I have a student that has severe asthma. When she has an attack, I immediately give her a nebulizer treatment which is the only medication that I have in my clinic. Let me tell you, her attacks are scary! She wheezes, has contractions and my pulse ox reader normally registers her O2 at 94-95%! After treatment, contractions and wheezes are gone but her O2 usually doesn't get much higher than 97%.
Last week, she came in for a treatment in the early morning but returned an hour later, having another attack. Mom was working as a sub so I immediately paged her. After an assessment I offered to call 911 but mom was hesitant. Mom did give her an inhaler, and it helped a little bit. I called her pediatrician because I knew she needed help but I didn't want to overstep mom and call 911 without her permission. I'm a new school nurse and still get anxious about those kind of things...
Long story short, Mom took her to the pediatrician after the student calmed down a big and she was admitted to the hospital for a couple of days. Mom stopped by the clinic this morning with an update and informed me that the next time this happens, I need to call 911 immediately, not her but 911. I was taken back seeing how I suggested that last week and she said no.
Anyways, I'm curious when would you call 911 for an asthmatic patient? I don't want to be put in that situation again. Now thinking about it, I feel like I should call 911 on her initial attacks because they are so bad! Help..new school nurse and I'm second guessing everything!
I've been in the situation with a student with no medication/inhaler at school having an asthma attack and a guardian who was an hour away (and reluctant to leave). This was my first lesson in parents not taking asthma seriously! I monitored the student carefully throughout, and if he had gotten worse I would have had no issue with calling 911. In our district, we currently don't have PRN anything for meds without doctor's orders, and the EMTs can do a neb treatment on site and I can consult with them, which is great.
I'm new this school year too, just this week I have a parent very upset because his student seemed to be having an allergic reaction and he did not take kindly to me interrupting his day to deal with it. He also didn't like it when his student needed an inhaler earlier in the school year (he refused to leave one at school too). This can be a tough job sometimes, and disheartening when dealing with these kinds of parents. I had a student hand me a wrapped bandaid today that said "Thank You" on it (this was a student who I had mildly scolded for not wearing a helmet with his bike on campus). Hanging onto the small pick me ups! I hope you do too.
Paramedics treated me like I was crazy, but I knew this kid.
Don't you just love this!? My go to response is "I didn't call you just to say hello" Last year I caught a post-flu pneumonia in a 1st grader. Paramedic said "oh maybe he's allergic to mold, the mold count is high right now" Ummm.... nope ?
On a somewhat related note. Have y'all noticed that parents make a big freaking deal of out the things that are NBD and turn around and poo-poo the things (such as asthma management) that are a big freaking deal!? Drives me crazy. I'm over here like "Y'ALL GOT THIS BACKWARDS!" ?
GertieGrantRN
6 Posts
I've been in the situation with a student with no medication/inhaler at school having an asthma attack and a guardian who was an hour away (and reluctant to leave). This was my first lesson in parents not taking asthma seriously! I monitored the student carefully throughout, and if he had gotten worse I would have had no issue with calling 911. In our district, we currently don't have PRN anything for meds without doctor's orders, and the EMTs can do a neb treatment on site and I can consult with them, which is great.
I'm new this school year too, just this week I have a parent very upset because his student seemed to be having an allergic reaction and he did not take kindly to me interrupting his day to deal with it. He also didn't like it when his student needed an inhaler earlier in the school year (he refused to leave one at school too). This can be a tough job sometimes, and disheartening when dealing with these kinds of parents. I had a student hand me a wrapped bandaid today that said "Thank You" on it (this was a student who I had mildly scolded for not wearing a helmet with his bike on campus). Hanging onto the small pick me ups! I hope you do too.