Teaching about asthma / eczema / anaphylaxis

I am sitting here like a lemon, brainstorming on my own (Yes, weep for me, please), and I thought - why not ask you lot?

I'm trying to come up with fresh, simple ideas for the medical training session for the Kick-A holidays. I'll be teaching lay people - sometimes with little or no knowledge about asthma and allied conditions - what they need to know about ther conditions to be able to help manage the kids for a week.

If you knew very little about asthma, and had to look after a child with asthma for a week, what would you want to know to help you feel confident in managing that child?

Remember - we're not trying to turn them into asthma experts, just to furnish them with enough knowledge that they feel happy to cope with the support of the health pros and more experienced volunteers.

Cheers in advance for any weird/whacky ideas,

Cathy

53 Replies

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  • Think main thing I would want to know is when to seek medical help and what to do to calm a distressed child who is making themselves worse especiall if they are under the age of 1 and still to young to understand. It bothered me when I had my babysat for my godson who was 10 mths at the time and he made himself worse by having a screaming fit on me. Thats what bothered me both as qualified Nursery nurse and having asthma myself. also ways of giving babied their inhalers when they are reluctant to have the face mask on.

  • Thanks for your reply Katharine - sorry I should have specified, the holidays are for children 6-17 years only.

    But I think the point about keeping children calm is very important, thank you.

  • sorry having loopy moment but would apply to any children babysiting!

    Relaxation teq - not that i can do

    get older ones to design funky teenage spacer/ inhaler casing as wud guess some reluctant to use them as boring and not trendy!

  • Right Cath I have sitting beside me (in the NC) my daughter and I said to her if I were to go shopping for your birthday present with a friend of yours what would warn your friends about me and my asthma, she said the most important thing is I am rubbish at early warning signs and admitting defeat anyway she will talk I will type.

    1) Mum is mad it goes with the asthma she says...

    2) She does not always wheeze not talking in sentences is a sure sign of trouble

    3) stopping for a rest more often may mean she is just being sensible or may mean she is in trouble ask her something random one word answer means she is in trouble.

    4) not talking at all [she did add: this might be a blessed releif but usually means mum needs all her air to breathe!] get help.

    5) Telling her to have neb is not going to work get her to stop for a coffee or something and she will probably neb on her own once you stop be tactful.

    6) constantly asking if she is ok will drive her mad

    7) Sometimes you might need to put your footdown and get her help, remember is she does not have the air to argue she needs help like 999 type help

    8) most of the time she will be fine but expect her to do stairs/hills etc more slowly might be worth tactfully finding a lift

    9) Check she has her neb before setting off she has been know to leave it or nebules in the car

    10) Don't be afraid most of the time she knows how she is and will sort it herself.

    Wow, I had no idea how clued up my lot are on when to panic and when it is OK. I could edit this as it is not totally what Cath is after I suspect. Although using other methods than are OK when you are worried about people is a great one. Now I know why sometimes she will come out with random things when we are out she is checking to see how well I am talking.

    Much as I hate to say it checking that everyone has their medications is so important. I guess if you are with a group you could employ the grandad technique when we all went abroad as a family we would all leave the house but before getting into cars or taxis Grandad would say wave your passports and tickets. Everyone would then wave their passport and ticket saving the old problem of arriving and not having your passport. I do it now before going to football, we get into the car and I say show me your tickets and I expect to see everyones season ticket being waved at me.

    I also guess the random other ways of checking up without seeming like you are checking up are good ones too. I hate people saying are you ok or do you need to rest or neb. Maddie says if she is worried about me she will suggest she needs a coffee cos I hate to hold everyone and everything up by stopping to neb etc so coffee breaks are her way of getting me to stop without actually saying for goodness sake sit down and take a break.

    OK enough wibble.

    Bex and Maddie

  • after reading your message on other thread cath could you not find way of using foam or putty in a mouthpiece to demonstare diff in PFER when healthy and vice versa? shaving foam prob go down a treat or that beady putty thats kids playing with at mo in lucid colours? cud use then to show diff b4 and after inhalers. or even at a push cud u not use foam from washing up liquid bubbles. messy but wud demonstrate point.

  • We have a special Kick-A nmemonic (at S'ton we usually put up a bright poster on the door) - ICE (we even have ICE bear!)

    Inhalers

    Creams

    Epipens!

    A lot of what you have come up with tallies and is very useful stuff Bex, and Kath, keep it coming please! I am forming ideas from what you say - thanks.

  • Oh how about star jumps get em to do star jumps as many as they can person who goes on longest wins. After handing mini mars bar to winner, ask them to do it again as they groan remind them that just getting up a few steps can feel like that for a child with asthma.

    Inch of cornflower in a bowel of water with a straw imbedded in it tell them to make a bubble in the cornflower.

    A variation on the spoons theory can be done with jelly babies. Get them to list all the things they do that do in a normal day think they need energy for (getting dressed, going out, washing up, hanging out the washing, meeting mates in town, cooking dinner etc) and set aside a jelly (energy) bean for each one. Then take half of them away and tell them to work out they are going to do everything without the full ammount of energy beans. The bright ones will cut their bean in half and not quite do all of everything :)

    The final one, get some shorts and tee shirt and loosly tack the arms and legs down, get a volunteer to put them on don't tell them you have tacked the arms and legs, after they have struggled and puffed their way into them remind them that when you are short of breath even the simplist of tasks can seem like a marathon.

    Bex

    ps you might want test how hard you tack the t-shirt and shorts with a handly Steve shaped volunteer

  • Eczema - cutting finger nails to try and limit scratching. I find putting cool things on affected areas are a good way of relieving itches as well.

    Quite often exzema sufferers will scratch sub consciously so not getting angry with them is important but also stopping them with a gentle ""no scratching!""

    Anaphylaxis - i know that they used to do trainer pens for people to be able to practice with so that they would know how the pens worked. Will see if i can find a link.

    I have a protocol for my anaphylaxis, depending on severity of attack etc. Might be worth drawing up some different scenarios so that people can get an idea of how anaphylaxis attacks can manifest themselves and the different ways of treating them.

    Hayfever - carry little bags with damp flannels in - very good for eyes - I never leave home without mine in the summer. sunglasses are good for limiting pollen contact with eyes. Small dabs of vaseline at bottom of nostril can also limit pollen into the nose.

    Rusty

  • Oh just thought of another. Get someone to lie on floor put 4 bags of flour onto their chest and get them to sing. As they laugh in their attempts to sing it will double the oh my gods I feel like I have an elephant sitting on my chest.

    Bex

  • in regards to excema i love the double base moiseriser cause its like blamonge (sorry can't sp) cause you shake bttly and it comes away from sides so is fun to use either as moisteriser or in shower.

  • This caused a row at a first aid training course on the asthma section but how about ignore anything you have been told a long time ago about breathing in paper bags and drinks of water fixing breathing and let them sit in a comfortable position don't force them to sit forward, upright etc etc.

  • Would you want to know about what asthma is, and what inhalers do? Diff inhaler types? Or do you think that's not important?

  • Oh I know get pictures of as many different inhalers as you can print them out on sheets with a brief explaination of what they are. Then get them to put them away and hand out sheets with one of the inhalers missing get them to guess which one is missing for a point and a point for knowing if it is a preventor/releiver/long acting releiver etc.

    Bex

  • Like the idea of a ""myth busting"" session too...nice, Marmite...

  • Oh gods brain juice is flowing today. At the start get them to write an action plan for someone in an attack explain this is not a test it is way for them to judge what they need to to know and don't know. Then get them to repeat it once the course is over again no prizes but a great way to evaluate what they have learned. The using the final ones put together a model plan. Or you could ask them all for one thing they have found out that they did not know or realise.

    Bex

  • Myth quiz, what a brillient idea ""Hit or Myth"" entitled Asthma Mythconceptions

    Bex

  • Love it. That would be a nice interactive session too!

  • not to panic, as that can make a person worse

    what the signs are

    getting them into the ideal of a routine with taking inhalers e.g at meals time so the kids do not feel like they are being singled out

    that if they are not happy with a sitution then to get help

    most importantly listen to the person having the attack, they are important to!!

    the more streeed they get the more streed the person gets, so try to stay clam

    hope this might help

  • show them how to make a spacer out of one of those polyesterine cups.

  • Hi Cath!

    There are loads of things that we have covered over the years in different formats for the medical session.

    Asthma - Manchester YHA has a good 3or 4 flights of stairs - Get the NON-ASTHMATICS to run to the top & down (Or just up if session on top floor) and then get them to read a poem or something! they will be puffed out and feel something similar to asthma. Breathing through a straw works too!

    Preventers, protectors & relievers - match the colours! You could mix up lots of different colour items like pieces of wool & ask them to pick out & ID the inhaler type eg Blue reliever. Use games similar to what you use for the kids! Helps the volunteers learn and they can then use the games with the kids! ( The wool game can be adapted to the caterpillar game - hide lots of wool bits then get the kids to find one of each etc)

    Excema - get some Gunk / diprobase or even double base and get some of them to apply it to someones arm in the quantity they think is right! Then show them how much is really needed!

    Use slogans such as

    ' sparing with the steroid cream'

    ' Dump on the dippy'

    importance of the itch cratch itch cyle - cream like mad - you can never put too much cream ( emolient) on a child! (It is amazing what a whole tub of aqueous cream can do to a childs skin over night! = one happier child in the morning)

    Distraction tequniques good too eg Scoobis!

    Anaphylaxis - Don't panic, get help / administer epipen ( we have lots of trainer pens to practice) clear all other kids etc out the way! Emphasise the fact that anaphylactic reactions rarely happen on the KA holiday (Get stats from PL) And there will always be a Health pro close to hand.

    You could do symptoms game - list sympotms and get them to fetch a cutout pictire of an inhaler etc

    show the tick sheets we use fo the kids so they know in advance what they look like.

    Anyway, will try to think of some weird stuff too!

    Kate

    PS Like the T-shirt + steve idea! LOL!

  • I'm not sure I do :/

  • Cath, I have been pondering your seed post and it has made me wonder just how do lemons sit?

    Bex

    sorry off topic randomness

  • How bout warning them not all asthmatics wheeze and some can still look extremly well when actually very unwell. Regular P/F is a very good indiction of any decline over period of hours/days.

  • Nestled in a fruit bowl! LOL!

    sorry, Cath, still thinking up some ideas - will plough through my PEAK KAH stuff!

    Steve - sorry - will make sure you don't get ambushed by a stitched up T-shirt!

    Kate

  • Lemon Sitting-from Wikipedia-""in certain Mediterranean countries,the gathering of lemons was also the local ""dating"" opportunity.Boys and girls on the first few days of the gathering would alternately gather the lemons while the opposite sex would sit back and watch-picking a boy or girl that took their eye and their parents would then try to match them together-this ,over the centuries has become known as the ""Lemon Sitting"" in those cultures.

  • Hows about flash cards... with what does this do...and it could be turned in a game with chocolate prizes for the winning team!

  • could put itching powder inside volunteers clothes so tey can experience first hand how it feels to constantly itch/scratch with excema .... ok that may be a bit harsh lol.

  • Oh Julie I thought the same thing arn't we wicked, I was trying to think of a way of showing them how dreadful the itching of eczema can be.

    Bex

  • Well, it might stop people saying ""it's *just* eczema"" when they've been like it for a day or two and had no sleep at all....

  • Yikes - itching powder - now that is a wee bit evil but then depends on who it is LOL!

    You could pop someone in a straight jacket and tickle them so they want to scratch but can't scratch ???

    Kate

    XXX

  • Just writing some bits and pieces for asthma myths - can people think of any misconceptions that they have heard regarding asthma?

    I already have:

    ""Steroid inhalers are dangerous and they can make you put on weight""

    ""Asthma is a sign of weakness and means you can't run"" (I found this gem on a website)

    Any others gratefully received...thanks so much for all your help so far, it's been really useful :-D

    Cathy

  • One myth that always gets me, but probably isn't particularly relevant for what your doing, is that asthma is a childhood illness that is almost always grown out of.

  • No, that's cool Becky, I can use that - thank you :)

  • 'Just take your blue puffer and you will be OK' .... what a load of , well ... er can't repeat it here! LOL.

    Oh, and another thing that anoys me - people who, once they discover that I have severe asthma, sidle up to me and boast how well controled theirs is with just a purple inhaler (Good for them and I am glad that they can control theirs and live a normal life!) but it makes me feel like I don't have control and don't take my meds. Has that come out right???

  • the myth that ""asthma isn't an illness, thats its not that and people don't relies that it can be life threating and how much it can affect quality of life"" oh and the ""just get on with you'll be find""

    hope thats the rigt sort thing u need

    xxx

  • How about ""all asthmatics panic while having asthma attack""

    Some do some don't the ones that don't can be more scarey!

    ""When you feel better you can stop all your inhalers""

    mmm NO!

    The Jury's out on this one and i don't smoke but lots of people have told me "" If a smoker has a cigarette it calms their lungs just as well as using their blue inhaler""

    ""If your allergic to dogs you're only allergic to other peoples dogs not your own""

    Another one i was told by a fellow mum ""young children with eczema have unhappy mothers and thats what causes it"" ????!!!!

  • This is all fantastic stuff...yes Duckie, perfect, thanks! and Marmite - wow - that is exactly the kind of misconceptions I'm after, isn't it awamzing what people come out with!!

  • How about ""Calm down, you're just panicking"", when clearly I'm calmer than the person saying it.

  • Another one we here often is .......... kids with asthma should't do much sport, asthma makes children very small/frail looking...

    Doesnt go down too well with a very tall, healthy looking sean who has just won a trophy for most tries in team scored during rugby season inbetween nebbing and costa admissions :-)

  • Hows abou8t 'just breathe through it' HA!

  • How about getting people to drink mc Donalds milkshake up thin straw

  • What about the 2 extremes of: a) 'It's only asthma. That's not going to kill you'; and b) 'Why don't you just have a lung transplant?'!

  • OMG do u get the lung transplant question as well???????

    I've lost count amount of times people have said 'sorry to ask but couldnt sean have a lung transplant' Where do people get that idea from, it not like you can just order one on internet and a transplant would help how??!!??

  • or whats long term prognosis........

    Ummmm now wheres that crystal ball gone? wanders off to find it.....

  • procrastinating from revision but a few random ones:

    the 'but you were coughing/wheeing last week, aren't u better yet?' and the ever helpful 'would a drink of water/cough sweet help?'

    oh the other really painful one is ppl patting/hitting you on the back when u are coughing- and u can't talk enough to tell them that is not astually going to help!

    and the brilliant:

    'its summer now though i thought asthma was just a winter thing....' and after we did the 10k run i got 'but you can't run or do sport ur astmatic aren't u'....'

    hope they is a bit of help cathbear

    *wanders back to revision, sobs*

    mouse x

  • I had one A&E nurse come to me in resus one time and said, ""Just concentrate on your breathing"" (!) As if I was, or could, do anything else! I just looked at her like ""WT*"" and she realised the stupidity of what she'd said. The sheer idea that you can think of anything else when you can't breathe, and the number of people who say, ""How about I distract you, then you'll be okay"" !?!?!?

  • 'Or lets put a video on it might help'

    Maybe the nhs were just trying to save money!

  • one thing i think to stressto anyone trying to help is not to rush in and boss the person around. Ask the peron sufferring what they normally do. I know with my brother with his problems we have had first aiders bossing us around insisting on ambulances when we know what we are doing. Often the person with asthma as long as get think straight often have a set routine of tratment and like to stick to it. Of course there are exceptions to the rule.

  • The biggest myth about anaphylaxis is that the symptoms happen in the same order at the same time in the same way after exposure and that you as the patient always recognise it happening. Although it can be dramatic it's not always the instant staggaring collapse they show on the tv!

    It depends whether i have actually eaten the food in which case stomach gets hit first before blisters and lungs or have spat it out in which case mouth blisters and throat closing come first followed by lungs then collapse. It's not the same order everytime as it depends how much and which nut i've been exposed to!

    another asthma myth "" you can tell someone's having an asthma attack as they will always have a white face not red""

    ""eczema is infectious if you touch it""

    ""If you put eczema under very hot running water it takes the itchyness away"" well it kind of does but only cos the skin is BURNT.

    And courtesy of my childhood brownie leader ""you can give alpen to a child with a hazelnut allergy as long as you pick the hazelnuts out"" not recommended.

    I'm afraid i've met a lot of daft people in my 31 years on the planet.....

  • 'Now take nice deep breaths and Calm down!' said by nurses in Rescus while I try to tell them NOT to give me atrovent nebs. Why do people think you are pannicing when you have problems speaking and it takes a minute to get a sentence out or you try to push away the neb that they have just put Atrovent in.

    Excema - don't tell a child 'Don't scratch!' it draws attention to the fact that they are scratching, sometimes subconciously, try ' lets pop some more cream on' or give them a distraction such as something fiddly to do with their hands - beads, scoubies etc.

    Anaphylaxis and allergies had a lot of bad press a few years ago because celebs thought it was trendy to have a ' food allergy' more like faddy eaters! This took the seriousness out of allergy and anaphylaxis.

    usuall line ...' Oh, just eat round it.' Nooooo way - send it back and get a 'clean' plate.

    'Oh, does it may you really ill?' is one question I get when asking for egg free food!

    Mum coined a phrase ... Kate + Egg = Blue light Job!

    re McDonalds milk shake - try blowing out through the straw into the mega thick milk shake to get an idea of how hard it is to blow out (PS Make sure lid is ON LOL)

    'Your not wheezing, you can't be having an asthma attack' - not all asthmatics wheeze!

  • best 1 i had was as attended a and e and traige nurse at desk said ""you got a bit of a cough love"" before deciding not a good question and asking if i was asthmatic.

  • I htink you should come and teach the nurse I saw in A/E the other week about asthma!!! SHe left me sat in minors and ignored me (isaid i ws really struggling sats were fine as usual it gases that aren't) told her i couldn't breath out and she told me not be stupid i would explode if i couldn't breath out!!! She was very not nice to me.

  • The one I get in School is ""Try and take Big Deep Breaths!"" or""I know it is not that bad!"" One thing That annoys me is My school Nurses attitude to Asthma!!!! Teach her not to annoy me!

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