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Original poster

Asthma people - does this look OK as a covering letter with inhaler for new school?

23 replies

Katisha · 02/09/2009 21:03

DS(9) starts a new school tomorrow and I am sending in the usual spacer and salbutamol.
Does this seem Ok as an explanatory letter?

"I would be grateful if DS could keep his inhaler and asthma medication at school. His asthma is well-controlled and he only tends to need it when he has a cold or had been running about in the cold air. He knows when he needs it and is able to administer it himself.

Generally he will take two puffs of salbutamol, sometimes more than once a day.

In the unlikely case that he has real trouble breathing he would need to take double or treble that dose and to see a doctor immediately. It is not possible to overdose on salbutamol and if it seemes to be an emergency then ten puffs can be given at a time. It is, however, extremely unlikely that this would happen."

I'm not talking bollocks about maximum dose am i?

OP posts:
mumandlovingit · 02/09/2009 21:36

sounds fine to me. i had to fill in a school form though so make sure you check when you take him or they might be funny with him using it till the form is filled in. you know how schools can be!

i had to write a lettar and a form

Original poster
Katisha · 02/09/2009 21:42

Yes I have a feeling I may have done the form. Will ask them - I seem to have filled on so many permission forms for this school that I can't actually remember!
I do hope red tape isn't going to stop him having access to his medicine - I have heard of it happening once or twice from friends...

OP posts:
Sidge · 02/09/2009 21:47

YOu should also contact the school nurse, who should draw up a protocol with you for the school. A protocol stipulates exactly what medication he should have and when, and what to do if things don't improve. Ours are written as a flow chart so they are clear and easy to follow, with explicit instructions as to what to do in an emergency.

The school can give you the school nurse's number.

Schools have an Asthma Policy and certainly at his age he would be able to self manage to a degree - he may not be able to keep his inhaler on him (which is what should happen at senior school) but it should be accessible and NOT locked away.

Original poster
Katisha · 02/09/2009 21:52

Thanks Sidge, I will add a line about not locking it away and enquire further.

OP posts:
brimfull · 02/09/2009 21:55

no you're not talking bollocks about the max dose

had to give ds 10 puffs today

ended up needing nebulizer and steroids though

thank god for steroids

Original poster
Katisha · 02/09/2009 21:58

Too true - we haven't had to use prednisolone for a year or so now but it revolutionised our lives when they gave us a packet to keep at home. No more eons at A&E and choldren's ward waiting waiting waiting to get some down him...

OP posts:
Tortington · 02/09/2009 22:00

i have deffo overdoesed on salbutemol

i feel icky clammy and get the shakes

Tortington · 02/09/2009 22:01

also - he should have the inhaler when he feels he needs it - only quantify this by saying if this persists he must see a doctor immediatley

Original poster
Katisha · 02/09/2009 22:04

I know that shaky heart-racing feeling after a lot of ventolin - but I don't think it's life-threatening is it? I know it took a while to convince the childminder that it wasn't a dangerous drug and that he could ask for it more than once a day.

OP posts:
dogofpoints · 02/09/2009 22:05

phone the school to ask for a medical form

RubberDuck · 02/09/2009 22:12

I know that if you have a nebulizer that it's more sabutamol than exists in an entire inhaler, so yes you're right about max dose.

Really really important to only use it to give you the time for emergency help though in that situation, imo, so spot on with adding that he'd need to see a doctor.

Also, is he aware that it can take a while for sabutamol to act (about 10 mins), so rather than taking multiple doses in quick succession (unless severe attack) it's best to take one puff, sit quietly for 10 mins then decide if you need another.

You could print out this guide from Asthma UK to staple to the letter re: what to do in the event of an asthma attack and what one is.

www.asthma.org.uk/all_about_asthma/what_to_do_in_an_asthma_attack/index.html

Original poster
Katisha · 02/09/2009 22:21

Thanks RubberDuck - I have added part of that webpage to the letter. Excellent!

Hopefully they know all about it - I rather doubt he's the first child there with asthma, but I just want to make sure they don't make it difficult for him.

OP posts:
labyrinthine · 02/09/2009 23:11

The dose of salbutamol in a nebuliser is approx equivalent to the ten puffs[given one at a time] through the spacer.

But as you said,that is a high dose and if that much is needed for relief then urgent assessment is required.

I tend to send ds with the easi~breathe salbutamol device for school as it is smaller and goes in to his own bag.

Then if he is in a wheezy phase I take in his spacer and normal evohaler[as it is more effective]as well and give it to the staff.

Also we have contact diaries and I write it in there,and speak to his own teacher if I can.

gigglewitch · 02/09/2009 23:14

Sounds spot on to me

I wish all parent were as clear and organised as you...

RubberDuck · 03/09/2009 08:59

Just double checked the figures.

A normal dose of salbutamol is 100 micrograms (1 puff) or 0.1mg. There's about 20mg in an entire inhaler.

Dosage of nebuliser depends on weight (figure I found was 0.15mg per kg so assuming a child of 20kg (my 8 year old!) then 3mg (30 puffs!)) up to a maximum of 5mg (50 puffs!) (and is also delivered with pure oxygen). So yes, labyrinthine is right, not a whole inhaler's worth, but you still have a LOT of leeway!

Original poster
Katisha · 03/09/2009 12:51

Laby what is the easy-breathe device? I haven't come across that.

OP posts:
labyrinthine · 03/09/2009 13:10

It is a device that is a little easier to use than the basic evohaler in that you shake it,then breathe in,fully out and then inhale from the mouthpiece and the powder is automatically ejected out of the device as you inhale,allowing more powder to be delivered to the lungs than with the evohaler.
I don't think quite as much powder is delivered as with the spacer but it is more convenient to use and keep in the bag at school or on the road.

labyrinthine · 03/09/2009 13:16

It is still the same salbutamol and you can request it from the GP something like
"Salbutamol easi~breathe inhaler"

will check proper name it is in ds' bag.

Original poster
Katisha · 03/09/2009 13:20

Thanks - I'll mention it to the asthma nurse next time we are there.

OP posts:
overthemill · 03/09/2009 13:30

katisha
we got given these when it became obv that my dd underbreathes all the time. her technique is therefore 'poor' with the other kinds. They are VERY expensive though and had to get paed to write a letter demanding she had them!

Original poster
Katisha · 03/09/2009 14:59

That's a shame - I like the idea of something portable he can keep in his school bag and not have to go and get from a teacher or school office.

OP posts:
labyrinthine · 03/09/2009 15:11

It is worth asking~the spacers are so big,and the evohalers deliver so little to the lungs.
The spacer is better for the steroid inhalation and for the salbutamol when quite poorly.
May have been lucky,but I didn't have a problem with the prescription myself.

overthemill · 03/09/2009 15:25

def worth trying - they also make dd feel grown up as she doesnt use her spacer any more at school. and this combined with ease of use i think makes her better at taking it at school - she used to hate it
good luck

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