Your EMS Unit has been dispatched to Purple Sage Elementary School for a reported child with asthma. You arrive on scene and are directed to the Vice Principle’s office. As you enter the room you are introduced to 9 y/o Tiffany.

You begin your assessment before you even make contact with the patient. Tiffany appears apprehensive and is concentrating on her breathing. You notice a normal inspiratory phase followed by a prolonged expiratory phase with audible wheezes. You can see that she is using some accessory muscles to breath. Her teacher informs you that Tiffany occasionally has bouts with asthma but is always assisted by the school nurse. However, the nurse called in sick this morning.

You begin your assessment by introducing yourself to Tiffany. You kneel at her side and are now at an eye-to-eye level. You reassure Tiffany and explain what you are going to do. Her airway is open and patent and she is breathing at 32 times a minute. Radial pulses are present and rapid at 120/minute. You detect no cyanosis. Auscultation of her breath sounds reveal expiratory wheezes in all lobes. Your partner applies a pulse oximeter, which indicates 93%. You direct your partner to start Oxygen at 15LPM with a Pediatric Non-Rebreather Mask. The remainder of the physical assessment is unremarkable. You ask Tiffany if she has or uses a medication inhaler. She tells you that it is kept in a cabinet in the nurse’s office. The Vice Principle states that he has a key and access to student medications, as well as, her medical records. You tell him that would be very helpful. You assist Tiffany to the stretcher as the Vice Principle returns with her Inhaler and Medical Records.

You contact Medical Control who instructs you to administer 2 puffs of her Ventolin Inhaler. You remove the Oxygen mask to assist with the medicine. She takes the medication. You move her to the ambulance and begin transport to Children’s Hospital. Tiffany’s mother is already on her way there from work.

During the 10-minute trip to the hospital, she improves with less wheezing heard and much less signs of distress. Tiffany says she feels better. You obtain the following Vital Signs: B/P 112/76, HR 120, RR 22 and SpO₂ is 96% on Oxygen. You quickly review her history where you find that she has NKDA. You also find that the only medication she takes is Ventolin. Her only Past Medical History (PMH) is asthma. When asked, Tiffany says she ate breakfast this morning. You deliver Tiffany to the hospital where her mother is anxiously waiting. You complete your run report and prepare for your next call.