Sports Asthma at School
Clear communication with the student, parents, teachers and school nurses is central to managing EIB or sports asthma at school. It is a good idea for parents to review their child's EIB or sports asthma treatment plan personally with the gym teacher or coach, teacher and school nurse in order to avoid any delays in treatment or any potential misunderstandings. A recommended action plan includes:
- Pretreatment with asthma medications including short acting bronchodilators (Proventil®, Ventolin®, Maxair™, albuterol, Combivent®, DuoNeb™, and Xopenex®) and/or cromolyn sodium (Intal®) at least 15 - 30 minutes prior to exercise (1 hour prior to exercise may be optimal).
- Alternatively, a long acting bronchodilator (Serevent®, Foradil®) administered in the morning may provide adequate EIB relief throughout the day.
- Pretreatment with leukotriene modifiers (Singulair®, Accolate®) and/or theophylline preparations may also be beneficial if control of EIB is not adequate with short acting bronchodilators and/or cromolyn sodium medications alone. A combination of medications may be necessary to achieve adequate control of EIB.
- Regular maintenance treatment of asthma with daily controller medication may be necessary if adequate control of EIB is not achieved with exercise pretreatment alone.
- If a student has been diagnosed with asthma and has some chest symptoms even when not exercising, maintaining optimum treatment throughout the year is very important in minimizing EIB or Sports Asthma.
- Performing warm-up exercises before and cool down exercises after exertion can help prevent EIB or Sports Asthma or modify its severity.
- Conditioning through a regular exercise program will decrease the potential for EIB or Sports Asthma.
- Quick relief medications (bronchodilators) should be available to individuals with EIB or Sports Asthma at all times. All students with EIB or Sports Asthma should be taught how to use an inhaler properly, and inhaler technique should be reviewed periodically. Keep tabs on the frequency of bronchodilator use and discuss the dangers of overuse.
- Cold, dry air provokes EIB or Sports Asthma and should be avoided. When this is difficult to achieve, students with EIB or Sports Asthma should wear a mask or scarf over their face during physical activities when outdoors in the cold air. This will warm and humidify the air before it reaches the lungs.
- Students with EIB or Sports Asthma should not exercise when their asthma is poorly controlled. They should stop exercising if they develop breakthrough symptoms and become short of breath. At this point, they need to rest and take a bronchodilator treatment (e.g. albuterol).When symptoms resolve, they can attempt once again to exercise.
Using a peak flow meter to measure pulmonary function before and after sports can be useful in objectively identifying the severity of the problem and its response to treatment. If your child's symptoms seem out of control or your child is simply not doing well, schedule an office visit with your doctor and review the situation with your child's teacher or coach. Perhaps your child's medication or exercise program needs to be modified. On the other hand, something else may be troubling your child, and infrequently, some children may use their EIB or sports asthma to avoid involvement in sports.