Extra resource: asthma in children

Extra resources: Tim explains an asthma attack to Susie

Watch the video and read the dialogue below. Dialogue from ‘Cambridge English for Nursing’ Intermediate Plus by Virginia Allum and Patricia McGarr (video by Virginia Allum on www.english360.com)

https://www.youtube.com/watch?v=suHnZ8Vp2P8

Tim: Hello, Susie. Can I come and sit here with you for a while? You’re looking a bit brighter than yesterday, aren’t you? We’ll have a chat about your breathing now, and then I’ll have a talk to you about what happens to your airways when you have an asthma attack. OK with you?

Susie: Why do I have to do all that? Sounds like school!

Tim: Come on. It’s not as bad as that! The thing is, Susie, I want you to be able to understand what’s happening to you during an asthma attack, so that you can cope when you have another attack. Does that sound like a good idea?

Susie: Yeah, I suppose so. So what do I have to do?

Tim: Well, I’ve got this little booklet for you to take home with you. Have a look on the first page, and you’ll see a diagram of what we call your respiratory system. That’s the one. Now, I’m going to tell you what happens to the air when it comes into our bodies and travels to our lungs.

Susie: Is that, like, when you’re having an asthma attack?

Tim: Good point. No, I’m talking about what happens normally, how the air should move into our lungs.

Susie: Oh, OK.

Tim: Right, let’s start. The air is breathed into your nasal cavity – that’s your nose – where it’s warmed and filtered. It moves past the oral cavity, that’s your mouth. Now it goes through your pharynx, or throat, and then comes to the epiglottis. That’s the little flap which stops food going into your lungs when you swallow. The tube which carries food to your stomach is right next to it, so that part is like a road which divides into two roads. Can you see that?

Susie: Yeah. Hey, this is interesting!

Tim: Oh, great! I thought you’d find it interesting. Now, the air is moving past your larynx, or voice box, so that you can make sounds. It moves down your trachea, or windpipe, and into the bronchus. That’s the part which swells when you have an attack. We’ll talk about what happens in an asthma attack later, OK?

Susie: Yeah, OK. What happens to the air now, Tim?

Tim: Oh, I can see you’re right into this! Well, see how the bronchus divides into the two lungs? That’s it. The lungs are covered by the pleural membrane. That’s the special covering that protects your lungs. Pleural is just a medical word for lungs. Inside the lungs are the alveoli, which are masses of tiny sacs which help your lungs to exchange carbon dioxide for oxygen. Then you can breathe out the carbon dioxide.

Susie: I get it now. What about these things around the lungs?

Tim: Those are your ribs. In between the ribs we have the intercostal space. Intercostal is the medical word for ‘in between the ribs’. Well done, Susie. You’ve got all the labels there.

Tim: Have a look at the next page for me. Can you see the two diagrams?

Susie: These ones? One says it’s a picture of healthy airways and the other is a picture of a person who’s having an asthma attack.

Tim: That’s right. Let’s call this one healthy airways and the other one asthmatic airways. You can see that the healthy airways have a lining of healthy tissue. The tissue layer isn’t very thick.

Susie: But the tissue in the asthma airways is thicker, isn’t it?

Tim: Yes, the tissue in the asthma airways becomes inflamed.

Susie: What’s the layer around the tissue called?

Tim: That’s a muscle layer. The muscle layer contracts, or squeezes. In the healthy airways, the air flows through the airways and is conducted into and out of the alveoli, or tiny air sacs. In the alveoli, carbon dioxide is exchanged with oxygen. This is called respiration, or breathing.

Susie: What happens to the other airway – I mean, to the asthmatic airway?

Tim: You remember that the tissue in the asthma airways becomes swollen during an asthma attack?

Susie: Yeah

Tim: Well, the muscle squeezes the swollen tissue and the lining of the airways swells as well. This means the airway is narrowed. Can you see that there is less room for air to go through?

Susie: Yeah, I can see that.

Tim: That’s why your chest muscles tighten and it becomes difficult to breathe. You start wheezing when you breathe in. It also takes much longer for you to breathe out again.

Susie: I hate that!

Tim: It’s frightening when it happens, isn’t it? Now that you know what happens during an asthma attack, it’ll make it easier for you to understand why you need your medication.

Susie: Yeah, thanks, Tim. I’ll look at the book until mum comes back.

Activity 1: Match the words which have the same meaning.

1. contract                          a. swap
2. swollen                           b. between the ribs
3. conduct                          c. squeeze
4. cope d. breathe in
5. pharynx                           e. breathe out
6. intercostal f. inflamed
7. exchange g. manage well
8. exhale                              h. throat
9. inhale                               i. bring into

Activity 2: Find a diagram of normal airways and one during and asthma attack. Make a leaflet for a child to explain what happens to them during an asthma attack.