Even the dinner ladies know how to treat it. They need to...

In the classroom

Asthma campaign

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The little girl had no history of asthma but she was having an attack. As her chest got tighter she began to wheeze badly and panic. The rest of the class, all five years old, became extremely distressed at what was going on.

It is a crisis so many teachers dread having to face in the classroom, because they do not really understand asthma and have no idea about how to deal with it. Even those who do know what they are doing can find themselves wasting precious minutes rushing to the school office, where the inhalers that would bring relief are kept locked away in a box.

The five-year-old girl was lucky. Her teacher at Fremington Community Primary School in Devon had an asthmatic daughter, and knew the symptoms. She gave the pupil a puff on another child's blue reliever inhaler, tried to get her to calm down, and sent someone to ring a parent.

The message that came back was startling. "Oh yes," said the mother, "I thought she might be asthmatic. She does use my inhaler sometimes."

Like many schools, Fremington then had no record of which pupils had asthma and which treatment they responded to. It does now. The headmaster sent out a questionnaire to parents and discovered that one pupil in four had asthma. No fewer than 40 per cent had not told their teachers, often because they did not know themselves and were not receiving treatment for symptoms that could be quite serious.

"We were really surprised," says Jenny Hill, the teacher who now acts as asthma co-ordinator for the school. "We also found that most of the staff were not confident about what to do with a child who was having an attack."

Ignorance breeds fear, says Phil Cloke, the headmaster. "Our former nurse Jayne once went into a school where a child was sitting in the hall with a brown paper bag over his head, because that's what people thought you should do. If the adults don't know, how can they expect the children to?"

The National Asthma Campaign has attempted to avoid disasters by encouraging schools to develop their own asthma policies, ensuring teachers know about the disease, triggers such as furry school pets are removed, and inhalers readily available. Unfortunately two-thirds of schools have no such policy.

At Fremington teachers, classroom assistants, office staff and dinner ladies have all been trained to deal with an attack. Parents have been offered the same information. "I was appalled at what we were doing before," says Mrs Hill. "Inhalers were kept in the office and children queued up every day to have a puff at 12 o'clock, whether they needed it or not. Now they are in baskets in each class, and can be used at any time." There are also two emergency inhalers with spacer attachments, which increase each dose's effectiveness.

A blue mark in the register shows who is asthmatic. Posters on the wall remind teachers what to do in an attack: "Keep calm and talk in a reassuring manner to the child. Sit (not lie) the child down." There is no need to worry about overdosing on inhalers, it says.

Many asthmatic children are bullied or shunned by others at school who falsely think they can catch the disease. But Brogan Lake, 10, has no reservations about using her inhaler in front of her friends. Several of them have their own. "I only know about the girls, but there are three others with asthma in this class."

The school is on the edge of a village away from a main road. Parents claim that their children feel worse when they go to Barnstaple. Ozone – a cause of asthma – is worse in the rural areas of southern England than in cities; then crop spraying and high pollen counts increase the risk.

Children are six times more likely to have asthma now than when Mrs Hill was at school. "We did a survey of who walks here. Some of the journeys by car were ludicrously short," she says. "The lack of exercise children get is extremely worrying."

Since the asthma policy was introduced into the Barnstaple area the number of children admitted to hospital with asthma attacks has dropped from 32 a year to just two. "Parents have more confidence in us now," says Mrs Hill. "If their son or daughter had a bad night they used to keep them off school the next day because they thought the teachers had no idea what to do. Now they send them in. There has been a dramatic reduction in the number of days off, which means individual boys and girls are getting a much better education."

National Asthma Campaign website: www.asthma.org.uk