Welcome back, me.

I won't complain about having a three week winter break, but I was ready to come back to work today. Good thing: my first asthma attack warranting EMS happened after recess this morning. A kid who has come wheezing into my office before came in again, except this time when I asked him to get his inhaler out of his backpack, he said he didn't know where the backpack was. I got his emergency card and we went through every number on the card, his parents twice. While he was dialing, I called the nursing coordinator to ask just at what point I should call EMS. As I began to give my assessment, I realized I didn't need to ask: his color was starting to turn, his coughing becoming unbearable, and his sweating became profuse. I hung up and dialed 9-1-1, because the best we had from any of his emergency contacts was that someone who knew someone who knew where his backpack was would tell her to bring it to school. After a tortuous wait (is it ever not?) the paramedics arrived and whisked him off. [Father called soon afterward asking why he wasn't called first. If he wanted to speak with me directly, I would be more than happy to tell him we tried and didn't have time to wait for a call back, but the secretaries got the brunt of that one.]

When I called the nursing coordinator back to tell her the end result, she said asthma attacks are one of the worst parts about this job; it's not usually a black and white decision, and watching and waiting for their condition to deteriorate is tortuous. Further, it's preventable, and in this case, disgustingly so: we've tried sending the medical forms home for this child to keep his inhaler in the office multiple times, plus, who lets their kid go to school without his backpack? Interestingly, the backpack did show up with the aforementioned emergency contact just before the paramedics arrived. I thought I was about to feel really stupid and have the paramedics find a perfectly happy healthy fifth grader, but the pack was inhaler-less.

Just before break I had received materials on asthma education distributed by the county. I was shocked to learn that kids die of asthma at school (only on the very rare occasion, but still), and I wasn't about to be one of the nurses at such a school today. The materials also included videos of wheezing. I felt ill watching them the first time around but in real life, it is even more sickening to watch a child with a severe asthma attack. The wheezing and coughing make me cringe, and it also makes me want to have a little chat with the parents who decided not to pack an inhaler for their severely asthmatic child on a cold winter day.

On a totally different note, a kid came in to ask for an ice pack for a crick in his neck. I told him his pillow must not have been fluffed right last night, and his accompanying friend said he got two pillows for Christmas. And a shotgun. "A real shotgun. My mom said it's for if anyone tries to fight me." These were first graders.