Asthma Attack

[ethiopia]

Hello everyone. It's been a while since I've been here. I am new to school nsg. The hrs are great but pay is AWFUL...anyway, I had this situation where a teacher bought in her student to my office who clearly was having an asthma attack. So I look through the students who have meds kept in the clinic, and of course he isn't one of them. According to him he usually keeps his inhaler in his bookbag but used it the night before & never put it back. Let me just say this child is in kindergarten(I don't know what parent would trust a 5y/o to be responsible for something as important as making sure they have thier pump. You would think that would be the last question you ask before you leave the house if you are going to let them carry their pump). So I contact the mom, she mention that he had to use his pump and get a breathing tx the night before and that she will bring his med, she also states that she lives about 2 mins from school. So of course I'm watching the kid like a hawk. He starts swing his feet because he's board I guess, I tell him don't swing your feet. He dropped his pencil, I said I'll get it. I want him to use as little energy as possible. Anyway, what seems like forever time wise passes by and still no mom. So I call my to see where she is, and she's still home. Oh I live 2 mins away I'm coming. I'm thinking what are you still doing at home. So yet another 5 mins pass I'm ready to call 911, eventhough the childs s/s didn't get worse it only take 1 sec for it all to change.

I say all of this to say, how long do you seasoned nurses wait before you call 911 for asthma attack?

[Flare, ASN, BSN]

I think it's a definite have to be there type situation. If a child is in distress and a med isn't available - 9-1-1. if a parent is taking too long, i think i'd probably call them and tell them that i am feeling uncomfortable with the situation, assess exactly how far away they are and if it's prudent to call 9-1-1 or wait. If they are on their way and i find that the child is in distress, i may call ems anyhow and advise that the parents are enroute to the school. If the parent decides that they do not want the child treated THEY can sign the refusal form and take their child with them. I think a lot would depend on how big your community is and how quickly your ems resonse takes too. I know that some areas have almost intantaneous ems response while some rural areas may wait 30 minutes for ems.

[Sudsy]

I would be very tough: "if you can't be here in five minutes, I'm calling 911". I think parents who have never seen how bad asthma can get and how quickly it can go south, sometimes don't think it's such a "big deal".

Good luck.