Asthma

Asthma – key information

People with asthma have sensitive airways which react to triggers, causing a ‘flare-up’. In a flare-up, the muscles around the airway squeeze tight, the airway swells, becomes narrow and there is more mucus. This makes it harder to breathe. An asthma flare-up can come on slowly (over hours, days or even weeks) or very quickly (over minutes). A sudden or severe asthma flare-up is sometimes called an asthma attack.

Symptoms

Symptoms of asthma can vary over time and often vary from person to person. The most common asthma symptoms are:

• breathlessness
• wheezing (a whistling noise from the chest)
• tight feeling in the chest
• a persistent cough

Symptoms often occur at night, early in the morning or during/just after physical activity. If asthma is well controlled, a person should only have occasional asthma symptoms.

Triggers

A trigger is something that sets off or starts asthma symptoms. Everyone with asthma has different triggers. For most people with asthma, triggers are only a problem when asthma is not well controlled with medication. Common asthma triggers include:

• exercise
• colds/flu
• smoke — including cigarette smoke and wood smoke from:
  • open fires
  • burn-offs , or
  • bushfires
• weather changes such as thunderstorms and cold, dry air
• house dust mites
• moulds
• pollens
• animals such as cats and dogs
• chemicals such as household cleaning products
• deodorants — including:
  • perfumes
  • after-shaves
  • hair spray, and
  • aerosol deodorant sprays
• food chemicals/additives
• certain medications (including aspirin and anti-inflammatories)
• emotions such as stress and laughter

Epidemic Thunderstorm Asthma

Every year during grass pollen season there is an increase in asthma and hay fever symptoms.During this season there is also the chance of an epidemic thunderstorm asthma event. Epidemic thunderstorm asthma events are thought to be triggered by an uncommon combination of high grass pollen levels and a certain type of thunderstorm, resulting in large numbers of people developing asthma symptoms over a short period of time.

Those at increased risk of epidemic thunderstorm asthma include people with asthma, people with a past history of asthma, those with undiagnosed asthma (i.e. people who have asthma symptoms but have not yet been diagnosed with asthma) and also includes people with hay fever who may or may not have asthma. Having both asthma and hay fever, as well as poor control and self-management of asthma increases the risk further.

For more information, refer to the Better Health Channel.

Medication

Most students can control their asthma by taking medication. Asthma medication is normally:

• taken via a metered-dose inhaler (puffer) preferably in conjunction with a spacer device or via a breath-activated dry powder inhaler
• provided by the parents/carers or the student, and may be self-administered
• self-managed by the student at secondary level

Below is a description of the common forms of asthma medication.

Reliever

• provides relief from symptoms within minutes
• used in an asthma emergency
• should be easily accessible to students at all times
• is preferably carried by the student
• is normally blue or grey in colour
• includes common brands such as Ventolin, Bricanyl, Airomir and Asmol.

Note: Most relievers can be purchased from a pharmacy without a prescription - schools must have a letter of authorisation from the principal to purchase reliever medication for the school's Asthma Emergency Kits.

Preventer

• used on a regular basis to prevent asthma symptoms and reduce the frequency and severity of asthma attacks
• usually autumn or desert colours (brown, orange, rust or yellow)
• prescribed by a doctor

Combination preventer

• combines a preventer with a long acting reliever in the same device
• there are two common types of combination medications, Seretide and Symbicort
• for students aged 12 or over, Symbicort may be used in an asthma emergency if documented on the student's Asthma Action Plan
• usually white/red or purple in colour
• prescribed by a doctor

Important: Teachers should refer to the student’s Asthma Action Plan to determine how to this use medication in an asthma emergency.

Preventers and Combination Preventers should not be taken to school unless:

• the combination medication is Symbicort and has been prescribed as a reliever medication
• the student is attending a school camp or overnight excursion, and will be required to take the medication as prescribed, whilst in the care of the school

Types of asthma attacks

Below is a description of the symptoms of different types of asthma attacks. Symptoms will vary from student to student.

Mild/moderate attack

• may have a cough
• may have a wheeze
• minor difficulty in breathing
• able to talk in full sentences
• alert, able to walk/move around
• have normal skin colour

Severe attack

• cannot speak a full sentence in one breath
• obvious difficulty in breathing
• sitting hunched forward
• tugging in of skin over the chest and throat
• lethargic (children)
• sore tummy (young children)
• reliever medication is not lasting as long as usual

Life-threatening

• unable to speak, or 1-2 words per breath
• drowsy/confused
• collapsed, exhausted, unconscious
• wheeze and cough may be absent
• gasping for breath
• discolouration (turning blue)
• not responding to reliever medication