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Asthma Emergency Guide for Schools
An assessment tool for teachers, aides and coaches
Thomas F. Plaut, M.D

Click here to view the Asthma Emergency Guide for Schools in English

Click here to view the Asthma Emergency Guide for Schools in Spanish

Clicking on the links above will automatically open Adobe Acrobat Reader. If you don't have Adobe Acrobat reader and would like to download the program for free click here:

For preschool age children, see the Asthma Emergency Guide for Preschools.

The Asthma Emergency Guide (AEG) identifies students who need emergency care and immediate transport (911) to a medical facility. Timely care will reduce the seriousness of asthma episodes and the number of hospitalizations, now 200,000 annually, for childhood asthma.

School nurses can use the Asthma Emergency Guide (AEG) to teach school staff how to identify students with a life threatening asthma emergency. Equally important, the AEG identifies children with urgent problems who need medical attention within two hours. The staff will be able to arrange transport before the problem becomes life threatening. Therefore, safety demands that schools have a simple emergency guide that covers all children.

The need for urgent care is based on the quantitative assessment of three common signs of asthma: cough, wheeze and retractions. A total score of nine or higher calls for transport within two hours. Retractions are heavily weighted because cough and wheeze may be absent or minimal in a seriously ill child.

These signs can be scored by an observer, whereas symptoms, such as tight chest and shortness of breath, rely on the patient’s report. Health professionals in five practices were able to teach the scoring of these signs to parents in less than five minutes. After that, they validated the parents’ ability to score these signs accurately.

A peak flow score is also a very useful measure of severity. It is included, but not essential to the guide.

The AEG helps school staff make decisions that lead to timely and proper use of emergency facilities. It is not a substitute for individual action plans on file with the school nurse. Nurses in the Early Childhood Education program of Chicago Public Schools developed the original version of the AEG. They have used it in individual contacts and workshops for 2,500 parents, teachers and aides and posted it in 330 schools. The use of the guide has led to appropriate transfer of children and better asthma care for parents, staff and their children.

Jennifer Boldt, BSN RN, Christine Ferraro, BSN RN and Frances Belmonte-Mann, MA.RN developed the original version.

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