Managing Asthma in Student Athletes

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For the student athlete with asthma, spring and summer pose particular dangers. The most significant danger is the all-too-frequent lack of access to a life-saving asthma inhaler, explains Maureen George, PhD, RN, of the University of Pennsylvania School of Nursing. Federal law permits students to carry their asthma inhalers with them, yet many schools do not because of safety concerns.

“Managing asthma is especially challenging for student athletes because many coaches do not feel comfortable assuming responsibility for administering asthma medications, nor are they trained to do so,” explains Dr. George. “School rules keep epinephrine pens and inhalers off the playing field and in the building or locked in an office when they should be immediately available to student athletes.”

In the worst case scenarios, she says, coaches will tell student athletes with asthma symptoms to sit out or, even worse, push them beyond their limits. “That lack of understanding and empathy is not only embarrassing for the student athlete,” she says, “it is dangerous and potentially life-threatening.”

Dr. George urges parents to know the right of their children to carry their inhalers, to encourage their children to pre-medicate before exercise, and to have gym teachers and coaches receive training to become skilled in the management of acute asthma.

Dr. George also makes these recommendations:
• Student athletes with asthma should use inhalers prophylactically before exercise or athletics, even if they feel well.
• Student athletes with asthma should have access to their medications in school, at the gym, on the field, on the court -- wherever they are playing.
• Parents should learn the law and work with their children’s schools, coaches, and teams to ensure asthma management is being handled appropriately during the school day and during sports.
• Student athletes and their coaches should know the early signs of an asthma attack: shortness of breath, audible wheezing, increased respiratory rate, cough, and complaints of chest tightness. Late signs include a bluish color to the lips and face; decreased alertness, such as severe drowsiness or confusion; extreme difficulty breathing; rapid pulse; sweating; or an abnormal breathing pattern. If a student is having an asthma attack, do not lie the student down; allow the student to sit or recline and rest.
• Students and coaches should have on hand a fully charged cell phone pre-programmed with emergency numbers.
• Coaches should never leave a student in distress; send other children to get adult help and reassure the child to prevent the child from panicking.
• Parents, students, and coaches should follow mold, pollen, and air quality counts and coaches should provide student athletes with alternative activities on days when triggers may cause an unsafe outdoor environment for sustained physical activity.

“Anyone with asthma can fully participate in physical education or competitive sports if their asthma is well-managed. In fact, many Olympic athletes have asthma,” says Dr. George. “All you need to do is see a healthcare provider, take your medication as prescribed, have your rescue medication immediately available to you, and know and avoid your triggers.”

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