Breathing Difficulties Related
to Physical Activity for Students With Asthma: Exercise-Induced Asthma
Information for Physical Educators, Coaches and Trainers
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First Aid for Exercise-Induced Asthma
If, during physical activity, you notice that a student is having
difficulty breathing, coughing frequently, or wheezing (noisy when breathing
out), it may be asthma:
- STOP the student's activity and encourage the student to sit
- Call 911 immediately if student requests or is in severe distress--struggling
to breathe, lips blue, unable to walk or talk.
- Follow the designated asthma management plan (individual student
plan, if available, or school protocol).
- Follow the school protocol to notify the school nurse (or other
designated staff) if medication is not available or if symptoms are
not resolved within 5 to10 minutes after using the inhaler.
- Never let a child with breathing problems leave the gym or
field alone .
- If symptoms resolve, permit students to resume activity when
they are ready, according to their asthma management plan.
- Follow the school protocol to inform parents of the event
and document actions taken.
Ways To Help Students with Asthma Participate in Physical Activity
Identify Students with Asthma in Your Class or on Your Team
- Ask your school nurse or use student health information to identify
those students who have a diagnosis of asthma or a history of asthma
symptoms with physical activity.
- Ask the school nurse for a copy of each student's asthma management
plan. Keep the copies easily available for all on-site and off-site
- Discuss with students (and parents, if appropriate), the individual
student's triggers, signs and symptoms that relate to physical activity.
- Take appropriate steps to inform a student's parents/guardians if
the student frequently experiences asthma symptoms with physical activity.
The student's asthma management plan may need to be re-evaluated by
the student's physician because most students with asthma should be
able to participate fully in physical activities, most of the time.
- Help students and the school nurse make sure that the students' prescribed
asthma medicines are available for use, according to their asthma management
plans, before physical activity and as needed for acute symptoms,
Encourage Students to Prepare for Physical Exercise
- Students who have been prescribed pre-exercise treatment (usually
an inhaled quick-relief bronchodilator) should take their medicine 5
to10 minutes prior to exercise
- Encourage a period of warm up activity before exertion (e.g., walking,
flexibility exercises, or other low intensity activities).
- Check the student's asthma management plan for information about his
or her triggers, and help the student avoid them when possible. Each
student with asthma is sensitive to different factors in the environment,
called triggers. Common triggers include dust, pollen, mold, air pollution,
and smoke. Cold, dry air can also trigger asthma; wearing a scarf or
cold air mask will help because it warms and humidifies the air before
it reaches the airways.
Consider Modified Exercise as Needed
- If a student has obvious wheeze, breathing difficulty, or measures
a low peak flow rate prior to exercise, have the student treat his/her
symptoms according to the asthma management plan. The treatment is usually
with prescribed inhaled quick-relief bronchodilator. Physical activity
may then be either resumed, modified or halted, depending on the student's
response to treatment.
- When a student is having mild symptoms or when triggers are present,
consider modifying the intensity, location, or duration of physical
activity. Very intense, continuous activity is more likely to cause
asthma symptoms than intermittent or very light or non aerobic exercise
(e.g., walking, some field events, or weight training). There is no
perfect physical activity for people with exercise-induced asthma. All
sports are tolerated well when a student's asthma is under control.
- When environmental conditions are bad (e.g., ozone alerts, high pollen
counts, freshly cut or sprayed fields) students with asthma may need
to avoid being physically active outdoors.
* This tip sheet is provided as a service to physical educators, coaches,
and trainers. It is meant to supplement existing school-based asthma protocols
and should not be construed as medical advice.
This tip sheet was developed as a partnership activity
facilitated by the NAEPP, coordinated by the NHLBI of the NIH/DHHS