asthma update | issue 44 | november 2011

1November 2011 I Asthma Update

AsthmaUpdate

Inside this issue...Lift out: Asthma First Aid

Asthma and Pregnancy

Asthma first aid training in schools and preschools

Asthma Friendly Parliament House

Issue 44 November 2011

You can help someone with asthma

2 Asthma Update I November 2011

Asthma Update

PO Box 603 KENT TOWN SA 5071P: 0404 690 552E: [email protected]

Published by Asthma Australia© November 2011 Asthma Australia

Content Panel Jan Saunders, Sara Morgan, Nathalie Maconachie, Cathy Beswick, Paula Murray

DesignJo Weismann

Contents

Helping someone who is having an asthma attack – online survey results ........................... 3

Asthma first aid training in schools and preschools ................................................................ 4

From the President ......................................................... 6

Asthma Friendly Parliament House ............................... 7

Helping Australia breathe better .................................. 8

ETSA Utilities powers Asthma Friendly Workplace Program ...................................................... 10

Lift out: Asthma First Aid ............................................. 11

Asthma First Aid poster annual review ....................... 15

Women’s Health Expos ................................................ 15

Asthma and Pregnancy ............................................... 16

Treat your asthma to help your baby ......................... 18

Are we helping more people to manage their asthma better? ...................................... 20

Live well with asthma Control Pack and DVD ............ 22

Readers’ postcard survey responses ............................ 23

DisclaimerAll Asthma Australia information is endorsed by our Medical and Scientific Advisory Committee and is consistent with the National Asthma Council Australia clinical guidelines.

Asthma Australia information does not replace professional medical advice. People should ask their doctor any questions about diagnosis and treatment.

This magazine can be copied foreducation purposes.


When the incident occurred in a sport setting 48% of people were helped by someone else. 13% of people in a sports setting were helped by someone with training. Only 22% of people who needed help in a sports setting had someone helping them who knew what to do - either through their training or personal experience.

When the incident occurred at work, 36% of people received help, and 16% of incidents at work had someone helping who

In National Asthma Week (September 2011) we conducted an online survey and asked people with asthma whether they had been able to get help when they had an asthma attack in the community. 432 adults told us about their experiences.

What they told us shows that asthma attacks can happen anywhere:

— 17% of attacks occurred in a sports setting

— 25% at work

— 25% out in the street

— 4% in an education setting

— 18% while socialising

One quarter of people weren’t carrying their blue reliever medication with them, and in 82% of places there was no asthma emergency equipment that they could use. It’s important to carry reliever medication with you at all times, just in case.

More than half of the respondents had someone nearby try to help them, but only 18% of people were helped by someone who knew what they were doing. Everyone can learn asthma first aid and help someone having an asthma attack.

Help was most likely to be provided to someone having an asthma attack in an education or care setting, and around half of those helping knew asthma first aid.

knew what to do, either through training or personal experience.

We asked respondents whether they thought people in public places should have the first aid knowledge to help someone in an asthma emergency:

— 69% said everybody in a public setting should know

— 28% said key individuals should know

— 2% believed people should just look after themselves/call an ambulance.

My chest felt tighter and tighter. I kept running. After a few more seconds I had to come to a stop. It was like no other attack I had experienced before. I didn’t have trouble breathing - it was that I could not take a breath in... or out. My chest felt permanently constricted, seized up. I couldn’t yell out for anyone to help me and no one stopped...

Anyone and everyone can learn Asthma First AidContact your local Asthma Foundation 1800 645 130asthmaaustralia.org.au

Acknowledgement: Thank you to Asthma Foundation NSW for conducting this survey for Asthma Australia and staff member Sara Morgan for her analytical skills.

Helping someone who is having an asthma attack

online survey results


As reported on the previous page, the online survey results show that many people in the community are unaware of asthma first aid. One way the Foundations are working to improve this is through the government funded Asthma Child and Adolescent Program, which trains school and preschool staff to manage an asthma attack.

Over 6000 (62%) of schools and 1300 (27%) of preschools have had staff trained through this program. A national training package is offered in a one hour session, generally held at local schools and preschools anywhere in Australia.

The program applies equally to adults with asthma and has proved useful in highlighting asthma management issues for staff themselves and their family and friends.

“ Knowing how to handle asthma is vital for my role as a teacher” – staff member

In addition to the training program, Asthma Australia provides schools and preschools with information they can place in their newsletters to inform the wider community about current issues in asthma management - for example the onset of the pollen season and the back to school asthma spike - and the

services available through their local Asthma Foundation.

We recently celebrated the 150,000th staff person trained through this national program. This celebration was held at Driver Primary and Preschool in Palmerston, Northern Territory (NT). The event was attended by the NT Minister for Health, Kon Vatskalis, who addressed a special National Asthma Week assembly and provided a certificate to acknowledge the training of the 150,000th staff member. Following the assembly Minister Vatskalis took time to talk with students, parents and staff about asthma and its potential impact on them, prior to the staff undertaking their Asthma First Aid training.

In his speech Minister Vatskalis stated, “Asthma is a serious condition with high prevalence in children. Training staff in schools and preschools to be able to manage asthma attacks contributes significantly to the well-being of students with asthma.”

▲ Staff at Kingston Heath Primary, Victoria practising the Asthma First Aid procedure.


School Principal Mr Rob Presswell said of the program, “Training for staff is the critical first step in our approach to asthma management. With help from our local Asthma Foundation, we have Asthma Emergency Kits throughout the school and ensure one of these and trained staff are present for all off-site school sport and excursions. We also receive asthma information to pass on to our community. It is pleasing to know that this is a national initiative with so many Australian schools involved. We are proud to be the school that hosts the training of the 150,000th staff member by Asthma Australia.”

Once a school or preschool has done the training Asthma Australia encourages them to work towards being Asthma Friendly. This involves ensuring that Asthma Emergency Kits are available and accessible, Asthma First Aid posters are on display and policies are in place. Sites returning a signed declaration will be provided with Asthma Friendly signage to highlight their

commitment to providing a safe and supportive environment for students with asthma.

During National Asthma Week the pool of over 400 ACAP Trainers across Australia were encouraged to take photos of training sessions in schools and preschools (over 30 sessions were held during this week). Some of these are shown here.

“ This should be a yearly event for all schools” – Principal

Despite a significant pool of ACAP Trainers there are areas where providing face to face training is difficult. Remote areas have been able to access training through web conferencing facilities and Asthma Australia is currently trialling an online version of the training.

Asthma Australia acknowledges the efforts of Asthma Foundation NT staff in managing the event at Driver Primary and Preschool, and the trainers who took photos of their sessions.

Principal of Driver Primary School, Rob Presswell, receiving a certificate from the NT Minister for Health, Kon Vatskalis, with AFNT Schools’ Coordinator, Jill McGee

▲ AFACT Schools’ Coordinator, Claire Miller, explaining asthma medications to staff at Cranleigh School, ACT


National Asthma Week was held in the first week of September and was a timely reminder that one in ten Australians has asthma and that asthma continues to affect many people’s quality of life – and their safety. Brock’s story, as told by his father Peter, reminds us all how serious asthma is.

For National Asthma Week we conducted an online survey and asked people with asthma whether they had been able to get help when they had an asthma attack in the community. We were told about 432 asthma attacks experienced by adults. Attacks had, not surprisingly, occurred across a wide range of settings in our community – and only 18% of people were helped by someone who knew what they were doing. This explains the theme for this issue: You can help someone with asthma.

In this issue we report on the online survey – and responses we received via the Readers’ postcard distributed with our last issue. We celebrate training the 150 000th educator in our Commonwealth government funded program in schools and preschools and congratulate the Department of Parliamentary Services for their work in making Parliament House Canberra Asthma Friendly. We also look at the latest asthma statistics from the Australian Institute

of Health and Welfare and some of the community programs being conducted by the Asthma Foundations to create a more asthma friendly Australia. And Dr Nicolette Hoydl reports on research which helps us understand how pregnant women can best manage their asthma to protect their unborn child.

Reading the articles in this issue, I was reminded again of the importance of the work of the Asthma Foundations. The people who responded to our online survey illustrated very clearly how their everyday lives are impacted upon by asthma and how important our role is in helping people live well with their asthma. As one person told us:

...it was obvious I was in quite some distress but no one stopped, people just stared. I eventually managed to text my mother who was working nearby to pick me up. It is quite scary to know that people won’t help, what if I didn’t have my phone with me that day? What if I couldn’t get hold of someone to pick me up? It would be more comforting to know that people understand what an asthma attack looks like and what to do in the situation.

From the

President

Terry Evans LLM President Asthma Australia

Could your workplace be asthma friendly?— Asthma First Aid is available

from asthma-trained first aid staff

— Asthma Emergency Kits are available and include salbutamol/reliever medication for administration via puffer and spacer

— Asthma First Aid information is displayed

— Occupational health and safety policies are explicitly inclusive of asthma


Asthma Friendly

Parliament House

In May this year the Department of Parliamentary Services in Parliament House Canberra achieved Asthma Australia’s Asthma Friendly criteria:

— Staff are trained in Asthma First Aid

— Asthma Emergency Kits are available and include salbutamol/reliever medication and spacers

— Asthma First Aid procedures are displayed

— Occupational health safety and welfare policies explicitly refer to asthma.

Asthma remains Australia’s leading cause of absenteeism from both work and school. Employers are now recognising health, economic and productivity advantages of offering an Asthma Friendly workplace.

We took the view that one worksite that definitely should be Asthma Friendly is the one serving all Australians: Parliament House Canberra. As one of Australia’s busiest workplaces, Parliament House was both a practical and symbolic venue to establish the Asthma Friendly Workplace Program. With Members, Senators, Advisers, media, security and auxiliary staff as well as hundreds of visitors every day from all over the world, it is essential this very busy workplace is equipped to identify and help manage an asthma emergency.

▲ Celebrating becoming Asthma Friendly at Parliament House, CanberraL-R: Secretary, Department of Parliamentary Services, Alan Thompson, AFACT President Kevin Gill, AFACT CEO Nathalie Maconachie, Chair Parliamentary Friends of Asthma Sen Trish Crossin, AFACT Educator Claire Miller, AFACT Board member, Allan Scroope

Under the Asthma Friendly Workplace program, Asthma First Aid updates can be scheduled in line with routine resuscitation and AED (Automatic External Defibrillator) refresher

courses to ensure staff have access to up-to-date asthma information and maintain skill and confidence to deliver Asthma First Aid.

To find out more about Asthma Friendly workplaces contact your local Asthma Foundation 1800 645 130 asthmaaustralia.org.au

◄ Parliament House staff learnt about asthma first aid


Helping Australia breathe better There are many ways you can help someone with asthma. The following stories show some examples of how people, whose own lives had been touched by asthma, decided to help others.

Bequests play a critical role in funding life-saving asthma education, research and community services.

Asthma education and research over the past five decades has changed the course of medical history. A half century of achievement by the Asthma Foundations across Australia was made possible only by a generous community of supporters.

One such supporter is Gail Burrow from Adelaide. She has supported her local Foundation for many years by way of regular donations to support the local programs and services for people with asthma. Some 17 years ago, after her husband passed away, she decided to include the Asthma Foundation in her Will.

Gail has a personal connection with asthma. She was diagnosed with pollen-induced asthma, and her symptoms typically recur seasonally during spring.

“I know exactly what it feels like when you can’t breathe and I appreciate the need for the community to be better informed about managing the condition and responding to the incidence of asthma.”

“After recently attending an information session at the Foundation, I realised the extent of the work by the Asthma Foundations’ across Australia in providing asthma education in child care settings, schools and preschools as well as workplaces and sporting clubs. The scope

of the work is enormous and I believe it is such a valuable cause. The incidence of asthma is still high, so informing the community about best practice asthma management is still very important. ”

Gail is pleased to be able to leave a lasting legacy to her local Asthma Foundation. “I have always enjoyed giving gifts more than receiving, to the point where my husband used to get quite annoyed with me!”

Since she was diagnosed, Gail has become even more aware of the seriousness of asthma, and how quickly it can take hold.

“A friend of mine – years ago – her younger sister never had asthma. She had her first attack at the age of 23 and it took her life.”

There are stories like this all across Australia, and they highlight the need for the Asthma Foundations to continue to provide up-to-date asthma information to help people with asthma and linked conditions to breathe better.

Gail says, “I would like the Asthma Foundations to keep up the asthma education across child care services, schools and preschools. Young people with asthma need to be educated about how serious it can be and how to manage it. I would also like people to be educated and

To find out more about how you can make a real difference to the world you leave behind, contact

your local Asthma Foundation: asthmaaustralia.org.au

1800 645 130

made aware of what it is that is actually happening to people when they have an attack.”

It is the generosity of donors and supporters that funds the vast majority of your local Asthma Foundation’s work. Bequests provide an especially critical source of funding because it provides an opportunity to leave a gift of particular significance.

A Bequest to your local Asthma Foundation truly does have the power to change the world you leave behind. It could fund the research project that might make important new discoveries in the treatment of asthma … and possibly find that elusive cure.


Unfortunately, people with asthma still underestimate how serious the condition can be and don’t recognise the symptoms of an asthma attack. Asthma First Aid Training in Sport and Recreation clubs, workplaces and education settings is important in providing a safer environment for people with asthma.

Asthma First Aid training is very important to the Jervois Football Club in light of the fact that they lost a loved member of their community last year.

At 27, Brock Burkett died from an asthma attack while holidaying with his partner Eva Harnischmacher in Germany last year. His father, Peter Burkett, said Brock had been sitting at the dinner table late one night last August, when he told Eva he needed his puffer. “His airways basically all shut down and he couldn’t breathe,” Mr Burkett said.

Brock was revived by a doctor but was declared brain dead when his family arrived in Germany a few days later.

“Unfortunately in Brock’s case, there was probably nothing that could have saved him. It was like a lightning bolt, it was unlucky, but people should be aware that asthma can be fatal. You don’t have to have severe asthma to have an attack.”

Brock’s story serves as a timely reminder about not being complacent and taking asthma seriously.

In light of the fact they lost a loved member of their community, Asthma Foundation SA provided Asthma First Aid training to Jervois Football Club members with Asthma Ambassador and Adelaide Crows star-forward Taylor Walker. Taylor shared his tips on managing asthma while playing sport at the elite level.

For information about asthma management and first aid training, contact your local Asthma Foundation: 1800 645 130 asthmaaustralia.org.au

There are many ways you can help someone with asthma and linked

respiratory conditions.

Peter Burkett with a photo of his son Brock and partner Eva Harnischmacher. Picture: Patrick Gorbunovs, The Advertiser.

Ty Burkett, Taylor Walker and Peter Burkett

You can help someone with asthma


Employers are becoming increasingly aware of the seriousness of asthma and are taking precautions to ensure they are adequately prepared in the event of an asthma emergency.

In South Australia, ETSA Utilities have long supported the asthma cause and have become a Program Partner of the Asthma Friendly Workplace Program throughout the state. ETSA Utilities are leading by example with key staff trained in Asthma First Aid.

Simon Trojan, an apprentice with ETSA Utilities who has asthma, says that having support through the workplace will help him to better manage his condition.

“I think it’s great we are supporting this program in South Australia – my asthma can potentially interfere with my work, and having workmates who understand about my condition makes me confident that should I have an attack, there will be good support around me.”

The Asthma Friendly Workplace South Australian launch took place on 22 June with the Hon John Hill, SA Minister for Health making the official announcement.

Workplaces are directly impacted by asthma, and in particular poorly managed asthma, in the following ways:

Absenteeism related to individual employee’s asthma

Caregiver absenteeism

Lowered productivity

Incidences of work-aggravated asthma

Incidences of occupational asthma

Poorly managed asthma is a common issue facing all workplaces, from offices to building sites.

ETSA Utilities powers Asthma Friendly Workplace Program

The Hon John Hill, SA Minister for Health and Simon Trojan from ETSA


National Asthma Emergency Kits Asthma Update’s lift out provides tools to help someone with asthma. This lift out covers:

— Equipment you need – what is an Asthma Emergency Kit and where to get one

— Key points - including recognising an asthma attack

— Asthma First Aid poster – the 4 step plan

We hope you find this useful, and that this guide will assist you if you ever need to help someone with asthma.

Everyone with asthma, no matter how mild or infrequent, should carry a reliever puffer with them. It is easier and more effective to use a spacer to take this medication, particularly if you are struggling to breathe.

Asthma Australia can provide Asthma Emergency Kits that contain asthma first aid equipment in a handy bag. All kits come with Asthma First Aid magnets, first aid log sheets and spacer instructions.

To order an Asthma Emergency Kit contact your local Foundation 1800 645 130

Lift out feature!

My daughter took her young brother out to the shops one day, and in the middle of the main street

my son had a massive asthma attack...

my daughter administered reliever medication and

carried him to her car and rushed him to hospital to be checked over. Not one

person in the street or from any of the shops gave her

assistance, not one asked if they were alright....

I am so lucky that all my family has training in this

area, as if it was not for my daughter knowing to

always carry reliever medication and knowing how to administer it, my

son may not be here now.

Everyone can learn asthma first aidThe recent National Asthma Week survey showed us that when someone had an asthma attack, only 18% of nearby helpers actually knew what to do and provided Asthma First Aid.

Watching a person you care about, or even just passing by someone having an asthma attack, can be a frightening experience. Unfortunately, even though over 2 million Australians have asthma, many people are not aware of Asthma First Aid and the help they can provide.

Everyone has a role to play in helping to keep people with asthma safe

1. Reliever medicationIf you have asthma:Carry your reliever medication with you at all times. People with asthma should always have access to reliever medication: at work, socialising or on holiday. Do not leave home without it, as you never know when you may need it.

Everyone – no matter where you work, e.g. petrol station/cinema/sporting club/cafe -

Ensure you stock Asthma Emergency Kits – and relevant staff are trained to use them.

Asthma First Aid –what you need to know

2. Recognising an asthma attackIt is hard to assist someone if you do not know what an asthma attack looks like. Remember that not everyone will have all of these symptoms. The table below outlines some common symptoms that people may have (or feel) when having an asthma attack. Asthma First Aid can be administered as soon as symptoms are noticed. Do not wait until symptoms are severe to commence first aid. In fact, giving asthma first aid to someone having mild symptoms may prevent a severe, life threatening attack occurring.

Mild Moderate Severe

Talk in sentences Shortened sentences Few words per breath or unable to speak

Cough Persistent cough Persistent cough

Soft wheeze Loud wheeze Wheeze may be absent

Minor difficulty breathing Difficulty breathing Gasping for breath/distress

Tightness in chest Tightness in chest Pale, sweaty, blue lips

Young children may Young children may Muscle exertion - use of upper body complain of a “sore tummy” complain of a “sore tummy” (chest, shoulders) to assist with breathing

If you have asthmaDo you know when your asthma is getting worse and what symptoms let you know that you are really struggling with your asthma? If not, discuss this with your doctor as part of your asthma action plan.

Everyone Would you recognise an asthma attack and know what to do? If not, contact your local Asthma Foundation to find out about accessing asthma information and education.

3. Asthma First AidIf you have asthma Many people with asthma are unaware of Asthma First Aid. People may reach for their reliever medication and take a few puffs, then ignore and put up with symptoms - or wait until they are really struggling to breathe before recognising that they need to do something urgently. Often, stopping and paying attention to symptoms and taking appropriate action can prevent a mild asthma attack turning into a severe attack that requires hospitalisation. Are you giving yourself first aid without realising it? Are you relying on first aid use of reliever medication instead of a proper, preventative approach to your asthma management? If you are using your reliever medication more than three times a week, it’s time to review your asthma action plan.

Everyone The Asthma First Aid plan is simple to learn and easy to follow: everyone can learn Asthma First Aid. The goal of Asthma First Aid is to assist the person having an asthma attack to take reliever medication: 4 puffs one at a time, then waiting for 4 minutes to see if the reliever medication is helping. Then 4 more puffs one at a time are provided, and if the situation is not improving, this is when emergency assistance (Dial 000) is called. You can keep giving 4 puffs of reliever medication every four minutes until help arrives - or as advised by emergency services.

See back page of lift out section

4. Contact your local FoundationEveryone can learn Asthma First AidWhether you have asthma or not, learning Asthma First Aid is a simple skill that may save someone’s life.

Whether you are an employer, in a sports club, an interested member of your local community, a teacher, have asthma or care for someone with asthma - your local Foundation has a range of education and training options to suit your needs

Contact your local Foundation1800 645 130asthmaaustralia.org.au

14 Asthma Update I December 2011

Asthma First AidSit the person upright

— Be calm and reassuring — Do not leave them alone

1Give medication

— Shake the blue reliever puffer* — Use a spacer if you have one — Give 4 separate puffs into the spacer — Take 4 breaths from the spacer after each puff

* You can use a Bricanyl Turbuhaler if you do not have access to a puffer and spacer

Giving blue reliever medication to someone who doesn’t have asthma is unlikely to harm them

Wait 4 minutes

— If there is no improvement, repeat step 2

If there is still no improvement call emergency assistance (DIAL 000)

— Tell the operator the person is having an asthma attack — Keep giving 4 puffs every 4 minutes while you wait for emergency assistance

4

To find out more contact your local Asthma Foundation:

1800 645 130 asthmaaustralia.org.au

Translating and Interpreting Service: 131 450© Asthma Australia September 2010 Supported by the Australian Government

2

3

Call emergency assistance immediately (DIAL 000) if the person’s asthma suddenly becomes worse

15

Asthma First Aid poster annual reviewAsthma Australia is reviewing its First Aid Poster (see the lift out section opposite), as part of our annual process. This is to ensure our community information is up to date, and serving the purpose for which it is designed.

It is very important that the information we provide people is useful and easy to understand. The First Aid poster has a simple 4 x 4 plan. Like all our resources, it has been signed off by our National Medical and Scientific Advisory Committee.

We want to ensure that people with asthma and their carers find the plan easy to follow and understand. We are inviting our readers to provide feedback.

If you have used our first aid poster, or might need to one day, we would love to hear from you. The feedback you provide will assist us in developing the best possible plan for wide community use.

Please use our postcard survey – it is all about the First Aid poster – or you might prefer to complete this on line at asthmaaustralia.org.au

Alternatively, please feel free to contact the Asthma Update editor.Email: [email protected]

Women’s Health Expos Asthma Foundation Victoria attended a Women’s Health Expo held by a local Rotary Club. Around two thirds of the people visiting the information booth made an enquiry on behalf of someone they cared for with asthma.

Women often take responsibility for their family’s health. Health Expos bring together a wide range of health and community organisations in the one place so that people have easy access to information and expert advice. Asthma Foundations regularly attend health events all over Australia. Foundation staff are able to offer advice on the spot, answer asthma questions, or let you know about upcoming education sessions in your local area. You may be interested in picking up a selection of brochures and handy checklists - to help you live well with asthma.

To find out what is being offered in your local area, or to invite your Asthma Foundation to be part of your community event:Contact your local Foundation1800 645 130asthmaaustralia.org.au

Asthma First AidSit the person upright — Be calm and reassuring — Do not leave them alone

1Give medication


* You can use a Bricanyl Turbuhaler if you do not have access

to a puffer and spacerGiving blue reliever medication to someone who doesn’t have

asthma is unlikely to harm them

Wait 4 minutes — If there is no improvement, repeat step 2

If there is still no improvement call emergency

assistance (DIAL 000) — Tell the operator the person is having an asthma attack

— Keep giving 4 puffs every 4 minutes while you wait

for emergency assistance

4

To find out more contact your local Asthma Foundation:1800 645 130 asthmaaustralia.org.auTranslating and Interpreting Service: 131 450

© Asthma Australia September 2010 Supported by the Australian Government

2

3

Call emergency assistance immediately (DIAL 000)

if the person’s asthma suddenly becomes worse

Help Foundations to help someone with asthma.

16 Asthma Update I December 2011

Pregnant or planning a pregnancy?

Controlling your asthma is more important than ever. You will be breathing for yourself and your baby.

With good asthma control, you can expect a healthy pregnancy.

However, it is possible that your asthma could become worse with pregnancy. Make sure you are well prepared.

DO:

— Be sure your obstetrician, doctor or midwife knows you have asthma and alert them to any change in symptoms.

— Make an asthma action plan with your obstetrician or doctor. This will describe which medications you need, when to take them and what to do if your asthma becomes worse.

— Keep taking your asthma medication, including your daily preventer.

Will my asthma become worse?

There is a significant chance it could, so prevention is vital. Around half of the women in Australia with asthma will find it becomes temporarily worse during pregnancy.

The risk of a serious asthma attack is higher if you stop taking your usual asthma medications. Follow your asthma action plan and have regular health checks throughout your pregnancy.

Will asthma medications harm my baby?

Most asthma medications, both preventers and relievers, are safe and should be continued during pregnancy. If you stop taking your medications there is a far greater risk of harm to your baby as it increases your chance of a serious asthma attack.

Asthma and Pregnancy

Remember: if you can’t breathe, neither can your baby!

Breathing for two: what you should know.

Can I just put up with asthma symptoms while I’m pregnant?

No – this is unsafe and not recommended. Asthma can increase the risk of pregnancy complications.

What happens if I have an asthma attack while I’m pregnant?

It will be treated the same as an attack that occurs at any other time. Remember to tell ambulance and emergency centre staff that you are pregnant.

Hayfever and allergy control?

If hayfever or other allergies trigger your asthma symptoms, you may be able to treat this with medications. Speak to your doctor or midwife before buying or taking allergy medications.

Need help to quit smoking?

Smoking can be harmful to your unborn baby, and it can make your asthma worse. There has never been a more important time to quit. For help, speak to your doctor or call the Quitline on 13 78 48.

Follow your asthma action plan to manage your asthma during pregnancy.

Breathing for two: what you should know. Asthma Foundation Asthma and

Pregnancy Ambassador, Kelly Nestor ►


Treat your asthma to help your babyDr Nicolette Hodyl PhDPregnancy and Development Unit Robinson InstituteLyell McEwin HospitalSouth Australia

One in every 8 pregnant women in Australia is affected by asthma.

If women stop taking medications to control their asthma during pregnancy they are at risk of having an asthma attack. This can lead to very poor outcomes for the baby.

Our research studies are aimed at understanding how asthma affects pregnant women and their unborn babies in the hope that this will lead to improved antenatal care and lead to a better

pregnancy outcome for both the mother and her baby.

Asthma is one of the most common chronic conditions to affect pregnancy. When becoming pregnant, many women are worried about the

effect that asthma medications may

have on their developing baby and stop taking their medications. However, we have previously shown that when

women do not adequately

control their asthma with medication

during pregnancy, their babies are born smaller than normal, and when asthma medications are

used during pregnancy, babies are born of

normal size1.


In this recent study2 we set out to determine if the baby or placenta were affected by one of the most common medications for asthma: preventers (see Preventer Medication Table). To do this, we measured maternal hormones in 200 women in each trimester of pregnancy. These hormones included those produced by the placenta throughout normal pregnancy and those produced by the baby, which cross back through the placenta into the mother’s circulation2. If the asthma medication was affecting the placenta or the baby, we would expect these hormones to be altered.

We found no difference in the levels of placental hormones and no difference in fetal hormones in women taking asthma medication compared to healthy women without asthma, regardless of the dose of the medication. This shows that continuing to take asthma medications (including preventers) is unlikely to affect the growth and development of the unborn baby.

This study shows that preventer medications can be safely used during pregnancy.

If women stop taking medications to control their asthma during pregnancy they are at risk of having an asthma attack. This can lead to very poor outcomes for the baby, including stillbirth, intra-uterine growth restriction and preterm birth3. We have found that the best way to avoid having an asthma attack is to continue to adequately control asthma during pregnancy4. Women should see their general practitioner or respiratory physician when becoming pregnant to check whether they are using the right medication and taking an adequate dose to control their asthma, remembering that pregnancy can change your asthma requirements. This will ensure the best possible outcome for your baby.

Note from the editor: This research shows that we do know that women should keep taking their medications during pregnancy to control their asthma – and that all women who are pregnant or planning to become pregnant should speak with their doctor. Dr Hodyl and her team are doing further research in this area. We will keep you posted on this excellent work.

References

1. MURPHY VE, GIBSON PG, GILES WB, et al. Maternal asthma is associated with reduced female fetal growth. Am J Respir Crit Care Med 2003;168:1317-1323.

2. HODYL NA, STARK M, OSEI-KUMAH A, BOWMAN M, GIBSON P, CLIFTON VL. Fetal Glucocorticoid Regulated Pathways are not Affected by Inhaled Corticosteroid use for Asthma During Pregnancy. Am J Respir Crit Care Med 2011;183:716-22.

3. MURPHY VE, CLIFTON VL, GIBSON PG. Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes. Thorax 2006;61:169-76.

4. MURPHY VE, GIBSON PG, TALBOT PI, KESSELL CG, CLIFTON VL. Asthma self-management skills and the use of asthma education during pregnancy. Eur Respir J 2005;26:435-41.

Preventer Medication (Autumn/desert colours)

Common Names

Alvesco, Flixotide, Pulmicort

What this medication does?

Reduces swelling and mucus in airways

Makes airways less sensitive

See Asthma Medications for full details of all asthma medicines and devices.


Are we helping more people to manage their asthma better?

The Australian Institute of Health and Welfare (AIHW) staff monitor our health and build a statistical picture of people’s asthma. This article, provided by AIHW looks at hospital visits and deaths from asthma, since the early nineties.

Asthma over the yearsAsthma affects many Australians. Around 1 in 10 Australians reported having asthma when the National Health Survey was conducted in 2007-08. That is more than 2 million people.

People with asthma, particularly children, often require treatment by their GP or in hospital. In 2007-08 there were more than 37,000 hospitalisations for asthma.

Notes:

1. Age standardised to the Australian population as at 30 June 2001.

2. Asthma classified according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code 493 and ICD, 10th Revision, Australian Modification (ICD-10-AM) codes J45 and J46. Hospital separations coded to ICD-9-CM (1993–97) were converted to ICD-10-AM using the following conversion: ages 5–34 years, converted by a factor of 1.0326; 35–64 years, converted by a factor of 0.7938; 65 years and over, converted by a factor of 0.4813. See A1.1.1 of Asthma in Australia 2008 for details about age standardisation and conversion/comparability factors.

3. Separations for which the care type was reported as Newborn with no qualified days, and records for Hospital boarders and Posthumous organ procurement have been excluded.

Source: AIHW National Hospital Morbidity Database.

Hospital separations for asthma per 100,000 population

1200

1000

800

600

400

200

0

1993-94 1995-96 1997-98 1999-00 2001-02 2003-04 2005-06 2007-08

Males, 0-14 years

Females, 0-14 years

Females, 15 years and over

Males, 15 years and over


It was far more common in the 1980s and early 1990s for people to see a general practitioner/local doctor (GP) for asthma or to go to hospital than it is now.

In the ten years between 1993-94 and 2002-03, the rate of hospitalisations almost halved for children (47%). And the rate of GP visits for children dropped by 43% between 1998-99 and 2009-10.

The rates of hospital and GP visits for children with asthma have been more stable over the past 5 years.

Unlike hospital visits, deaths due to asthma are uncommon and are more common among older Australians than children.

The rate of deaths due to asthma has followed a similar trend to hospitalisations. There was a peak in the 1980s. This was followed by steady declines throughout the 1990s and early 2000s. More recently the decline in the rate of deaths has slowed.

It is not known what has caused these increases and then declines in asthma in Australia.

For more information go to:http://www.aihw.gov.au/asthma-and-chronic-respiratory-diseases/

Notes:

1. Age standardised to the Australian population as at 30 June 2001. Asthma classified according to the International Statistical Classification of Disease, 9th edition (ICD9) code 493 and 10th revision (ICD-10) codes J45 and J46. Deaths coded to ICD-9 were converted to ICD-10 using conversion factors (see A1.10.3 in Asthma in Australia 2008).

2. Because attribution of death due to asthma is more certain among those aged 5–34 years, this age group is commonly used for examining time trends. In older people, other causes of death, in particular chronic obstructive pulmonary disease, cause difficulties in the attribution of causes of death.

Source: ACAM analysis of AIHW National Mortality Database.

In late October, the Australian

Institute of Health and Welfare

released a report, Asthma in

Australia 2011. One of the

significant findings of this report

showed the prevalence of asthma

among children and young adults

has decreased over the past

decade.

Professor Guy Marks, Director

of the Australian Centre for

Asthma Monitoring (ACAM)

at the Woolcock Institute of

Medical Research in Sydney said,

‘Between 2001 and 2007-08, the

prevalence of asthma declined in

people aged 5 to 34 years by over

one quarter, but remained stable in

adults aged 35 years and over.

The report also shows a decrease

in deaths from asthma, with the

mortality rate due to asthma

dropping by 45% between 1997

and 2009.

To find out more about Asthma in

Australia 2011 go to the following

website:www.aihw.gov.au/publication-

detail/?id=10737420159&tab=2

Asthma Update will provide a

full story on this publication next

edition.

Breaking news

1993-94 1995-96 1997-98 1999-00 2001-02 2003-04 2005-06 2007-08

Deaths from asthma per 100,000 population

4

3

2

1

0

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Females

MalesAll

5-34 years


A new resource designed to help people

Live Well with Asthma

Asthma can be a confusing condition – different types of medication, the correct use of delivery devices, as well as a range of triggers to be aware of. The recently released Asthma Control Pack contains a DVD entitled “Live Well with Asthma” The Live Well with Asthma Control Pack uses national resources and information and we hope soon to be able to also make the DVD available nationally.

These resources are designed to support people with asthma to:

— Better understand asthma and how it affects them

Parliament House Brisbane, hosted the Asthma Foundation Queensland launch of their new resource: Live Well with Asthma Control Pack and DVD.

— Increase their knowledge of medications and understanding on what medications should be used when

— Use their asthma devices correctly, and

— Be able to manage an asthma attack with Asthma First Aid.

When people are empowered with knowledge of their condition, they are able to better manage their asthma and minimise its impact on their life.

The ‘Live Well with Asthma’ resource is an initiative of Asthma

For information and advice on asthma, contact your local Foundation 1800 645 130 asthmaaustralia.org.au

Foundation Queensland and the Asthma Work Group of the Queensland Health Statewide Respiratory Network; and funded by the Centre for Healthcare Improvement’s Patient Safety and Quality Improvement Service, Queensland Health.

▲ Celebrating the launch of the Live Well with Asthma Control Pack and DVD (L-R) Simon Toy, Dr Adel de Klerk-Braasch, Rhona MacDonald, Joanne Mitchell,

Lisa McCarthy, Deborah Hill and Brett Taylor.

▼ The Hon. Health Minister Geoff Wilson MP (right) presents CEO Mark Brooke with the new Asthma Control Pack.


We asked about your experience regarding asthma first aid, and what you feel are the most important issues for you around asthma medication use.

We greatly appreciate your input, it helps us provide you with the information you need to live well with asthma.

Here is what you told us:

What are the most important issues for you around asthma medication use?— Cost of medication— Correct use of medications— Children and the use of

asthma medications— Transitioning to teenagers

taking responsibility

If you needed help with asthma, was there an asthma first aid emergency kit available with reliever medication and spacer?— Yes – 79%— No – 21%

Was there a first aider who could provide asthma first aid?— Yes – 71%— No – 29%

In response to our question, what would you like to read about in future editions of Asthma Update, here is a sample of your suggestions:

— Strategies to improve medication use for children and adolescents

— Practising family centred care with asthma and children

— Rights to confidentiality with adolescents

— Impact of chronic health on children and adolescents and strategies for health professionals

— Information about allergies and triggers

— Emergency actions— New natural alternative

medications— An ask the educator section— How do schools and sports

clubs make sure the system does not break down?

— Update on asthma medications; relievers and preventers

— Dietary effects on asthma— New research— Improved treatments— Buteyko method i.e. non drug

methods of treating asthma— The history of asthma

treatment — Personal stories

How would you prefer to receive Asthma Update – hard copy or online?— 68% - Hard copy— 32% - Online

Interestingly, you may have noted that the readers postcard survey results differ from the recent National Asthma Week online survey results (conducted separately). We can only assume that readers of Asthma Update are informed and engaged with the management of their asthma, and that they assist in encouraging their local communities to do the same? Let us know what you think?

Have a look at the Asthma Update postcard survey in this edition; we are looking for your feedback on Asthma Australia’s First Aid Poster. We are very keen to hear from you.

You can post in your response, or find it on our website asthmaaustralia.org.au

Thanks again for your suggestions. And thank you for all your positive feedback on the magazine; we will continue to strive to bring you a wide range of interesting articles in every edition.

The Editor [email protected]

Readers’ postcard survey responses

The EditorAsthma UpdatePO Box 603 KENT TOWN SA 5071

AFFIX STAMP HERE

Asthma First AidSit the person upright

— Be calm and reassuring — Do not leave them alone

1Give medication


* You can use a Bricanyl Turbuhaler if you do not have access to a puffer and spacerGiving blue reliever medication to someone who doesn’t have asthma is unlikely to harm them

Wait 4 minutes — If there is no improvement, repeat step 2

If there is still no improvement call emergency assistance (DIAL 000) — Tell the operator the person is having an asthma attack — Keep giving 4 puffs every 4 minutes while you wait for emergency assistance

4

To find out more contact your local Asthma Foundation:1800 645 130 asthmaaustralia.org.auTranslating and Interpreting Service: 131 450© Asthma Australia September 2010 Supported by the Australian Government

2

3

Call emergency assistance immediately (DIAL 000) if the person’s asthma suddenly becomes worse

First Aid Poster Survey

Asthma Australia promotes the use of the community asthma

first aid plan. This is widely available in all Asthma Australia

resources, posters, and Asthma Australia website and first aid

kits. We are keen to hear from you about the first aid plan,

to ensure it is easy to follow, clear and a useful tool to assist

someone giving asthma first aid.

1. Is the plan easy to follow?

If yes, what makes it easy to follow?

If no, what makes it hard to follow?

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2. Do the images help you understand the steps?

If yes, any in particular?

If no, which ones and why?

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Name: ..............................

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Email: ............................

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3. How could we improve the First Aid Poster?

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4. Would you be interested in providing further

feedback on the poster?

Yes No

Please affix a stamp

and return via post,

or complete the survey on-line at:

asthmaaustralia.org.au

or email your thoughts to the

[email protected]

Asthma Update Issue 43 -

Thank you so much to everyone who found the time to respond either via the postcard or the on-line survey from the previous edition.

As you can see, our readers had a lot to say!

To find out more about asthma information and training contact:

1800 645 130 (office hours)

asthmaaustralia.org.au

Helping people with asthma breathe better

asthma update | issue 44 | november 2011

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