About Asthma
Asthma is a long-term lung condition that causes the airways to become inflamed, narrowed and sometimes filled with mucus, making breathing difficult.
Asthma is one of the most common medical conditions in UK schools. Approximately one in eleven children in the UK are living with asthma. With the right support and a well-managed Individual Healthcare Plan (IHP), most pupils with asthma can participate fully in school life, including physical education and outdoor activities.
Since 2014, schools in England have been permitted to hold emergency salbutamol inhalers for use when a pupil's own inhaler is unavailable or not working. Guidance on this provision is published by the Department of Health and Social Care.
Common Triggers
Triggers vary between individuals and should be recorded in the pupil's IHP. Common triggers include:
- Colds and viral infections (the most common trigger in children)
- Exercise, particularly in cold or dry air
- Pollen (grass, tree and weed pollen)
- House dust mites
- Animal fur or dander
- Air pollution and cigarette smoke
- Changes in weather or temperature
- Stress, excitement or strong emotions
- Mould spores
- Certain chemicals, cleaning products or strong fumes
Recognising an Asthma Attack
According to Asthma + Lung UK guidance, key warning signs include:
- Persistent coughing
- Wheezing (a whistling sound when breathing)
- Shortness of breath or difficulty breathing
- Tightness in the chest (younger children may describe a "tummy ache")
- Difficulty speaking in full sentences
- Becoming unusually quiet
- Looking pale, grey or blue around the lips or fingernails (a sign of severe attack)
- Keep calm and reassure the child
- Help the child to sit upright; do not lie them down
- Give one puff of the reliever inhaler (usually blue) through a spacer if available
- Wait 30 to 60 seconds
- Give another puff, up to a maximum of 10 puffs
- If symptoms do not improve after 10 puffs, or if the child is distressed or unable to speak, call 999
- If the ambulance has not arrived after 15 minutes, repeat the cycle of 10 puffs
- Stay with the child until help arrives
Understanding Asthma Medication
| Type | Purpose | Details |
|---|---|---|
| Reliever (usually blue) | Quick relief during an attack | Opens the airways rapidly. Should always be accessible. Used when symptoms occur or before exercise if advised. |
| Preventer (usually brown, orange or purple) | Reduces inflammation over time | Taken daily as prescribed. Reduces the likelihood of attacks. Usually taken at home, morning and evening. |
| Combination inhalers | Both preventer and long-acting reliever | Some older pupils may use these. They do not replace the need for a separate reliever inhaler. |
Pupils should have immediate access to their reliever inhaler at all times, including during PE, on trips and during exams.
Classroom and School Strategies
Planning and Preparation
- Ensure every pupil with asthma has a written IHP, reviewed annually
- Know where each pupil's reliever inhaler is kept and ensure it is always accessible
- Consider holding an emergency salbutamol inhaler and spacer under the school's medicines policy
- Train all staff to recognise an asthma attack and follow the emergency steps
- Record all asthma incidents and share information with parents
- Display an asthma action poster in the staff room and relevant classrooms
In the Classroom
- Allow pupils to take their reliever inhaler whenever needed without waiting for permission
- Never send a pupil having an attack to collect their inhaler alone
- Be aware of potential triggers in lessons (e.g. paint fumes in art, chemicals in science, dust in textiles)
- Ensure classrooms are well ventilated
- Watch for signs of tiredness or loss of concentration, which may follow a poor night due to asthma symptoms
- Allow brief breaks if a pupil is coughing or wheezing
Physical Education and Exercise
- Encourage pupils with asthma to participate in PE and sport; exercise is beneficial
- Ensure the reliever inhaler is at the point of activity, not left in a changing room
- Allow the pupil to use their inhaler before exercise if recommended in their IHP
- Include a thorough warm-up, which can reduce exercise-induced symptoms
- Be flexible; allow rest if the pupil becomes symptomatic, and let them rejoin when ready
- In cold weather, consider indoor alternatives or allow the pupil to cover their mouth and nose
- Swimming is generally well-tolerated due to the warm, humid environment
Trips and Outings
- Ensure the reliever inhaler and spacer are taken on all trips
- Check pollen counts before outdoor activities during spring and summer
- Risk assess venues for potential triggers
- Brief accompanying staff on individual pupils' needs
Further Information and Resources
Asthma + Lung UK provides schools guidance, action plans and training resources.
NHS information on asthma offers accessible guidance for families and staff.