School opening windows and cold triggering asthma

[Burnt0utMum]

Got myself in a bit of a panic over this and don't want to act irrationally. Kids have only just gone back to school today and we've had a message about 11am asking that children are sent in a jumper or cardigan to school as they will be having the windows open due to covid guidance. DS is in year 1 and has been hospitalised twice in the past couple of months with difficulty breathing. He is on an asthma plan now and we believe the cold to be the main trigger for the attacks. I'm in the process of getting him a blue inhaler to be kept in school but prescriptions seem to be so slow at the moment so right now he doesn't have an inhaler at school. I am panicking that he could get very ill again today as it's freezing and has been snowing. I've asked the school to keep a close eye on him but I'm still concerned. AIBU? Is it fair to keep him in the cold despite the harm it can cause him? They told be he can wear extra layers if needed but the trigger is actually breathing in the cold air so layers is beside the point.

Can he sit away from the window? I would imagine the air wouldn't be cold enough by the other side of the classroom to trigger it. I would make the school aware, and if it causes any problems keep him off until he's got his inhaler.

Can you send him inhaler from home to stay in his bag and come back home each day? I agree with PP that they should make sure he is sitting away from any drafts.

If he's got asthma he'll be at greater risk of serious illness if he gets Covid. On the balance of probabilities he's probably better off in school with the window open. You can ask that he's sat as far away as possible and that teachers are aware of his condition and know what to do if he gets an attack.

I've known people whose asthma would be triggered by this, regardless of where in the room they sat. I don't know what the answer is but your worry is not unreasonable.

One of the asthma charities had advice on Facebook a few weeks ago about wearing a thin scarf/snood and pulling it over mouth and nose to warm the air as it's breathed in to stop it being such a shock to the lungs.

Not sure if it was this specific link or not but the info is here

www.asthma.org.uk/advice/triggers/weather/scarfie/scarfie-faqs/

Lots of schools have inhalers that they can give to pupils if needed in an emergency. So if your dc has one at home and hasn't got a spare, if you dont want to keep his blue reliever in his bag for them to use, maybe discuss with them whether they have a school inhaler.

He needs an asthma care plan ASAP! The teachers should know which inhaler he needs and how many puffs (and how long between puffs), they need to know triggers and signs that he’s struggling.

It isn’t always coughing that’s a sign. My DS would get a blue line across his nose that the class TA would spot.

Can he wear a mask? It might protect him but also make sure he breathes warmer air. Just an idea! I’m autistic and I hate cold air so I love wearing a mask.

My DS had covid and has severe asthma. And his peak flows increased during and after Covid. An unexpected positive!

I know it’s a worry, I spent the whole pandemic worrying too!

I've worked in a number of schools that don't keep inhalers in as spares so please don't rely on this. It's really important you send one in from home and your son brings it back with him.
I'd go for the snood option and ask that he is sat near a radiator, out of the breeze. We've had windows open since covid first hit and it's pretty unpleasant for the children. We let them wear coats whenever they want to but I would invest in some thermals.

Is it the actual cold temperature that triggers it or is it a change from hot room to cold outdoors (or vice versa, as in my case)?
If he's in a constant temperature, even if it's cold, he may well be ok. The only thing you can do is monitor him closely and see the Gp if you think it's affecting him.
Is he OK outside in the playground in this weather?

If you go in to the pharmacy and explain that you have a request for a prescription in but need it as a matter of urgency they may be able to issue it as an emergency ahead of receiving the prescription.

My friend is a TA in a primary school with severe asthma and she has struggled. If she has a serious attack she can be off for a few days recovering. The school have got quite arsy with her over her sickness record, despite the fact that it's entirely caused by the freezing conditions. Both windows and doors constantly open to get air circulating. She would wear a mask to warm up the air but can't when in class as she works with children who need to see her talking.

I'd suggest a thin mask. At least there are plenty about to choose from.

I agree with above that changing temperatures are worse than constant cold. My asthma has been awful through the pandemic BTW because of wearing masks, so be careful those suggesting to use of these to help asthma.
How bad are his attacks? Is it a case of gets a bit wheezy and an inhaler sorts it out, or is it a rush to q&e job?

Q&e? A&E!!

I guess a mask or a snood is a possibility. I doubt he'd want to keep it on all day though. He is sat away from the window but not near a radiator. I could ask about him being moved but I don't think there is a radiator he could realistically sit near because of the layout of the classroom. He seems to be managing break times OK but they're only short, not all day and the last attack was when he'd been in the cold for a significant amount of time. The attacks don't seem to be relieved with the blue inhaler anyway which is why I'd much rather prevent before it gets to needing it. So far he's needed to go to hospital both times and needed the combined nebuliser, with even that not working the first time and having to be repeated. It's honestly very scary even when I'm right there with him but even more scary when I'm not there. I really don't want him to have to go to hospital again, it's not fair on him.

Every child is different, so I am going to tell you about mine in the hopes it might prove useful.

Cold is listed as a trigger, but it’s really changes in temperature. The open windows in winter wouldn’t concern me.

The thing we worry about the most is getting sick. What is a small cold for other kids can trigger 5 days of non-stop coughing for my child or even a trip to the hospital.

I would make sure he wears a mask at school and washes or sanitizes his hands often to lower his odds of catching anything. Then keep advocating for getting an asthma action plan in place.

Take an inhaler to school every day until you get another it’s too risky not too.

I totally understand your concern, OP, but we've had windows and doors open for months in our school. I think the only thing you can do is ask if he can be seated away from the window (possibly near a heater if it's on) and give him an extra layer to wear.

By a radiator could well be even worse!

It’s such a tough one to balance. Ds is a severe asthmatic and is triggered by cold (5 minutes outside today and he was off) but as long as not sat by the windows would be fine inside.

You need to send the blue inhaler you have into school until a second has been arranged though. School need a proper action plan.

And of course when you get the preventer inhaler right then the risk should be lessened even further.

If the attacks aren’t managed by Ventolin then he needs something else prescribed for him ASAP.
Does he have a nebuliser?
Does he have a Clenil? What dose is it?

His asthma needs better management.

Also, he really does need something in place at school. It’s unfair to send him to school without anything.

@DrMadelineMaxwell

Lots of schools have inhalers that they can give to pupils if needed in an emergency. So if your dc has one at home and hasn't got a spare, if you dont want to keep his blue reliever in his bag for them to use, maybe discuss with them whether they have a school inhaler.

Never heard of this. Schools are not allowed to prescribe medication which is essentially what you are doing if you randomly decide a child needs an inhaler. Even putting a dab of disinfectant on a bit of cotton wool for a scraped knee as happened when we were kids (such a nostalgic smell! ) would be frowned on these days and would get you in deep trouble. Water only!

Would an extra layer help - vest under his shirt and some football leggings or something under his trousers?

Does he have a brown preventer inhaler to use at home? Once we started using one of those, DS has never needed to be hospitalised. As with your DS, the blue inhalers didn't really work for him and he ended up in hospital with nebulisers.

I don't understand why you can't get a second inhaler? My DS is asthmatic and has a blue inhaler on repeat prescription and he has one for school, one for home and a spare.

Difficult one but Can he have a ‘snood’ for over his mouth?
My DS with cold and exercise induced asthma used one for football training and It kept the air around his mouth moist and warm. They aren’t actually called snoods but can be used for cycling and such like. They are kind of a little tube-like scarf.

I would give your gp a call now and ask for a ventolin inhaler and spacer to be prescribed - it's quite worrying that he's had two hospital admissions and you don't yet have one, I would have thought that the hospital would have given you one on discharge.