I am a relatively new school nurse. The other day I got a phone call from one of my elementary schools
(while I was at one of the my other schools) that a student was short of breath and struggling to breathe. They stated that she had been running in gym class when it started. No PMH or allergies that we knew of. I asked a few questions and then drove over to that school as fast as I could (about 15 minutes). Her face was bright red, lung sounds were wheezing, very labored breathing, tachypneic, O2 in the low 80s. She'd been like this for about 20 minutes at this point. Principal said she hasdn't gotten any better. Attempted to call mom, but initially could not reach her, so I called 911. While I called 911, the secretary reached the mother and she was on her way as well. EMS got there and put 2L of O2 on her. Within a couple of minutes, the wheezing went away, her O2 went up to the mid 90s, and her breathing became less labored. Mom arrived after the student looked much better from the oxygen. Mom has asthma. We took the O2 off of her and she continued to do fine at this point. EMS talked to the mom and didn't feel that she needed to go to the ER, but encouraged her to follow up with her PCP and get tested for asthma (which I generally agreed with). Mom ended up taking the student home and said she was going to call her PCP.
Of course, since this has happened I've been questioning whether calling 911 was the right thing to do or if I should have held off. The nearest hospital is 45 minutes away. I had absolutely nothing at school that I could give her (we can only stock epi and narcan). What would you have done?
Oct 31, '17
Quote from AdobeRN
You did fine. I would have done the same. The only thing I may have done differently was to tell the secretary to go ahead and call 911 since you were not on campus and 15 minutes away.
We now have stock albuterol along with stock epi in our district. Maybe you can check to see if that is a possibility. Having the albuterol on hand has cut down our calls to EMS in situations like this.
I did at least tell the secretary that if she seems to be getting worse before I got there, not to hesitate to call 911, but I wasn't sure if I should have went ahead and told her to call 911 or not. The bad thing is is that I have no cell service between the two schools
. Of course, I did not think of this until I was on the road.
I wish we could stock albuterol, but it's a state law we can only stock epi and narcan. Narcan was just added this year, but our schools don't stock that as of now. Just epi.
Last edit by basketball13 on Oct 31, '17
: Reason: add info