Every year there are between one and four deaths due to asthma in Malta, a figure which can partly be put down to the fact that health centres are rarely too far, according to Professor Stephen Montefort.
Prof. Montefort, a consultant respiratory expert, said that in the UK, where asthma care is very good, around 2,000 people die of asthma-related problems annually. Despite the difference in population size, this is still a much higher figure, he said, which indicates that Malta’s size is advantageous in this case.
When an asthma sufferer has an attack, he said, it is very important that they are first calmed down, provided with their inhalers, which they should be carrying, and then be rushed to the nearest hospital or health centre.
In a school it is important, if it is available, he said, to administer the nebulised bronchodilator, a sort of reliever inhaler. If after this, things are seen to improve, it is still important to seek medical advice; however, it does not remain so urgent.
The paper bag technique, whereby sufferers having an attack are provided with a paper bag to breathe into, is dangerous and could be fatal, Prof. Montefort said.
This technique can only be used in cases of people hyperventilating, not in the case of an acute asthma attack. This is why the technique can only be used by a doctor, who can decide with certainty whether the patient is having an asthma attack or a panic attack, and will only use it in the case of the latter.
Following the death of a 14-year-old student from an asthma attack while in the school playground, Prof. Montefort highlighted the necessity that all students who suffer from asthma carry their inhalers around with them.
If, at the time of an attack, the person who is keeping their inhaler can’t be found, it might just be too late, he said. It is also important to have a teacher who is well versed in first aid in every school.
Having a nebuliser available and ensuring that all asthmatic students have parental consent, which permits trained teachers to administer treatment, would go some way towards helping, he said, as otherwise teachers might feel they are putting themselves at risk.
If an asthmatic student has a cough there is no need for them to be sent home, he said, but if they are showing symptoms, then they should not be pushed into doing sports, for example.
Prof. Montefort said it was important to stress that asthmatics take their preventive treatment regularly, whether they feel well or not, as an attack can come on without much warning, being an inflammatory condition.