Asthma is a serious problem in our society. This is particularly so in my home state of Tasmania, which has the highest rate of asthma sufferers per capita in Australia, with around 13 percent of Tasmanians having the condition. That means that around 62,000 Tasmanians have been identified as having the disease. Many more may not have been identified and could be living with it unmanaged.
Asthma is a condition of the airways. People with asthma have sensitive airways in their lungs which react to triggers that set off their asthma. It manifests through a number of symptoms, including difficulty breathing, shortness of breath or very rapid breathing; severe wheezing when breathing both in and out; coughing that will not stop; chest pain or pressure; tightened neck and chest muscles, called retractions; and difficulty talking and performing normal daily activities. It is an extremely serious condition and can have utterly tragic consequences. An estimated 411 people died from asthma in Australia in 2009 alone.
Many sufferers of asthma are young children, so it is important that those around them—particularly parents, carers and teachers—are aware of their condition and are able to assist in the management of the condition and provide treatment if an attack occurs. This is particularly important in the place that children spend a large portion of their lives in—schools. The statistics show that asthma affects around one in nine school-aged children. This means that in an average classroom there will be at least three students with asthma.
As co-convenor of the parliamentary asthma group, I am aware of the importance of promoting awareness and understanding of this terrible disease. Recently I met with the Asthma Foundation of Tasmania to discuss an innovative new program that they are running in Tasmanian schools. The new Asthma and Anaphylaxis Schools Program is a revitalisation of Asthma Tasmania’s previous schools program. It aims to provide school staff with practical means to help prevent asthma and/or anaphylaxis from causing deaths, anguish and absenteeism. Anaphylaxis is the most severe form of allergic reaction and is potentially life threatening. Asthma and anaphylaxis are inextricably linked, as nearly everyone who dies from anaphylaxis suffers from uncontrolled asthma.
The Asthma Foundation of Tasmania has also changed the emphasis of the program to give risk minimisation greater prominence. While it is still vitally important that school staff are trained in the emergency management of asthma and anaphylaxis, it is equally important to ensure that schools do not get into a situation where they need to use first aid in the first place. As the old saying goes, prevention is better than cure. Consequently, they have developed a system whereby schools can identify students who are at high risk and then help staff to develop strategies to avoid emergencies. The new system awards one of two levels of status to a school—’asthma and anaphylaxis active’ and ‘asthma and anaphylaxis proactive’—based on the training that staff do and the way the school has implemented the program.
‘Active’ is the entry-level status that is focused upon identifying high-risk students and providing emergency training for staff. Active status is current for two years. To reach active status, the school needs to meet the following criteria: sufficient staff members have to have undergone training approved by the Asthma Foundation of Tasmania so that they can adhere to the two-minute rule, there has to be sufficient equipment and basic prompting information to enable first aid to be delivered within the strictures of the two-minute rule, the school has to have found out which students have asthma or anaphylaxis, and the school has to have established who the high-risk students are. The two-minute rule is the core concept behind emergency training within the Asthma Foundation of Tasmania schools program. The rule says that, when it is identified that a student may be having an asthma exacerbation or a severe allergic reaction, it will take two minutes for an appropriately trained staff member to give emergency treatment. That is important because oxygen deprivation can cause permanent damage to a child in only two minutes. It is vitally important that a child affected be treated within that two-minute time period.
‘Proactive’ is the higher level status aimed at reducing the likelihood of an asthma or anaphylaxis emergency. The prerequisite for the proactive program is that the school has already achieved active status. Proactive status is current for four years. To reach proactive status the school needs to meet the following criteria: personal safety plans have been developed for each high-risk student; the school has given a commitment that at the beginning of each school term there will be a brief staff first aid demonstration; and the school has also committed to point the parents of a child with uncontrolled asthma toward a service that will assist in getting the student’s asthma under control. It is really important for schools to identify high-risk students, because they are the ones who are most likely to have a severe asthma attack or allergic reaction and require emergency management of their conditions.
The Asthma Foundation have outlined a set of criteria to determine whether a student is a high-risk student and is in danger of a severe flare up of asthma or an anaphylactic reaction. A high-risk student with anaphylaxis is any student who has been prescribed an adrenaline auto-injector. A high-risk student with asthma is any student who has one or more of the following characteristics: they use their asthma reliever medication two times or more per week; they have visited emergency or been readmitted to hospital due to asthma in the past 18 months; an ambulance has been called due to an asthma flare up in the past 18 months; they have been prescribed oral medication for asthma, either a tablet or syrup, in the past 18 months; they are regularly absent due to asthma; or the doctor believes the student might need extraordinary supervision at school because of their asthma. As mentioned earlier, each high-risk student should have a personal safety plan. This is an agreed set of protocols and precautions devised by the school to avoid or manage risks posed by the student’s asthma or anaphylaxis. It must be stressed that an individual safety plan is tailored to an individual student’s needs. It is certainly not one size fits all.
The Asthma Foundation of Tasmania have prepared a whole suite of materials to go with their new training program. These include posters, information for school newsletters, letters to parents, information sheets about asthma and anaphylaxis, personal safety plans and asthma brochures. These resources have been specifically designed and tailored for use by schools. I urge all schools to visit the Asthma Foundation of Tasmania’s website at http://www.asthmatas.org.au to download the new guide. It is easy to read and in it you will find all the information needed to start your school off on becoming an ‘active’ or ‘proactive’ school. Students, parents and schools would benefit from better management of asthma in schools, it would reduce suffering of students and absenteeism and it may just save a life. It would be an incredibly positive step for all schools in Tasmania to gain ‘active’ or ‘proactive’ accreditation, and I urge them to do so.
Just as a final word: asthma not only affects children. As I mentioned earlier, tens of thousands of Tasmanians know they have the condition but there could be many thousands more who might not know they have it. Unfortunately, if you are unaware you have the condition you are of course unable to manage it. If you need help to understand the issues around asthma further, you can call the Asthma Foundation of Tasmania on 1800 278 462 on weekdays and talk directly to one of their asthma and allergy advisers or make an appointment to have a face-to-face consultation. Talking to the experts may help you treat your condition better or identify that you have asthma, if you have not already been diagnosed. Obviously, a better understanding of asthma would reduce the tragic statistic of hundreds of Australians dying from it each year. I urge everyone to find out more about it.