It happens pretty often that students forget their inhalers (MS). Every time it's happened there was no distress, O2 sats were mid to high 90s, mild wheezing and every other time someone was able to bring the inhaler within a reasonable time. But yesterday I had a student who had some wheezing and chest tightness, O2 93-95% up to 98% with deep breathing. I called dad who said he will bring her inhaler. 30 mins go by, no dad no inhaler, no change in student. I called and he said 15-20 mins. 30 mins go by still no dad. I called for admin to bring me a Coke (it had worked for a previous student) and then I called dad with no answer. I had the secretaries calling him too with no luck for about an hour. She was stable to where I did not feel an ambulance was necessary but I wanted to call one anyway because she was going on 2 hours wheezing and chest tightness. Finally dad shows up. She takes her inhaler, we wait about 5 mins and O2 is up to 99%, clear lungs, no chest tightness. I was so frustrated because this whole thing took 2 hours where I was constantly assessing her for changes while other students are still coming in and out. Had I known it was going to be 2 hours I think I would have called for an ambulance just to get her help sooner. I'm also not going to give them Coke and send them to class because it's definatley not a replacement for their inhaler.
What do you all think of this? Would you have called an ambulance?
I called dad and told him that we don't have an action plan in place and that the student NEEDS to be bringing her inhaler to school or she can leave one here. Dad said, "well she doesn't really have asthma, she grew out of it but when she gets out of breath I give her her sister's inhaler." ? What?!
I told him that she has asthma on her physical forms, therefore she has asthma and needs an action plan in place along with her OWN inhaler in school everyday. Otherwise she can go to her pediatrician and have them evaluate if she still has asthma or not. Judging my assessment of her last week, she needs an action plan..
Specializes in Emergency Medicine, Women's Health,School Nursing.
This happened to me 2 years ago...what a nightmare. I had a 3rd grade kid with a pretty decent asthma history that peaks in fall and Spring (of course). He had been battling an upper respiratory infection for a bit which flared the asthma. Did not bring his inhaler to school that day (self carry), no back up in nurses office (long background with family history and poor care at home and C&Y involvement). Anyway I called 'mom' to bring in his inhaler...she was at the hair dresser an hour a way and had color in her hair and couldn't leave. Told me he was 'faking it' and to send him back to class. She had no one else to bring his inhaler from home. So I try some tricks that may help but he was just getting worse...then he looked at me and said "I'm scared". That did it...called mom back up...said I was calling the ambulance, she said "yeah thats fine...let me know what hospital they take him to so I can come get him" then hung up. ? poor kid
Ambulance came for him, he needed 2 long neb treatments in the ER to finally get his lungs to the point they were clear enough to go home. Honestly the inhaler probably wouldn't have helped much to begin with but thats a WHOLE other story on the poor care this kiddo receives at home. Next day I had an extra inhaler to keep in my office pretty sure thanks to my billionth call to C&Y
...then he looked at me and said "I'm scared". That did it...called mom back up...said I was calling the ambulance, she said "yeah thats fine...let me know what hospital they take him to so I can come get him" then hung up. ? poor kid
Ambulance came for him, he needed 2 long neb treatments in the ER to finally get his lungs to the point they were clear enough to go home. Honestly the inhaler probably wouldn't have helped much to begin with but thats a WHOLE other story on the poor care this kiddo receives at home. Next day I had an extra inhaler to keep in my office pretty sure thanks to my billionth call to C&Y
CanIcallmymom, BSN, RN
397 Posts
AYE YAY YAY!