ATHLETES WITH ASTHMA

1. ATHLETES WITH ASTHMA Sports Injury Management

2. History / Definition of Asthma • 2 A.D.: Aretaeus – “If from exercise, the breathing becomes more difficult, it is called Asthma.” • Chronic inflammatory pulmonary disorder characterized by reversible obstruction of the airways of the lung • Often genetic disposition • Often triggered by allergens, irritants

3. ASTHMA SYMPTOMS • Shortness of breath • Wheezing • Chest tightness • Excess mucous production • Cough

4. TYPES OF ASTHMA • Allergic asthma • Exercise Induced Asthma (EIA) • Cough variant asthma • Nocturnal asthma • Occupational asthma

5. Exercise Induced Asthma • Usually occurs with strenuous exertion • Occurs within 5 – 8 minutes of starting exercise • Peaks 5 – 8 minutes after stopping • Late phase may happen hours later

6. Prevention of EIA • Make sure athlete’s Asthma Action Plan is available • Athletes should use rescue inhaler 10-15 minutes prior strenuous activity begins • Warm-up prior to exercise • Cool down afterwards • Treat like asthma if symptoms occur

7. Medications * Rescue Meds - Taken only as needed to relieve symptoms - Taken before strenuous exercise to prevent exercise induced asthma (EIA) - Immediately and easily accessible at every sporting event (with spacer) * Controller Meds -Taken every day to prevent inflammation

8. Peak Flow Monitoring • Useful monitoring, NOT FOR DIAGNOSIS • Provides a quantitative measure of impairment • Can be helpful in detecting changes in asthma control that may require adjustment in treatment

9. Asthma Action Plan • Every athlete with asthma should have an individualized plan, readily available (if previously diagnosed, school nurse may be able to share) • Know symptoms and Peak Flow readings for each of the green / yellow / red zones • Coach and teammates should know about athlete’s asthma

10. Asthma Exacerbation • When symptoms start to appear – usually triggered by irritant or allergen • May occur suddenly, or “stew” for a few days before symptoms begin • Be aware of weather conditions, pollen count, etc.

11. Handling Asthma Exacerbation • Remain calm, reassure athlete • Check athlete’s asthma action plan or emergency card for actions • Give “rescue” medications if ordered and available • Have athlete sit up and breathe slowly; in through nose, out slowly through pursed lips • Give athlete sips of room temperature water / fluids • Contact parent or legal custodian as necessary • DO NOT LEAVE the athlete unattended

12. WHEN TO CALL 911 • Athlete has difficulty talking, walking, or drinking • Lips or nail beds are bluish • Rescue meds are ineffective or not available • Neck, throat, or chest muscles are pulling in (retracting) • Nostrils flare out when trying to breathe • Obvious distress • Altered levels of consciousness / confusion • Rapidly deteriorating condition

13. PREVENTING AN EMERGENCY • If athlete is complaining of breathing difficulty – BELIEVE IT and take action • Allow return to play only when you know breathing is normal again • Inform athlete’s parents of breathing difficulties and request they see their regular doctor • Assign someone to stay with athlete off the field / gym while the event continues • Athlete should never “tough it out”.

14. Parting Thoughts • Athletes with asthma can participate in exercise / sports without restrictions. • If an athlete is having trouble participating, their asthma may not be in good control. • If athlete is symptomatic with activity, encourage them to use rescue inhaler before the event. • Ensure athlete is taking medications correctly • If you are concerned about an athlete, take with the athlete AND their parents. • Encourage athletes with asthma to see their regular doctor for asthma check-ups at least twice a year.