Some level of emergency care is required every year at every school across the US. When a life-threatening emergency occurs, the quality of the response in the first few minutes can make the difference between life and death. An asthma attack can be just such an emergency. At the first sign of symptoms, all school staff should be prepared and able to respond quickly and confidently.
A well-developed SWAP is a safety net. It includes risk reduction through school walk-arounds and return of school health forms. It also addresses communication with the medical office school-wide and, possibly, a local emergency medical service. There should be periodic checks that emergency equipment and protocols work effectively. Well-coordinated response plans will apply not only to asthma, but to other emergencies such as cardiac arrest, allergic response, seizures, and falls.
Every school should have an individualized School-Wide Asthma Protocol that meets the requirements of that school. Because both emergency and non-emergency asthma management requires a multi-faceted approach, a team approach is required to make it happen. Begin with building a team.
1) The Asthma Support Team
The ideal Asthma Support Team has a diverse core group of four or more members drawn from the administration, PA/PTA, and custodial medical, classroom, cluster, or support staff. The team should recruit others outside the core group such as parents, family workers, classroom volunteers, and even concerned neighbors to help with Program Kit actions.
The AFSZ program emphasizes team-building, education and action. By working together and taking responsibility for overseeing one or more program areas, each team member plays an important role in creating an informed and asthma-free school zone.
2) The SWAP Document
The Asthma Support Team should drive the effort to develop a school-wide asthma emergency plan, or protocol, which should be practiced and understood by all. The SWAP poster, which lays out steps to take in an emergency, is one piece of the puzzle. But there is much more for a school to consider.
If an emergency occurs, is it clear what to do?
Who is called first and when?
What precautionary steps can a gym teacher, a classroom teacher, and a librarian take?
Who in the school knows CPR?
Who knows how to use an HFA inhaler?
Where is an Epi-pen?
Does the school have an existing emergency code for the public address system?
How can the medical office work with the custodial office to make the air on the playground safer and healthier?
Which students have asthma and what and where is their medication?
SWAP Response to Asthma Symptoms
If a child begins to show asthma symptoms, SWAP advises the following:
• Stop all activity, stay calm, and have the child sit up straight.
• Ask the child to tell you or point to the location of his quick-relief inhaler.
If the inhaler is not immediately available, contact the medical office. Request that medical personnel come to you, or have an adult take the child to the medical office. The child should not go alone or with another student.
• Administer quick-relief medication. (p. 104) Check the time.
• Demonstrate slow, deep breathing. Give sips of room-temperature water.
• Repeat quick-relief medication after 5 minutes, if needed.
• If a school nurse has not arrived within 15 minutes of first giving the medication, and the asthma symptoms have not improved or seem to have worsened, call 911. Immediately report the incident to the school medical office.