Dealing with asthma? Breathe easy

Asthma is one of the most common conditions experienced by both adults and young people in the UK. But it is not a barrier to the full scouting experience, says Lesley Weston.

More than five million people in the UK have asthma. On average there are two children in every classroom who have the condition, so it stands to reason that many scout groups will be the same.

Asthma is often thought of as a childhood condition, but it can affect anyone at any age or even seem to disappear, only to reappear later in life. Adults who have asthma probably have memories of being unable to participate in activities or sports, but this is often an unnecessary precaution.

What exactly is asthma?

It’s a disease that affects the airways. When a person with asthma comes into contact with something that irritates their airways, the muscles around the walls of the airway tighten. The lining becomes inflamed, swollen and sometimes sticky mucus or phlegm builds up causing further narrowing. These reactions lead to the symptoms of asthma.

What do I do if I have an asthmatic young person in my scout group?

A young person whose asthma is well controlled should be able to participate in most activities. You should always be aware of any health problems that your young people have and this information should be shared with other responsible adults as appropriate.

Certain environments may pose a problem depending on what the individual’s trigger factors are. For example, extremes of temperature, handling animals or smoke in a confined space. It’s advisable for you to be aware of trigger factors.

What warning signs should I keep an eye out for?

o A young person complaining of shortness of breath or a tight chest, particularly when they have had puffs of their reliever (blue) inhaler.
o An inability for the young person to speak in sentences, or increased use of their reliever (blue) inhaler, seemingly with little or no effect.

What precautions should I take before setting out on a hike?

o Make sure that InTouch details are in place, and that a mobile phone signal is available. See that the scout has their reliever (blue) inhaler with them. Each asthmatic should also have a personal asthma management plan and a volumatic spacer that fits with their inhaler.
o Know the terrain and let the young person know in advance if there are hills. They may require puffs of their reliever inhaler before attempting the climb.
o Set a steady pace – this should be at the rate of the slowest person on the hike – and take rest breaks.

What precautions should I take before going on camp?

o Again, make sure that InTouch details are in place. Completed medical forms are essential.
o Adults/young leaders should be aware of any asthmatics.
o You need to be aware of any changes in rules and guidance. For example, scuba diving used to be off-limits for asthmatics, but now the individual merely requires a ‘fitness to dive’ medical prior to the event.
o Know the individual’s trigger factors. Don’t let the young person leave for camp without ensuring they have all their medication, including a spacer for emergencies. You may need to speak to parents in advance. Ensure that leaders/adult helpers know what to do if the young person experiences an asthma attack.

What do I do if someone has an attack?

o Remain calm. Stay with and reassure the person. Discourage them from talking; they need all the air they can get.
o Encourage them to take one or two puffs of reliever inhaler. Sit them down and encourage them to take slow, steady breaths. If there is no improvement, encourage them to take two puffs of their reliever inhaler using the spacer (one puff at a time) every two minutes to a maximum of 10 puffs.
o If the person is not feeling better after 10 puffs of reliever, or if you are at all worried, call 999.
o If help has not arrived within 10 minutes, repeat the 10 puffs of reliever via the spacer again.
o If the symptoms improve and there is no need to call for help, the person should be advised to see their asthma specialist nurse within 24 hours of the exacerbation.

Never a barrier to scouting

‘As an asthmatic teenager, some extracurricular groups had blanket bans on people with asthma taking part in adventurous activities, or had rules like never allowing me to go more than half an hour from a road.

‘When I joined scouting as an explorer scout, the leaders were all aware of my asthma, but it was never a barrier to my taking part in any activity. Within a year of starting explorers I’d been on expeditions in the Brecon Beacons, the Alps and the Tatras, and climbed Rysy, the highest peak in Poland.

‘I still love hillwalking and mountains, and the fitness I’ve gained over the years of outdoor activity that started with scouts helps to keep my asthma under control.’ Archie

Lesley is a nurse practitioner in primary care and a cub scout leader.

For more information, visit Asthma UK at www.asthma.org.uk