22282VIC

Course in the Management of

Asthma Risks and Emergencies in

the Workplace

Online Workbook

Version 3 Jan 2015 Page 1

Reference Manual

Section 1

Asthma – What is Asthma?

You can help someone with Asthma

Asthma Facts:

Over 2 million Australians have asthma

1 in 10 Australians have asthma

Onset can occur at any age

Most common reason for hospital admissions in children under 12

On average more than one Australian dies every day from asthma

Makes it difficult for people to breathe

Asthma signs and symptoms vary from person to person

Asthma can be serious

Where does asthma occur?

Asthma is a condition of the airways in the lungs

Version 3 Jan 2015 Page 2

What is Asthma?

Asthma inflames the airways. During an asthma attack, the air passages

(airways) of the lungs become inflamed, swollen and narrowed. Thick

mucus may be produced and breathing becomes difficult. This leads to

coughing, wheezing and shortness of breath.

People with asthma have inflamed (red and swollen) airways which react

too easily to certain triggers. Asthma triggers are usually only a problem

when an individual’s asthma is not well controlled.

Triggers – Cause the airways to narrow and vary from

person to person

Exercise

Colds/Flu

Smoke

Weather changes

Dust and dust mites

Moulds

Pollens

Animals

Chemicals

Deodorants and perfumes

Foods and additives

Certain medications

Emotions

Version 3 Jan 2015 Page 3

Signs and Symptoms

Most Common: Other:

Breathlessness

Rapid Breathing

Difficulty talking

Wheezing

Behaviour changes

Distress and Anxiety

Tight Chest

Pale and sweaty

‘Sore tummy’ in young children

Persistent Cough

Sucking in of skin over chest and

throat

Blue Lips

Signs and symptoms vary from person to person

Linked Conditions

Hay Fever

60-80% of people with asthma

also have hay fever

Often triggered by pollen

Allergies

Range of reactions including eczema and food allergy

Anaphylaxis

Extreme allergic reactions (commonly to foods and bees)

Remember that an asthma attack can occur at any time without warning

Version 3 Jan 2015 Page 4

Section 2

Exercise Induced Asthma (EIA)

Major trigger for over 50% of people with asthma

Can occur during and after exercise

More likely if unwell or asthma is poorly managed

Minimised by use of regular preventer treatment

Exercise is the one asthma trigger NOT to be avoided

Managing Exercise Induced Asthma (EIA)

Before

During

After

Use reliever medication 5-20 minutes before

activity

If symptoms occur: Stop activity Take reliever

Return to activity only if symptom free

Cool down

Warm Up

If symptoms reoccur:

Take reliever Cease activity

Be alert for symptoms

Notify parents/carers of any incident

Version 3 Jan 2015 Page 5

Reliever medications

Used in asthma first aid

Blue / grey

Relaxes tight airway muscles

Works in minutes

Should be accessible

Can be used before exercise

Safe – CANNOT OVERDOSE

1. Mouthpiece cover 2. Expiry date 3. Metal canister 4. Plastic holder

Indicators of poor asthma control

Using reliever medication more than 3 times per week

Waking at night from asthma symptoms

During the day wheezing, breathless and difficulty breathing

Asthma interferes with daily activity

If you have poor asthma control a visit to your doctor to have you asthma reviewed is

recommended

Other medications

Preventers, symptom controllers, combination medications

Not for use is asthma first aid

Used for daily management of asthma

Variety of colours

Long acting

Prescribed medications – Only available on prescription from a

doctor

Older children (12 and over) may have Symbicort (a combination

medication) prescribed as both their reliever and preventer under strict

guidelines (SMART protocol)

Version 3 Jan 2015 Page 6

Spacers

Why use a spacer?

Recommended for everyone who uses a puffer (from 2 – 102)

Greatly increases medication reaching airways

Reduces medication deposited in the mouth and throat

Reduces the side effects of the reliever medication

Don’t need to coordinate pressing the puffer and breathing in at

the same time

Cleaning a personal spacer

New spacers and about every 4 weeks, wash in detergent and

warm water

Do not rinse. Allow to air dry

Reassemble the spacer correctly

Discard and replace if broken or contaminated with blood

Note: If a spacer is used from a community or asthma emergency kit the spacer

should be given to the individual or thrown away and replaced in the kit.

.

Version 3 Jan 2015 Page 7

Asthma management / Action Plans

Staff

Asthma First Aid Training

Familiar with students with asthma

Medication access for students

Equipment and Information

Asthma Emergency Kits

Asthma First Aid posters on display

Policy

For all on and off site activity

Regulations and guidelines

Asthma Action Plans / Asthma Care Plans

Version 3 Jan 2015 Page 8

Asthma action plan

Is developed in consultation with an individual’s doctor and is written

instructions to assist you manage your asthma. It should be followed

when your asthma is controlled, getting worse or you are having an

asthma attack.

Outlines management:

Daily medication regime even when well

How to know your asthma is getting worse

If symptoms get worse what you should do

Identifies known triggers

Explains medications use

Instructions if you have an asthma attach

Why have an action plan:

Reduces need to go to hospital

Improves lung function

Reduces time off work or school

Version 3 Jan 2015 Page 9

Asthma emergency kits

Must be accessible at all times

Ensure medication is in date

Kit Contents

Blue reliever puffer – in date

2 spacer devices

Instructions for Asthma First Aid

Medication record sheet

Legislation and Policy

In developing asthma management strategies and an asthma policy

consider:

Education and care services (see note below)

Legal and industrial responsibilities

Work Health and Safety

Amendments to the Education and Care Services National Regulations

came into effect on 1 September 2013 in all states and territories except

Western Australia. Education and Care Services National Regulations for

information on the Medical Conditions Policy

Version 3 Jan 2015 Page 10

Assessing the severity of an asthma attack

Mild

Moderate

Severe

Talk in sentences

Shortened sentences

Few words per breath

Cough

Persistent cough

Persistent cough

Soft wheeze

Loud wheeze

Wheeze may be absent

Some shortness of breath

Obvious difficulty

breathing

Severe difficulties

breathing

Tightness in chest

Tightness in chest

Pale, sweaty

Distressed and anxious

Young children ‘sore

tummy’

Young children ‘sore

tummy’

Blue lips

Sucking in of the throat and rib muscles

Version 3 Jan 2015 Page 11

Asthma – it’s about time!

With time being a critical factor, either:

Follow an individual’s Asthma Action Plan (only if known or easily

accessible)

or

Follow the nationally recognised Asthma First Aid procedure

Call emergency assistance immediately (DIAL 000)

If the person is not breathing

If the person’s asthma suddenly becomes worse, or is not improving

No blue reliever medication available

If you are not sure if it’s asthma

Asthma First Aid

Emergency Asthma First Aid procedures are suitable for anyone having an Asthma

Attack. It can be used for children and adults. It is commonly referred to as the 4 X

4 Asthma First Aid procedure.

Version 3 Jan 2015 Page 12

Step 1

Sit the person upright

Be calm and reassuring

Do not leave them alone

Step 2

Give 4 puffs of blue reliever puffer medication

Use a spacer if there is one

Shake puffer

Put 1 puff into spacer

Take 4 breaths from spacer

Repeat until 4 puffs have been taken

REMEMBER: SHAKE, 1 PUFF, 4 BREATHS

Step 3

If there is no improvement give 4 more puffs as above

Step 4

If there is still no improvement call emergency assistance (DIAL OOO)*

Say ‘ambulance’ and that someone is having an asthma attack

Keep giving 4 puffs every 4 minutes until emergency assistance

arrives

*If calling Triple Zero (000) does not work on your

mobile phone, try 112

Version 3 Jan 2015 Page 13

Identifying Asthma Equipment:

1. Face Mask

2. Blue Reliever Medication

3. Spacer