Limestone Learning Foundation
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Health Issues Handbook - Asthma

This handbook is an official guideline issued under AP-140, Safe Environments of the Limestone District School Board

Table of Contents


What Is It?

Asthma is a common respiratory condition which affects people of all ages. It is the most common disease of childhood. In Canada, about 15% of children have asthma. The incidence and mortality rates of asthma are increasing worldwide. At present, there is no known cure for asthma, but understanding how asthma affects the lungs and controlling asthma symptoms can improve the quality of life.

People with asthma have extra sensitive airways. Three things happen to the respiratory system during an asthma attack: the muscles around the bronchi (air tubes) tighten; the inner linings of the bronchi swell; and an excessive amount of mucus is produced. As a result, it is difficult for the child with asthma to breathe.

Many children with asthma have a relatively mild form, which is fairly easily controlled. Other children with moderate or severe asthma may exhibit more symptoms, including dry cough, wheezing and difficulty breathing. On occasion, any asthmatic child may experience severe breathing difficulty. Such episodes should be regarded as emergencies requiring immediate treatment.


Causes of asthma differ from person to person. Asthma triggers are the things that cause asthma symptoms. Common triggers include:
  • allergic reactions
  • the most common allergens are house dust, pollen, mold, animal dander, latex, feathers and foods
  • respiratory infections and colds
  • exercise;‚ air pollution, fumes, chemical odours or other strong odours
  • cigarette smoke
  • exposure to cold, windy or humid air, or sudden temperature changes
  • fatigue, excitement or stress.

Management and Prevention

Medications play a vital role in the management of asthma.

The two types are:

  • Relievers or short acting bronchodilators (commonly known as inhalers), are used for quick relief. They open the airways and make breathing easier by reversing airway spasms (i.e. Ventolin, Bricanyl);
  • Preventers/Controllers are used to keep the disease under control by preventing the development of symptoms (i.e. corticosteroid, anti-allergic, and anti-leukotriene).
As well, the following preventative guidelines for school staff may be helpful:
  • do not keep furry animals or birds in the classroom;
  • if a child is very allergic to specific animals, he or she should not sit next to a child with that type of pet at home;
  • do not ask the child to clean chalk-filled rags or brushes;
  • if a child is allergic to pollen, do not sit him or her next to an open window in the spring or fall;
  • regularly clean and air: gym mats; shoes; lockers; classroom carpeting; and old library books, since they are often loaded with dust and mold;
  • be aware that strong odours from cosmetics, perfume, chemicals, cleaning fluids and art supplies may be irritating;
  • if possible try to make sure the child does not sit next to someone with a respiratory infection;
  • give the child the option of spending recess indoors on a very cold, humid or windy day;
  • provide the child with a normal classroom experience: treat the child as you would any other child; encourage the child to participate in activities within his or her limits; do not regard the child as ill or isolate the child.
If the child is on medication, the principal is required to follow the Policy and Procedures of the Board, including the completion of all forms related to AP-314, Administration of Medication and/or Medical Procedures to Students. The above documentation will assist the school in developing the Emergency Medical Alert Form included at the end of this section.

Emergency Treatment

In case of breathing difficulty:
  • have the child stop activity;
  • take the child to as private an area as possible;
  • encourage the child to take reliever medications that may have been prescribed for use during breathing difficulty;
  • have the child assume an upright position, with shoulders relaxed;
  • talk to the child reassuringly and calmly. His or her anxiety can be lessened if you are in control;‚ if the medication does not seem to be helping, or if the child’s condition is continuing to deteriorate, then follow this emergency treatment plan:
Severe Asthma Signs
  • obvious shortness of breath
  • heavy wheezing
  • chest indentation/stomach distention
  • persistent cough
  • difficulty talking (less than 8 words)
  • sweating unrelated to fever or air temperature
  • blue lips and/or nails
  • extreme paleness with shallow breathing
  • need to sit upright and forward
  • accelerated breathing
  • obvious discomfort
  • signs of fatigue
  • agitation
  • confusion
Severe Asthma Emergency Treatment
  • administer inhaled reliever medication
  • repeat the inhaled reliever medication if no improvement in 3-5 minutes
  • go immediately to the emergency department of the closest hospital. If quickly available, consider ambulance transport for access to oxygen
  • take reliever medication along and use every 15-20 minutes if necessary, until arrival at the hospital
  • if medication is not available, call parent and go to the emergency department immediately

Guidelines for Physical Education and Sports

  • The student should use pre-exercise medication if exercise regularly causes asthma (exercise induced asthma).
  • If a student has obvious wheezing, persistent dry cough, or breathing difficulty in spite of pre-medication, exercise will be hazardous and should be avoided. A recent cold or sore throat or a recent asthma attack increases the risk of exercise induced asthma.
  • Warm-up prior to vigorous activity should be progressive.
  • Exercise in cold or humid temperatures can be a significant trigger for asthma.
  • Students should exercise along with the rest of the class. If coughing, wheezing or chest tightness develops, the student should stop and treat if necessary with medication.
  • The frequency of exercise should be the same as for the rest of the class.
  • The intensity of exercise should start at a low level and gradually increase to develop exercises tolerance. This will vary greatly among students with asthma and from day to day in the same student.
  • Should a student become wheezy during exercise, stop the activity and treat if necessary with medication.
  • Cool down. Avoid stopping the exercise abruptly. Follow the usual "cool down" procedure.


  • All About Asthma - What Teachers, Coaches and Caregivers Need To Know -The Lung Association
  • The Asthma Handbook - The Lung Association
  • Asthma - Take a Look at Facts About Your Lungs - The Lung Association
  • The Lung Association's Asthma Action Helpline 1-800-668-7682
  • What You Should Know About Asthma - Asthma Society of Canada
  • Asthma and Exercise - Asthma Society of Canada
  • Asthma InfoLine - Asthma Society of Canada 1-800-787-3880
  • Asthma Society of Canada website -

The Lung Association
105-797 Princess Street
Kingston, Ontario
Tel: 613-545-3462

Asthma Society of Canada
425-130 Bridgeland Avenue,
Toronto, Ontario
M6A 1Z4
Tel: 416-787-4050
Fax: 416-787-5807

The Limestone District School Board is situated on traditional territories of the Anishinaabe & Haudenosaunee.