In Case of Emergency: Managing Asthma at School

While you can help to control what happens in your own home, you can’t always control what happens at school. Work with your school to make sure there is an emergency plan in place for students with asthma. Even if your school has taken every action for students with asthma, an episode could still occur. Being prepared for an emergency respiratory situation is critical. If a child is undiagnosed or does not have an Asthma Action Plan in place, use these standard protocols from the American Lung Association and National Asthma Education and Prevention Program as a guide. 

Watch for one or more of the following: 

  • Coughing, wheezing, noisy breathing or whistling in the chest 
  • Difficult breathing, tightness in chest, shortness of breath or chest pain 
  • Self-reporting/complaints of discomfort when breathing 
  • Breathing hard and fast 
  • Nasal flaring (front part of nose opens wide to get in more air) 
  • Can only speak in short sentences or not able to speak 
  • Blueness around the lips or fingernails 

If the above are observed, take these actions: 

  • Quickly evaluate the child. Call 911 and immediately administer quick-relief medication if in severe distress. (For example: unable to speak, lips blue or peak flow less than 50 percent of predicted best). Give oxygen, if available, if patient is in respiratory distress. 
  • Limit 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 a new location without someone with the student. 
  • Check and record: peak-flow meter reading. (If personal best is unknown, use prediction chart.) 
    CALL 911 if peak flow is less than 50 percent of personal or predicted best. 
  • Respirations and pulse. (Normal rates listed on back. Report to MD or EMS) 
  • Administer quick-relief medication. Medication must be ordered by a personal physician order or a standing order signed by a school physician or public health physician. Administer albuterol from school supply, if available and student does not have a personal albuterol inhaler. Use a spacer and throw away mouthpiece. 
  • Contact parents (even if situation does not appear severe). 
  • Look at student again 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. 
  • If student is not improving contact student’s physician or call 911. 
  • 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. 

An emergency response poster (such as the one above can be hung in classrooms and staff locations for easy reference. CPR and first aid training, including respiratory components, is also suggested.

To learn more about Asthma and the Taking on Asthma initiative, visit our website!

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