Asthma medication which often recur

>> [narrator]: during the school year, students spend most of their wakeful hours in school. for many students with chronic health conditions, including asthma, schools play an important role in the overall management of their condition. this role is two fold; the first is to support the student in managing their asthma independently and the second is having the knowledge and confidence to respond to asthma situations. at school, students learn lifelong skills and it is where students with asthma, in particular, start to take responsibility for the management of their condition however, students with asthma still need the support of principals,teachers,

support staff and volunteers in order to assume increasing responsibility for managing their asthma. creating an asthma friendly school with supportive, knowledgeable staff is vital in allowing students to feel confident to take control of their asthma. this dvd will give you the information to support you in this role by: â· providing you with a basic understanding of asthma. â· alerting you to the symptoms of worsening asthma or an asthma episode. â· preparing you to help studentsmanage worsening asthma. â· and providing you with asthma resources that will help support your role. although this dvd was created to respond to the needs identified in elementary

schools and the scenarios reflect this, the content is generic and can be applied to a secondary school setting. >>[dr.lisa cicutto, certifed asthma educator]: asthma is a chronic condition that affects the airways or breathing tubes of the lungs. as many as 1 in 5 ontario students are affected by asthma making it the most common chronic disease. because asthma symptoms come and go, it is often dismissed as not very serious by students with asthma, their parents or guardians and school staff. in fact,asthma is a leading cause of school absenteeism, hospitalizations and emergency department visits. although very rare, asthma can be lifethreatening.

everyday in canada, someone dies from their asthma. students who have both asthmaand anaphylaxis are at a much greater risk of dying from their conditions. these conditions are preventable with proper management and education. >> [vice-principal]: as a vice principal at the school i support my students withasthma by doing a few things. one of them is to identify a process to identify our. what i mean by that is we send home newsletter inserts sometimes we send home specific letters and definitely asthma managementforms and medication use forms so that the parents can then return those forms to us and then we can proceed.

we provide our teachers with annually with updatedstudent asthma lists and information on how to use the inhalers. we do encourage student to carry their inhalers on them especially in cases wherethey need to use them prior to gym class for example. what we also like to do is provide opportunities for our students, our staff and our parents to gain a general understanding of asthma. and so what we do is we have divisional assemblies or in-services or parent nights or displays throughout the school to help inform the larger community. and finally we provide asthma education for our students that usually is a six week process where our public health nurses supports us in providing asthma

information to our students and that is usually done over the lunch period. i would tell other principals that creating an asthma friendly school is really not a big deal. at our school and in our school board we have a policy already in place and that is along side anaphylaxis protocol. asthma and anaphylaxis commonly coexist so when we have these in place it is very helpful in managing asthma in schools. >> [narrator]: children withasthma have sensitive airways in their lungs. when they are exposed to certain triggers, such as colds or flu viruses, physical activity, allergens or irritants the airways narrow making it hard to breathe

three main changes cause the airways to narrow: inside the airway, the lining becomes red and swollen and extra mucus production causes the blockage of the airways. outside the airways, the musclestighten around and squeeze the airways. these airway changes often lead to the development of asthma symptoms. there are 4 common symptoms for asthma: coughing, chest tightness, difficulty breathing,

and wheezing, which is a whistling sound inside the chest. children with asthma may experience one or more of these symptoms. coughing may be the first symptom recognized in schools because it can be very disruptive to a class. a common response to coughing is to send the student for a drink of water. this is not helpful in relievingthe symptoms, and may in fact delay the student from getting their reliever medication. using their reliever medication is an important step in relieving asthma symptoms. >> [student 1]: well i know when my asthma is getting worse because i cough more and i cough really hard.

i ask my teacher if i can take my puffer and then i feel much better after. >> [student 2]: i know when my asthma is getting worse because i cough more and have trouble breathing. it also feels like someone is sitting on my chest. >> [narrator]: children with asthma have more sensitive airways to things in the environment that typically don't cause problems for children without asthma. these are called “triggers” because they trigger asthma symptoms. every student■s asthma is different. not all students will have the same triggers, nor will they react to every trigger discussed in this dvd. the most common triggers are colds or viruses, physical activity and cold air

we will talk more about physical activity as a trigger later in the dvd. most triggers can be divided into 2 groups: allergic and non-allergic. allergic triggers are things like tree and grass pollen, animal dander, dust mites, housedust, mould, and some foods. non-allergic triggers are thingslike smoke, cold air, strong smells and smog. some triggers are more commonly found in and around schools. these include chalk dust; marker and crayon scents; paints and glues; musty and dusty gym mats, carpets and drapes; or exhaust fumes from idling cars and school buses. triggers are unique to every student. helping students to avoid or limitexposure to their triggers is one way to

prevent asthma symptoms from developing. >>[teacher]: as a classroom teacher it is important to know what triggers are in environment that the student with asthma will be working in. it is important that those triggers be eliminated whenever possible or in the event they cant be eliminated that the student be removed from the area where where the triggers might be to the extent that it is possible. students going outside for recess may experience triggers simply related to atmospheric conditions. they need to be prepped ahead of time,make sure that they are aware of where there puffer is that it is with them.

support staff that are on duty supervising need to know what students have this condition and what to do about it and where medication is. >>[narrator]: one of the most common triggers of asthma in children is physical activity. physical activity at school may include daily physical activity phys-ed class, recess, intramurals or interschool athletics. >>[teacher]: so when preparing my students for gym class or for a dpa activity i make sure that these students have an inhaler with them and if needed they can can take it beforehand. i also try to ensure a proper warm up and with that if i know that exercise is an asthma trigger i can manage the activity more properly.

during an activity, some things that i look for are worsening asthma signs for example coughing wheezing shortness of breath, taking frequent breaks to catch their breath. it is important to recognize asthma and to know the procedures to take if an attack should occur. and it is important to communicate with the student and so with that have them feel more comfortable to talk to me to be able to come up to me and let me know if there are pre existing symptoms and they will be allowed to sit out then. >>[narrator]: exercise-induced asthma may occur during vigorous exercise or following cessation of physical activity. it is more common when activities areperformed in hot, cold or humid weather, when air quality is poor, or when the student has a cold or flu.

a student should not be discouraged because an activity may induce asthma symptoms. all students need to be physicallyactive, including those with asthma. however, physical activity should not beforced if the student knows that some distres is likely to occur. there are several strategies you can use to encourage students with exercise-induced asthma to participate in physical activity to the best of their abilities. these include: encouraging the use of their reliever medication 10-15 minutes prior to physical activity, if directed by a health care provider. this can prevent the onset of symptoms such as coughing, wheezing, chest tightness and difficulty breathing.

providing a gradual warm up and cool down. and allowing easy access to their reliever medication throughout the activity. a student who is experiencing asthma symptoms before physical activity should not begin the activity. they need to take their reliever medication, and then sit and rest until their breathing improves. if symptoms develop during physical activity, the student should: stop the activity. sit and rest. and take their reliever medication.

symptoms should improve within 5-10 minutes of taking their reliever medication. >> well i usually tell the teacher and take my puffer and after that i just rest for awhile and see what happens. student: i am feeling better. >> [teacher]: are you feeling better, then you can join us. >>[narrator]: once symptoms have improved, the student can then resume the activity. if you have concerns about a student with asthma who is having ongoing difficulties participating in regular activity, it is important to communicate with the parentor guardian of the student. this may indicate that theirasthma is not properly controlled and medical follow up is needed. >>[teacher]: teacher: it is very important for all students to participate

in physical activities even though they have asthma. physical activities strength the lungs andstrengths the body and makes sure that the student is better prepared for physical activities in the future. and with the proper support and understanding every student can participate fully in all activities. physical activity is good for everyone. it helps to provide opportunities for students to experience the positive benefits of both their health and their learning. there are certain symptoms that you will notice if a student's asthma is getting worse. they may experience one or more of these symptoms:

continual coughing, [coughing sound] fast, shallow breathing, wheezing, which is not always heard, and increased reliever medication use. any of these symptoms may be accompanied by restlessness, irritability and fatigue. when symptoms occur, students should be encouraged to use the reliever medication and take slow, deep breaths. usually symptoms will disappear within 5-10 minutes of using the reliever

medication and the student can return to regular activities. it is important to notify the parent or guardian that an episode ocurred so they can monitor the asthma at home and follow up with a health care provider if necessary. some asthma episodes are more severe than others. a student is having a severe asthma episode if there is no improvement in a studentâ– s breathing within 5-10 minutes of taking their reliever medication or if these symptoms are present: lips or fingernails become blue or gray breathing is very difficult and fast

the student can only say 3-5 words between breaths breathing involves the whole ribcage and neck muscles tighten with each breath the student appears very anxious or agitated this is an emergency and you should: call 911. inform the attendant that the call is for asthma and that an inhaler has been given but is not providing relief. >>[vice principal]: it is not getting any better. is there anything i can do right now? >>[teacher]: yes please, have the secretary call 911. >>[vice-principal]: yes i will do that right away. excuse me liz. i need you to call 911 immediately. let them know that we have

a student here who is having an asthma attack. >>[liz]: ok>>[vice principal]: thank you [dialing 911] >>[narrator]: have the student sit up with their arms resting on a table.give their reliever medication immediately. continue to give their reliever medication every few minutes until help arrives. >>[teacher]: are you still having a hard time breathing? [student coughing - nods]teacher: ok let's take a dose >>[narrator]: it is important to wait for emergency medical personnel do not drive to the hospital.

remain calm and stay with the student. there are 2 main types of asthma medications: controllers and relievers. controller medications, which can be orange, purple, green or brown in colour, are typically used at home every day, in the morning and evening. they work slowly and can take days to several weeks to work. controller medications are not designed to work fast enough to relieve symptoms during an asthma episode. for this reason, controller medications very rarely need to be kept at school. reliever medications, which are usually blue in colour, provide quick relief of asthma symptoms by opening up the airways.

relievers work within 5-10 minutes to make breathing easier. it is very important for students to have easy access to their reliever medication throughout the school day, including when off-site on school outings. you play a critical role in supporting students to access their asthma medication. most students 7 years of age andolder, are capable of learning how and when to use their reliever medication. it is very important that school staff support these students in getting and using their reliever medication when needed. it takes only minutes for the airways to narrow enough to cause severe breathing difficulties. some students may be unable to use their reliever medication on their own and may require assistance from you.

for this reason, a brief overview of asthma medications and how to use them will now be provided. reliever asthma medications come in two devices: a metered dose inhaler, or mdi, is a device that delivers the medication in the form of an aerosol spray. it sprays a cloud of medication when pressed. and these are often called puffers. a dry powder inhaler, or dpi, does not have a spray but relies on breathing in forcefully enough to deliver a powder of medication to the lungs. the most common device seen in schools is the mdi. students using a metered dose inhaler should also use a spacer, which is a

holding chamber that makes the mdi easier to use and increases the amount of medicine reaching the lungs. the steps involved when using an mdi with a spacer include: remove the covers of the inhaler and the spacer shake the inhaler well attach the inhaler and the spacer breathe out through the mouth to empty the lungs place the spacer in the mouth press down on the inhaler to provide a dose of medication breathe in slowly and deeply

hold breath for a slow count of 10 and breathe out the main difference when using a dry powder inhaler is the way the student inhales. it should be done quickly and forcefully. it is important to have written instructions from the parent or guardian regarding what medications are needed at school. asthma medications are life saving medications, similar to the epi pen for anaphylaxis, and should therefore be treated similarly. ideally, students with asthma should carry their medication with them for easiest access.

school staff play an important role in helping students with asthma manage their condition at school. schools are critical partners in communicating with parents or guardians about their child's asthma. you are often the first to notice symptoms starting, and the first to respond when breathing difficulties occur. if properly managed at home and fully supported at school, asthma should not interfere with a student's attendance, performance or participation in school activities. as a school staff member it is important for you to: know which students have asthma

know their triggers and how to reduce exposure to them encourage physical activity provide easy access to reliever medication recognize symptoms of worsening asthma and know how to take appropriate action during an asthma episode together with parents or guardians, health care providers, community agencies and the students themselves,â– every school can become an asthma friendly environment, supporting students with asthma to leadfull, active and healthy lives. >>[student 1]: it used to make me feel scared or embarrassed but now that the

school knows i have asthma i am having a better experience. my classmates they know that i have asthma and so they know what to do, what my puffer looks like and when i am having an asthma attack they will come and help me. and asthma is now not a big deal and is not horrible. >>[student 2]: it makes me feel sort of anxious because i am coughing so hard it is hard for me to breathe. my friends ask me do you want me to get a teacher, because now that they know that i have asthma they understand. and i feel better after because they tell the teacher and the teacher says that i can take my puffer and then i feel much better after i take it.

>>[narrator]: for more information on the wide variety of support materials available to educators regarding asthma management and prevention in schools visit:www.ophea.net and www.asthmainschools.com. additional web-based and print resources to support the management of asthma are available from: the lung associationat www.on.lung.ca and the the asthma society of cawww.asthma.ca to speak to a certified asthma educator, please contact the lung association's asthma action helpline at 1-888-344-lung or the asthma society's asthma support line at 1-866-787- 4050.