High School Breathing

Dispatch: "Community Rescue, proceed to Skyline High School gymnasium at 543 Skyline Dr. for a 15-year-old boy in distress." This is a familiar place within your district. As you arrive, there is a DARE officer waiting for you at the front door.

Scene Update: The DARE officer directs you to the gym where the young man is lying on the floor complaining of difficulty breathing.

General Impression: The patient seems to be very anxious, and is currently in the tripod position.

Initial Assessment:

Level of Consciousness: The patient is anxious, but can answer you appropriately, so you deem him to be AAO X4.

Airway: The patient is only able to speak in one and two word phrases, but it seems as though the airway is patent.

Breathing: The patient is breathing at a rapid rate, 26 breaths per minute and is stating, "I can't get… enough… air".

Circulation: The patient's pulse is rapid at 110 beats a minute. Skin tone is warm and sweaty. BP is 110/70.

Physical Exam:

Lung Sounds: The patient's lung sounds demonstrate wheezing in all fields.

Physical Exam: Demonstrates that the patient has small bluish tinge to his lips, and is pursing his lips when he exhales.

Focused History (SAMPLE):

S: Onset - was 10 minutes ago. Provokes - usually symptoms improve with inhaler, which is in the locker. Quality – feels just like an asthma attack. Radiates – all around the chest. Severity – an 8 out of 10 for an asthma attack. Time – this has happened twice in two weeks.

A: Allergies to pollen, and dusts.

M: Medication is a Proventil inhaler.

P: Asthma.

L: Breakfast.

E: Started playing basketball and came on quickly.

Treatment: Depending on local protocols and the availability of the patient's inhaler, it would be very appropriate to administer either the patient's inhaler or administer an Albuterol and Atrovent nebulizer. If this does not help the patient to breath easier, it is appropriate to transport the patient to the hospital with lights and sirens.