Suggested Emergency Protocol For Students With Asthma Symptoms
Who Don't Have A Personal Asthma Action Plan
Supplies:
Albuterol inhaler, spacer/holding chamber, peak flow meter,
chart of predicted peak flow values, oxygen (if available)
Possible observations/symptoms (May include one or more
of the following):
- Coughing
- Wheezing, noisy breathing, whistling in the chest,
- Difficult breathing, tightness in chest, shortness of
breath or chest pain, breathing hard and/or fast, discomfort
when breathing,
- Nasal flaring (nostril opens wide to get in more air)
- Can only speak in short sentences or not able to speak
- Blueness around the lips or fingernails
Actions:
- Restrict physical activity and allow student to rest.
Encourage student to breathe slowly and relax.
- Place the student in an area where he/she can be closely
observed. Never send a student to the health room alone
or leave a student alone. Limit moving a student who is
in severe distress. Go to the student, instead.
- Quickly evaluate the student.
- Check and record:
- Respirations and pulse (Normal rates listed on back.
Report to MD or EMS).
- Peak flow meter reading. (If personal best is unknown,
use prediction chart.)
CALL 911 if peak flow is less than 50% of personal
or predicted best.
- Administer albuterol--2 puffs albuterol, 5-10 seconds
between puffs. Medication must be authorized by a personal
physician order or a standing protocol signed by a school
physician or public health physician. School nurses
(or designee if authorized and appropriate) may administer
albuterol from school supply, if available, and student
does not have a personal albuterol inhaler. Use a spacer/holding
chamber and disposable mouthpiece.
- Contact parents (even if situation does not appear severe).
- Re-evaluate student after 10-15 minutes. Check for ease
of breathing, peak flow, pulse and respirations.
- If student is improving, keep the student in the health
room under supervision until breathing returns to normal.
Follow school protocol for returning to class.
- If student is not improving, contact student's
physician or call 911. Administer albuterol again--2
puffs, 5-10 seconds between puffs. May repeat for up
to 3 treatments.
- With parental permission, provide report of health room
encounter to student's physician.
- Obtain a personal asthma action plan for this student
from the student's family or physician.
Call 911 and immediately administer
albuterol
and O2 (if available) if in severe distress!
(For example: unable to speak, lips blue, or
peak flow <50% personal or predicted best).
Contact parent/guardian. |
Normal Breathing and Pulse Rates by Age (from EPR-2)
Age |
Breathing Rate |
Pulse Rate |
<2 months |
<60/minute |
<160/minute |
2-12 months |
<50/minute |
<120/minute |
1-5 years |
<40/minute |
<110/minute |
6-8 years |
<30/minute |
<110/minute |
9-15 years |
<30/minute |
<100/minute |
16-18 years |
<20/minute |
<90/minute |
Peak Flow predicted best chart (add chart for type
of meter used)
Developed July 2005.
|