What is asthma?

Asthma is an inflammatory lung condition in which the airways become blocked or narrowed. It is often characterized by acute episodes or “attacks.”

What causes asthma?

• Airway muscle tightening (bronchospasm)

• Airway swelling (inflammation)

• Extra mucus secretions blocking airways

View images of the lungs and the impact asthma has on the respiratory system (PDF)

What can trigger these physical changes?

• Allergens such as pollen, animal dander, dust mites, cockroaches, mold, grasses

• Irritants such as strong odor or chemicals, cigarette smoke, wood smoke, cold air, indoor and outdoor pollutants

• Upper respiratory infections

• Physical exercise, especially with changes in weather- Students with asthma should self-pace their physicial activities and have access to medication if needed as prescribed by their physician.

• Ambient temperature changes (going from cold to hot or hot to cold)

• Strong emotions such as hard laughing or crying

Possible early warning signs of asthma:

• Decreased appetite

• Headache

• Behavior changes

• Fatigue

• Dark circles in eyes

• Grumpiness or irritability

• Agitation

• Complaint of funny feeling in the chest

• Stomachache

• Drop in peak flow meter to yellow or red zone

• Coughing

• Stuffy or runny nose

How will I know if a student is experiencing an asthma attack - what might I see?

• Constant Cough
• Difficulty breathing with struggling or gasping for breath, stooped body posture, chest and neck pulled in with breathing
• Trouble walking or talking
• Stops playing and can’t start activity again
• Lips and fingernails are gray or blue (children with light complexion)
• Audible wheezing with breathing
• No improvement 15-20 minutes after initial treatment with medication

What should I do for severe symptoms?

n CALL 911- never hesitate to call for medical help!

n CALL PARENT/GUARDIAN

n Start medication if prescribed and available if you haven’t already (some students have inhalers, nebulizers and/or Epipen's available on campus in the main office or on their person for severe symptoms.)

n Separate child from known trigger if possible

n Never send a child with asthma symptoms anywhere alone

What should I do for less severe symptoms?

• Assist student with medication administration- Instructions on how to use an inhaler effectively

• Accompany to office if needed

• Encourage student to pre-medicate for known trigger exposure as prescribed (such as P.E.)

• Provide accommodations as needed during times of asthma flare-ups.

• Limit exposure to known triggers if possible

Medications commonly used for asthma:

n Metered dose inhalers both long acting and short acting or “rescue” drugs

n Inhaled steroids

n Nebulizer treatments

n Oral steroid medication

These can often have side effects that may impact a students ability to perform in the classroom.

Can students carry their medication at school?

n Yes, but they must have an authorization to do so on file in the office signed by their health care provider and parent/guardian.

n Student must agree to contract for self-administration of medication.

• Medication may also be stored in the office for staff administration with proper health care provider authorization form signed. Often a younger student may store their medication in the main office on campus for easy access especially at times when the classroom is at recess or under the supervision of a specialist i.e.: PE, Music, Library. If a supervising staff member is taking the student off campus for reasons such as a field trip, the supervising staff member is responsible to carry the medication and supervise the student at all times even during transportation to and from the event. The only exception would be if the child's parent was a volunteer chaperone and was responsible for medical management of his/her own child during the time away from campus.

• Other situational considerations: bus transportation to and from school with possible self-administration orders and access to medication for an asthma attack while en route.

Asthma can impact a students quality of life by:

n Restricting participation in activities

n Increasing fatigue due to lack of sleep and medication side effects

n Missed class time due to illness/treatment

n Interfere with performance, concentration and memory

n Lead to hospitalization or in severe cases, death.

Student’s with asthma may qualify for assistance:

n Home and hospital tutoring

n 504 accommodation plan

n Individualized emergency health plan

n IEP

n Please contact your school nurse or counselor if you have concerns about a student with asthma

Educational Implications of asthma may include:

Frequent nighttime symptoms (coughing and respiratory distress) may result in loss of sleep and subsequent fatigue in school. Sometimes these symptoms are related to allergies, changes in the weather, stress, exercise and fatigue. Treatment includes oral and inhaled medications, some of which primarily manage acute problems and others, which prevent the development of symptoms. Potential risk factors for academic impairment include medication side effects, increased school absenteeism, and possible limitations in physical activity. Another risk factor can be neurological insults (i.e.: brain hypoxia) resulting from respiratory crises and decreased ability to breathe, thus a decrease of oxygen in the blood.

Oral steroids may increase anxiety and depression as well as interfere with short-term memory. Patients on steroids may experience agitation and confusion or display overtly psychotic behavior. Traditional antihistamines may cause drowsiness and impair school performance. The secondary effects of having asthma on academic performance are consistent with the general findings on chronic illness and can be highly influenced by concomitant risk factors such as poverty, family dysfunction, and preexisting psychological problems.

What about allergies and the impact they have on a student and learning?

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