak in full sentences, student tiring or becoming drowsy This is an EMERGENCY Call 999 and contact 1st aider immediately Start Salbultamol via the spacer 10 puffs Salbutamol should be repeated if patient not improved whilst awaiting paramedics (It is impossible to overdose with this type of medication) Contact parents Accompany the child to hospital Remember, Asthma is a serious, and potentially life threatening illness, and should be regarded as so. Resources
1.Asthma UK. http://www.asthma.co.uk Medical conditions at school. http://www.medicalconditionsatschool.org.uk/ Teenage Health Freak (for students) http://www.teenagehealthfreak.org/ British Thoracic Society Guidelines Disclaimer
This advice has been provided to a variety of skilled and unskilled members of staff and therefore assessment of degrees of exacerbation by staff maybe variable. Staff should seek advice from the 1st aider on scene and should treat as severe/life threatening where there is doubt. Advice from the medical/paramedic teams overrides this advice. Policy agreed: 9 December 2009
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