A Back-to-School Asthma Management Protocol for Parents & Guardians
Heading “back to school” continues to bring us new challenges in 2021. As the parent or guardian of a child with asthma, you may still be feeling additional anxiety due to COVID-19. The Lung Health Foundation is here to help guide you in getting your child’s asthma controlled. Lung health is more important than ever. Lung health starts now!
Our goal
Your child’s asthma is under control before they return to the classroom. Your child can focus on their mental, emotional, and social growth – not their asthma symptoms. And most importantly, no children are lost to asthma.
First, make the back-to-school decision that’s right for you
Asthma doesn’t make your child more likely to catch the SARS-CoV-2 virus (COVID-19). However, you should know that any respiratory virus has the potential to cause an asthma flare-up (even the common cold!). COVID-19 is no exception.
If your child’s asthma is well managed, they should be able to participate in in-person learning. If your child’s asthma is not well managed, the Lung Health Foundation is here to get you back on track before school starts (and all school year long). If you need personalized guidance, you should talk to your child’s healthcare provider to determine what’s best for your child and your family.
Many provinces are giving families the choice of in-person or fully remote learning. Make the schooling choice that is right for your family. Whichever choice you make, be sure to continue your child’s asthma management routine.
Asthma Control Check
Is your child’s asthma under control? Take this simple test to find out:
- Does your child need to use their reliever inhaler more than twice per week?
- Does your child have asthma symptoms more than twice per week (cough, wheeze, difficulty breathing)?
- Does your child ever have difficulty exercising or playing sports because of asthma?
- wake up even one night a week because of asthma (cough, wheeze, difficulty breathing) and if so, are the symptoms mild?
- Has your child missed school or work days in the last month because of asthma?
- Does your child ever have asthma flare-ups (worsening of cough, wheeze, difficulty breathing)?
Answering yes to any of these questions may mean that your child’s asthma isn’t under control. Get back on track by calling the Lung Health Foundation to speak with a Certified Respiratory Educator at 1-888-344-LUNG (5864), and contact your healthcare provider.
Step 1: Follow these steps to prevent the September Spike
In a typical year, returning to school can mean more emergency department visits for kids due to asthma flare-ups. This is known as the “September Spike”. There are many possible reasons for the Spike, but the two biggest are:
- Asthma management routines weren’t followed during summer break, leading to poor asthma control in the fall
- Exposure to respiratory viruses and other triggers.
September Spike prevention tip: Get back on track
If the COVID-19 pandemic turned your world upside down, you’re not alone. If your child’s asthma management routine got off track, act now to get their asthma controlled before school starts. Right now, you can:
Speak to an expert.
You have free access to Certified Respiratory Educators (CREs) through our Lung Health Line. A CRE can talk to you about asthma management, the medications used to manage asthma, the use of an action plan and discuss your concerns such as triggers caused by respiratory infections like COVID-19. Chat with us live at lunghealth.ca, email info@lunghealth.ca, or call 1-888-344-LUNG (5864). The Lung Health Line runs Monday to Friday from 8:30 to 4:30 EST.
Review your child’s Asthma Action Plan (AAP).
An asthma action plan is a set of instructions written out by your healthcare provider that can help you better manage your child’s asthma.
An Asthma Action Plan is divided into three sections: green, yellow and red. It gives you specific instructions on what to do to keep your child’s asthma under control (green zone) and instructions on what to do when you realize your child’s asthma is worsening (yellow or even red zone).
Your child is in the "green zone" if they:
- Don’t need to use their rescue inhaler (usually blue) more than 3x per week
- Have symptoms of cough, wheezing, chest tightness and shortness of breath less than 3x per week,
- Have no nighttime asthma symptoms
- Are able to do physical activity without difficulty
Review your child’s inhaler technique.
If your child isn’t using their inhaler properly, their medication won’t be able to do its job. View videos for a range of devices at lunghealth.ca/inhalers.
One school starts, share your child’s Asthma Action Plan.
Provide a copy to their teacher and to the school administration. Continue to monitor your child’s asthma symptoms.
September Spike prevention tip: Slow the spread of respiratory viral infections
While COVID-19 has given parents new things to worry about, even the common cold can flare a child’s asthma symptoms. Planning ahead will ensure that your child arrives in the classroom prepared. Right now, you can:
Have the germ talk.
Even small children are capable of understanding concepts like germs and social distancing. Don’t wait until school has started to get them comfortable with the behaviours expected of them, or the environment they’ll be re-entering in September. Start a “no face touching rule” early, and teach your child proper respiratory hygiene. Remind them how to cough or sneeze into a tissue, or if a tissue isn’t available, the crook of their arm. The tissue should be thrown away immediately, and hands should be washed.
Review your child’s handwashing technique, and practice often.
This is one of the most effective ways to prevent the spread of most respiratory viruses, including SARS-CoV-2 (COVID-19). Lather with warm water and soap for at least twenty seconds – about how long it takes to sing your ABCs! Learn more at lunghealth.ca/handwashing.
Make a plan for your child’s care.
If your child shows symptoms of COVID-19 or any other respiratory virus, you must keep them out of school. Having a contingency plan will help you avoid making difficult or dangerous decisions later on. If you suspect your child has COVID-19, get them tested. Follow your school’s policies and consult with your primary care provider regarding getting tested for COVID-19.
Make a family flu shot plan.
Flu shots are typically available in October, and all family members should receive them. Kids under the age of five will need to receive their shot from a doctor’s office; if you have young children, consider booking an appointment ahead of time.
Watch for respiratory virus symptoms.
If your child displays symptoms, they must stay home from school to prevent others from getting sick.
Step 2: Watch for common classroom asthma triggers
Triggers are things that cause asthma symptoms. Triggers vary from person to person. Here are some of the most common asthma triggers in a typical classroom:
- respiratory viruses (including the common cold)
- mould
- pollen
- pet dander (dandruff)
- dust (including chalk dust)
- dust mites
- scents
- cleaning products (see below)
Deep cleaning: a “new” trigger for 2020?
The chemicals that will be used to protect students from COVID-19 though deep cleaning of classrooms and common areas may be an asthma trigger for children and adults alike.
Step 3: What's in your child's backpack?
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Asthma Plan of Care: Each school board will have its own Plan of Care document, but you can start gathering the right information before you receive it from your school. Use the plan to communicate your child’s needs with their teacher and school administration. Once completed, the principal must review and sign it.
The plan includes topics like emergency contacts, triggers, where their asthma emergency rescue inhaler will be kept, and when its use may be required. It also allows you to give consent for your child to carry their asthma emergency rescue inhaler with them.
- Asthma Action Plan: Every person with asthma should have an asthma action plan. A copy of your child’s AAP should be given to school staff at the start of the year.
- Reliever Inhaler: Make sure there are doses left in the inhaler and that it’s not expired. Review its use with your child.
- Spacer Device: A spacer ensures that more inhaler medication reaches your child’s lungs. Check if your province covers the cost of a spacer for your child. Using a spacer is recommended for all age groups when using a metered dose inhaler (MDI).
- Extra Tissues and Hand Sanitizer: Slow the spread of COVID-19!
Should your child be sidelined from sports?
No! If asthma is preventing your child from staying active, that’s a signal their asthma is not under control. Make sure your child can participate by keeping their asthma properly managed.
- Like anyone else, kids with asthma should warm up before beginning any physical activity or exercise.
- If a reliever puffer is needed, it should be taken 10 to 15 minutes before starting physical activity. Most children who have their asthma under control should not have to use a reliever puffer before physical activity or exercise.
- If your child has any symptoms, they should stop and use a reliever puffer. Physical activity should only be started again if all the symptoms have disappeared.
Step 4: Have THESE conversations now!
The classroom environment will continue to feel different in 2021. Prepare your child by discussing your school’s public health protocols with them in advance. Then ask questions like:
- Would you feel comfortable telling your teacher that you’re having trouble breathing? Let’s practice that conversation.
- Show me how you take your emergency inhaler. Let’s watch a video on inhaler technique, then practice together.
- Are you worried about experiencing asthma symptoms in front of other people? Let’s practice explaining our asthma symptoms.
- Let’s go over the proper way to sneeze and cough using a tissue or if a tissue is not available, the crook of your arm.
- Let’s look over your Asthma Action Plan, too – if we follow it together, we should be able to keep your symptoms under control.
Step 5: Download our pediatric asthma resources
The Pediatric Asthma Action Plan
The Pediatric Asthma Action Plan (for children 1-15 years of age) provides asthma patients/parents with a set of written instructions to help them manage their asthma symptoms. It is filled out with a healthcare provider and helps guide decisions about what steps to take when asthma symptoms occur. It is based on the traffic light system: GREEN means asthma is under control, YELLOW means asthma is getting out of control, and RED means it’s an emergency and help needs to be sought
Managing Asthma Attacks
Do you know what steps to take if someone is having an asthma attack? Be prepared for asthma emergencies with this poster, which can be placed in your classroom, workplace, or home. You could save a life.
Asthma Active
Asthma Active is a free book of puzzles, games and information to teach children how to control their asthma and stay active. It’s a great way to learn that having asthma doesn’t mean having to sit on the sidelines.
Call Me Brave Boy
A colourful picture book on childhood asthma designed for a parent or caregiver to read to a young child who has asthma.