Exercise-Induced Asthma

1. Exercise-Induced Asthma A Presentation For YOUR NAME YOUR AFFILIATION Coaches

2. Presentation Overview • Asthma Background • Asthma Medications • Overview of Exercise-Induced Asthma • How to Handle an Asthma Attack • What to Do Before You Play • Communicating About Asthma

3. Prevalence of Asthma • 10.4% of Montana high school students have asthma • In a typical Montana classroom of 30 students, three will likely have asthma • On a team of 15 athletes, at least one will probably have asthma

4. Asthma and the Lungs

5. Airways in an Asthma Attack

6. Triggers of Asthma • Allergens: pollen, mold, furry and feathered animals, cockroaches • Irritants: perfume, paints, wood smoke, tobacco smoke • Viral infections • Emotional anxiety • Cold weather • EXERCISE

7. Medications

8. Two Categories of Medications • Controller Medications: Taken every day to prevent swelling in the airways • Quick-relief/Rescue Medications: Taken when needed to relieve symptoms • Can also be taken before strenuous exercise to prevent exercise-induced asthma (pretreatment)

9. Quick-relief/Rescue Medications • Pretreatment, by using the medication 10-15 minutes before strenuous or aerobic activity begins, can reduce the likelihood that asthma symptoms will develop • Also taken when needed to relieve symptoms • Coaching staff must be aware that an athlete is using this medication and be prepared to assist

10. Using a Metered-Dose Inhaler • Remove the cap and shake the inhaler • Tilt your head back and breathe out • Put your lips around the mouthpiece • Compress the canister while breathing in slowly for three to five seconds • Hold breath for five to ten seconds • Exhale • Wait at least one minute and repeat puffs as recommended by your healthcare provider

11. What is Exercise-Induced Asthma? • EIA – Exercise-induced asthma is a transient narrowing of the airway during exercise in people who have a diagnosis of asthma • People without a diagnosis of asthma can also experience airway narrowing during exercise • This is called exercise-induced bronchoconstriction (EIB)

12. Prevalence of EIA • Up to 90% of people with asthma experience symptoms with vigorous exercise or activity • About 10% of the general population has EIB when they exercise

13. Causes of EIA • Temperature and water content of inspired air • Drier, colder air is more likely to cause airway narrowing • Level of ventilation reached/sustained during exercise • The more aerobic the sport, the more likely it is to cause airway narrowing

14. Responding to an Exercise-Induced Asthma Attack

15. Other Useful Tips • Remain calm and reassure the child • Check the child's asthma action plan • Have student use quick-relief/rescue medications if available, according to the asthma action plan • Some students carry their own asthma inhalers with them

16. Other Useful Tips • Have the athlete sit up and breathe slowly • Inhale through the nose • Exhale through the mouth • Have the athlete sip room temperature water/fluid • Contact the school nurse and parent/guardian as necessary • Never leave the athlete unattended

17. Call 911 if... • Lips or nail beds are bluish • Athlete has difficulty talking, walking, or drinking • Quick-relief/rescue meds (e.g. albuterol) are ineffective or not available • Neck, throat, or chest muscles are pulling in • Nasal flaring occurs when inhaling • Athlete is in obvious distress • Altered level of consciousness/confusion • Rapidly deteriorating condition

18. The Good News • Asthma can be controlled! • Students who have asthma can participate in sports just like any other child or teen • The key to full participation is proper control and management

19. Olympians with Asthma A study in the November 1998 Journal of Allergy and Clinical Immunology found that: • In the 1996 Summer Olympics, thirty percent of the asthmatic athletes on the US team took home team or individual medals • They fared as well as athletes without asthma

20. World-Class Athletes with Asthma • Jackie Joyner-Kersee- Olympic Gold Medalist (track & field) • Amy Van Dyken- Olympic Gold Medalist (swimming) • Isaiah Thomas- NBA • Jerome Bettis- NFL • Gary Roberts- NHL • Donnell Bennett- NFL • Emmit Smith-NFL • David Beckham- MLS/UEFA

21. Before You Play • Know which athletes have asthma • Make sure you receive an asthma action plan for each student with asthma • Pretreat with quick-relief/rescue medication approximately 10-15 minutes prior to exercise, as per health care provider’s instructions • Do warm-up and cool-down activities • Check outdoor ozone/air quality levels • Air quality in Montana can be checked at http://todaysair.mt.gov

23. Talking with Parents and Athletes • Form a partnership with parents, athletes, and their healthcare providers to create the norm that asthma is not an excuse to sit on the sidelines but is a disease that can be controlled • If an athlete is complaining of breathing difficulty- BELIEVE IT and take action! • Inform parents/guardians of breathing difficulties and request that the athlete see a healthcare provider • Do not allow other athletes to tease athletes with asthma symptoms

24. http://www.winningwithasthma.org

25. Key Take Home Messages • Asthma is a common disease that is often triggered by exercise • During a student’s asthma attack, follow the protocol outlined in his/her asthma action plan • To prevent exercise-induced asthma: • Pretreat with rescue inhaler 10-15 minutes before activity • Allow warm up and cool down periods • A student with asthma that is well-controlled should be able to participate in both sports and physical education classes: • If a student is not able to participate because of asthma symptoms, inform his/her parents/guardians that the athlete’s asthma is not well-controlled and that the student should see a health care provider Conclusion

26. Questions? BJ Biskupiak MACP, Health Educator wbiskupiak@mt.gov Phone: 406-444-0995 www.dphhs.mt.gov/asthma Jessie Fernandes MACP, Program Manager jfernandes@mt.gov Phone: 406-444-9155