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Asthma Management Guide
Signs of an Asthma Episode
An early warning sign of an asthma episode may be a drop in the student’s peak expiratory flow rate (PEFR) and/or symptoms. Therefore, it is important to establish a peak flow monitoring program.
Students with asthma are often aware of other warning signs such as those listed below. These usually happen before more serious symptoms occur. Awareness of these warning signs allows early medication at a time when asthma is easiest to control. Encourage awareness of these symptoms, and if any are detected, a peak flow measurement should be taken to define the severity of the problem.
Knowing the signs of a beginning episode will help you avoid a more serious medical emergency. Do not delay once a student has notified you of a possible problem or a drop in peak flow has been detected.
Signs exhibited during the initial phase of an asthma episode:
During the initial phase of an episode, the student will experience a drop in peak flow without observable signs.
Other changes in breathing you may observe are:
- Recurrent coughing
- Wheezing
- Breathing through the mouth
- Shortness of breath
- More rapid breathing than usual
- Retractions of the ribs
- Nasal flarings (when nostrils flare open to take a deeper breath)
- Watch for rubbing of the chin or neck
Signs vary from individual to individual. Not all children wheeze; persistent cough is often the first sign, especially for young children.
Verbal complaints such as:
- “My chest is tight”
- “My chest hurts”
- “I can’t catch my breath”
- “My mouth is dry”
- “My neck itches”
- “I don’t feel well”
Emergency signs are:
- If a student shows blueness or grayness of fingernails, lips or lining of the mouth or if the student is speaking in very short, choppy sentences, call 911 or the emergency telephone number in your community immediately.
- If a student says “I need my inhaler.”
- If the student’s medication fails to relieve worsening symptoms, call the student’s family or physician or call 911 or the emergency telephone number in your community immediately. Relief from the bronchodilator administered at school should be prompt (within 15-20 minutes) and sustained (usually lasting more than an hour, although the time may vary).
- You may wish to review the NAEPP Suggested Emergency Protocol for Students without a Personal Asthma Action Plan . Students who have their individualized plan will have the steps in place for staff to follow.