I have a student who is always wheezing. I could listen to his lungs at any time of the day and there would be wheezing. This student can take every the inhaler every 4 hours. Today, the student needed his inhaler less than 2.5 hours after his first dose. The doctor is aware on how uncontrolled the asthma. Avg spO2 is around 94-95%.
I closely monitored the child until mom arrived to give the inhaler. She was here in less than 5 minutes.
What happens if you can't reach a parent? Obviously if there was serious distress I would give the inhaler early and then call 911.
Do I just monitor and wait for the situation to become an emergency? I feel backed into a corner.
I agree. It is a family medicine doctor. Mom states she is waiting to see a specialist.
Waiting for what? Does it really take that long to get an appointment or is she waiting for it to really get bad (eyeroll)? Having worked in a doctor's office, anytime we got a referral from a doctor that bumped them up to the front of the line.
Waiting for what? Does it really take that long to get an appointment or is she waiting for it to really get bad (eyeroll)? Having worked in a doctor's office, anytime we got a referral from a doctor that bumped them up to the front of the line.
Does your state allow for an albuterol protocol?
The student is on medicaid. It can take awhile.
On 2/19/2020 at 3:45 PM, NutmeggeRN said:
AND, are we sure the kid is getting his AM and PM meds....? asking for a friend ?
It sounds like this kid needs to be put on maintenance inhalers (LABAS) or maybe just an Inhaled corticosteroid. Also are you checking this kids peak flow? You guys should know what his green/yellow/red zones are.
Don't wait to administer the albuterol MDI, waiting with asthma is a very dangerous game. Also this child should have a spacer with his albuterol MDI with every administration to ensure he receives all the medication. Make sure you are performing proper MDI administration. He shouldn't be taking a fast deep breath with it, it should be a slow inhale with a breath hold for 5-8secs.
Hope this helps. Asthma with kids can be very dangerous.
SaltineQueen
913 Posts
Waiting for what? Does it really take that long to get an appointment or is she waiting for it to really get bad (eyeroll)? Having worked in a doctor's office, anytime we got a referral from a doctor that bumped them up to the front of the line.
Does your state allow for an albuterol protocol?