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A Study Guide on Children's Health
Unit 1: Asthma
How will this unit help me?
This unit will:
raise your awareness of the main features and symptoms of asthma; enable you to identify strategies to support young people with asthma in schools.
On completion of this unit, you will be able to: identify the main signs and symptoms of asthma; identify the range of treatments available to young people; assess ways of responding to an asthma attack; evaluate the support and information resources available.
Setting the scene
What is asthma? The word 'asthma' is derived from the Greek word azein meaning 'to breathe hard'. Asthma is a condition that affects the airways, the small tubes which carry air to and from the lungs. In people with asthma, these airways are sensitive and can develop reactions to a range of triggers which irritate the airways and cause the symptoms of asthma to appear. The symptoms of asthma include coughing, wheezing, being short of breath and a tight chest.
What are the triggers? Triggers can be anything that irritates the airways and provokes the symptoms of asthma to appear. Each person's asthma is different and people have their own triggers. Common ones include: colds and flu, cigarette smoke, pollen, house-dust mites, furry or feathery pets, stress, exercise and laughter.
What happens? The airways do three things:
- muscles around the tubes constrict, making the airway narrow;
- the airway lining starts to swell and become inflamed;
- the lining secretes a sticky mucus.
The combination of these three changes results in the tubes becoming narrower, making it difficult to breathe normally. Asthma symptoms such as coughing, wheezing, tightness in the chest and shortness of breath appear; this is an asthma attack. Children have commented:
It feels like someone is standing on my lungs.
It feels like I am being squashed.
When I am having an episode it feels like a rope is being slowly tightened around my chest.
(The National Asthma Campaign Blue Peter Asthma Survey, 1995)
Developing your understanding
I didn't know that!
Activity 1:
The following short quiz is devised to enable you to learn a little more about asthma and how it affects young people. Each question has three answers; your task is to identify the correct one by ticking the appropriate box. The correct answers are provided at the end of the unit.
1. The number of people currently receiving treatment for asthma in the United
Kingdom is estimated as:
a) 1.5 million |  | b) 2.6 million |  | c) 5.1 million |  |
2. The proportion of children estimated to have asthma in the UK is:
a) one in 15 |  | b) one in 8 |  | c) one in 4 |  |
3.The inhaler to be used in the event of asthma symptoms appearing is:
4. A spacer is:
a) a device which makes metered dose (spray) inhalers easier to use |  |
b) a device to give children more space around them |  |
c) a device to help children take tablets |  |
5. Should a child with asthma take part in sport?
a) yes |  | b) no) |  | c) don't know |  |
Activity 2:
Avoiding triggers
This is an activity you can complete on your own, with a partner or in a small group. The picture below highlights some of the triggers that can make people experience asthma symptoms or lead to an asthma attack.
For each of the triggers you see, list some things you could do to avoid setting it off. You can compare your ideas with the list of suggestions provided at the end of the unit.
Trigger How to reduce risk or avoid trigger:
Example: Tobacco No smoking in the home where someone has asthma; Avoid smoky pubs/smoke clubs;
What would you do?
Consider the following two situations and the related questions. You may find it helpful to discuss them with a partner or in a small group. Once you have shared your views read the commentary at the end of the unit.
Situation1
During the lunch break, you are passing through the school playground. A boy aged nine runs up to you and tells you that his friend is having an asthma attack. The boys are not in your class.
What is your immediate response?
In what way can you help the young person?
Situation 2
There are three children with asthma in your class. Each has a reliever inhaler which they keep in their bag. One day, you come in after the break and find that a child without asthma has taken an inhaler out of a bag and taken a puff from it
What is your immediate response?
What further action should you take?
Want to know more?
These are considered useful background reading and references for students involved in initial teacher education. They are not intended as recommendations for classroom use.
http://www.asthma.org.uk
The National Asthma Campaign web site
http://www.srs.org.uk
The Scottish Respiratory Site provides links to a large number of sites and a range of resources.
Asthma Helpline: 08457 010203
Living with asthma raises all sorts of questions and concerns. Call the Asthma Helpline for help and advice from asthma nurses who have the time to listen to concerns and discuss what is right for you, in confidence.
For the price of a local call they give independent, up-to-date advice- no matter how small the query might seem.
The Asthma Helpline: 0845 7 01 02 03. Monday to Friday 9am to 7pm.
National Asthma Campaign Scotland
2a North Charlotte Street
Edinburgh EH2 4HR
Tel: 0131 226 2544
Fax: 0131 226 2401
National Asthma Campaign (1998) School Pack. London: NAC
Irvine, S. (1997) A Guide to Child Health in the Primary School. Edinburgh: Health Education Board for Scotland.
National Asthma Campaign (1999) Asthma at school. London:NAC
A booklet aimed at parents, teachers and older children available from the NAC web site.
National Asthma Campaign (1998) School Pack. London: NAC This pack provides everything a school could need to help it develop a good asthma policy.
Answers :
Activity 1: I didn't know that!
1c The National Asthma Campaign estimates that 5.1 million people in the UK are currently receiving treatment for asthma.
2b The National Asthma Campaign estimates that 1.4 million children in the UK have asthma: this is approximately 1 in every 8 children.
3b The reliever helps to relieve breathing difficulties as they happen. (Aerosol inhalers or 'puffers' release measured doses of medication in a fine mist, which is breathed in. Reliever inhalers: these are normally blue and should be taken immediately asthma symptoms appear. they relax the muscles in the airways, allowing the airways to widen and ease breathing. Preventer inhalers vary in colour, including brown, white, red and orange. These are taken each day and work by calming the airways, thus stopping them from swelling; they also stop the extra phlegm or mucus developing.)
4a The spacer is a large clear plastic "bubble-shaped" device which is attached to the inhaler and helps children to breathe in the medication straight down into the lungs. Spacers are useful for young children and those with severe asthma.
5a If the asthma is under control, then the child should be able to join in any kind of exercise or sport. A child with asthma should take his reliever inhaler as directed by his doctor before exercise, if required. Swimming is a particularly good form of exercise for children with asthma.
How did you get on?
You may wish to find out more about asthma or about the National Asthma Campaign. A visit to their website will be helpful: http://www.asthma.org.uk
Also, the American Lung Association has a good information site at: http://www.lungusa.org/asthma/
Activity 2: Avoiding triggers
Tobacco smoke:
No smoking in the home where someone has asthma; avoid smoky pubs clubs.
Dust from furniture, carpets:
House dust mite droppings is a common trigger. Dust all surfaces with a damp cloth; avoid using woollen blankets; use short-pile, synthetic carpeting, linoleum, tiles or wooden floor; keep house well-ventilated.
Furry animals:
Pets are not advisable if someone has asthma. Pets should be bathed weekly; do not allow them in the sitting room or bedroom.
Having a cold or flu:
A healthy diet, i.e. including plenty of fruit and vegetables, and regular exercise are important. A flu vaccination is sometimes advised for people with asthma; preventer inhalers should be used according to medical advice.
Long grass and flowers:
If the pollen count is high, keep windows closed; avoid long grass.
Wet clothes:
Avoid hanging wet clothes inside; prevent condensation by opening windows on good days.
Exercise:
Exercise is good for people with asthma if they have it under control; avoid exercising on cold days and warm up sufficiently before any exercise class.
Food:
Some foods can cause symptoms to appear. The most common are dairy produce, shellfish, fish, yeast and nuts. People with asthma may find that keeping a detailed food diary can help to identify trigger foods. A parent/ health professional may wish to consider referral to a dietician or allergy clinic.
Commentary:
What would you do? Situation 1
This incident has taken place in the playground. Your first priority is to safeguard the child but at the same time, provide reassurance. You must remain calm as attacks can be very frightening:
- Ensure the child is sitting upright in a safe and comfortable position with as much privacy as possible.
- Check if the child has a reliever inhaler; this is normally blue and should be taken immediately. It will open up the air passages and allow the child to breathe more easily.
- Provide comfort to the child but do not put your arm around the child's shoulders as this can be restrictive.
- Talk calmly to the child, encouraging slow and deep breathing. Children know what a comfortable position for them is: it may be sitting upright or leaning forward a little. Do not have the child lying down.
- Ensure that tight clothing is loosened.
Once the child has recovered a little, offer a drink of water. As soon as the child feels better, allow a return to normal class activities. If the reliever has no effect after five minutes and the child is becoming increasingly distressed and/or exhausted, you should arrange to call an ambulance or doctor. (The school will have agreed procedures for such an incident and normally such decisions will be made by the head teacher.) In addition, school procedures may suggest that parents are informed of the attack; try to identify what the trigger was so that parents can be fully appraised of the situation and that a similar event can be avoided.
Many children are open about having asthma and it is often discussed in a normal way in class; nevertheless, having an attack in the playground can be embarrassing. As you deal with the casualty, ask another child to go and tell another teacher or responsible adult who can ensure that the other children are cared for. You may wish to discuss the incident with the other pupils as soon as possible if you feel they are distressed or worried.
Situation 2
- Remain calm: the medicine in relievers (Salbutamol, sold as "Ventolin" or Terbutaline, sold as "Bricanyl") is not normally dangerous. However, if the child is showing any signs of distress then encourage slow and deep breathing.
- Check what the child has used; it is unlikely to be harmful but if a number of doses have been inhaled, there may be increased heart rate.
- If there is concern about the child's well-being, follow agreed procedures for contacting the doctor or ambulance service, and for informing parents.
- Once recovered, you should ensure that the child (and the class) is aware of the risk in using someone else's medicine; open discussion about the specific use of inhalers could be incorporated into health education work.
What you can do to help
- Most schools will have a written policy about handling children's medicines. Ensure you obtain a copy and familiarise yourself with it.
- Parents will often give the class teacher a reliever inhaler to keep in class. Make sure that each one is clearly labelled with the child's name.
- Know your children. Find out which ones have asthma and compile an asthma register. Most children will carry their own inhaler and only in exceptional circumstances, e.g. a very young child or some children with special needs, would this not be the case.
- Ensure that at times when they may need the inhaler, e.g. during physical education classes, that it is accessible.
- Avoid triggers in the classroom, e.g. furry pets, excessive dust, strong smells and very cold air. Be aware that chemicals from science and art classes may act as triggers.
- Consider introducing asthma as part of a health education topic which focuses on medicines. Children with asthma may be willing to contribute their experiences, thus removing uncertainty and concern about asthma.
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