Table 2.

School Health Protocol: RED ALERT Asthma Patients

In the event a child in the RED ALERT PROGRAM should demonstrate:
1.  Complaint of difficulty breathing or tightness in breathing
2.  Wheezing and/or coughing
3.  Signs of respiratory distress such as use of accessory respiratory muscles, retractions, increased respiratory rate, nasal flaring
4.  Change in color to pale or dusky
He/she should sit down, relax, and use an inhaled bronchodilator. This medication will be either a metered dose inhaler or a nebulized medication, usually albuterol. If no improvement is noted within 5 to 10 minutes, the medication should be repeated and the parent called. If the parent cannot be reached, call the other number provided on the letter. If that person cannot be reached, call the pediatric pulmonary office at (352) 392-4458 and tell the person answering whom you are calling about and that he/she is in the RED ALERT PROGRAM. Indicate to that person that it is a sick call and they will STAT page a physician to instruct you regarding the child's management.
It is important to note that the children in this program typically can and should live a normal lifestyle that includes physical education activities. They should, therefore, not be treated any differently than their peers. When they have an exacerbation of their asthma, chances are that early administration of their medications will be adequate to stabilize them to return to regular school activities. We would caution you, however, these children may outwardly look fine and say they are well. It is the signs noted above that will help you validate your observations. If in doubt, feel free to call the pediatric pulmonary office to ask for advice.

The RED ALERT PROGRAM is a program set up by the pediatric pulmonary team at the University of Florida to provide children with life-threatening asthma with a network of well-informed health care professionals capable of responding rapidly and effectively. If a child in your school is in this program, you should receive a letter similar to the one attached notifying you of this fact and giving you names of specific persons to contact in the case of emergency. The following are the steps you should take to stabilize the child in the event of an asthma exacerbation. Basically, these children should be treated in the same manner as any other child with asthma except that it is more essential that they receive their medications both routinely and in a very timely manner for management of an exacerbation.