Appendix 6
Symptom and Action Flowchart for Asthma Attack
Mild Asthma Attack




Increase in coughing
Slight wheeze
Able to speak in a sentence
Not distressed
Severe Asthma Attack

Using tummy muscles or muscle at the
throat
Tells you that the blue inhaler at the
normal dose is not working
Cough/audible wheeze/ complaining
of tight chest

Help the pupil to:
 breathe slowly
 sit upright or lean forward
 loosen tight clothing
 take Reliever Inhaler (BLUE),
preferably through a spacer
 repeat as required, up to a
maximum of 4 puffs, until
symptoms resolve

• Multi dose Reliever (BLUE) Inhaler
giving 10 puffs over 10 minutes
through a spacer
NO
Is the pupil responding?
Is the pupil responding?
YES
YES




Reassure pupil
Stay with pupil until attack has
resolved, then return to class if able
Inform parent/carer
Offer a drink to relieve mouth
dryness
While waiting for the ambulance:
 Continue to give Reliever Inhaler
through a spacer
 DO NOT attempt to put your arm
round the pupil’s back or “cuddle”
the pupil
 Help the pupil to:
o Breathe slowly
o Sit upright or lean forward
o Loosen tight clothing


NO
Reassure pupil
Contact parent/carer –
pupil to be sent home

Distressed and gasping or struggling
for breath
Unable to speak in a sentence
Showing signs of fatigue or exhaustion
Pale, sweaty and may be blue around
the lips
Reduced level of consciousness









Dial 999
Follow instructions from ambulance
control staff
Stay with pupil
Reassure pupil
Contact parents
Appendix 6
Symptom and Action Flowchart for Severe Allergic Reaction (Anaphylaxis)
Using an Adrenaline Pen
Severe Reaction
Mild/Moderate Reaction





Swollen lips
Flushed, itchy, blotch skin
Abdominal pain and nausea
Swelling round eyes
Fast breathing



Swollen tongue
Hoarse voice, difficulty swallowing
Cough, difficulty breathing, noisy,
laboured breathing




Change in colour
Feeling faint
Deteriorating consciousness
Collapse
Give Antihistamine Dose: as
stated on pharmacy label
Lie pupil down and raise pupil’s feet.
If asthmatic, give reliever via
spacer (2 puffs).
Another 8 puffs, 1 puff per
minute, can be given.
Administer Adrenaline Pen
 Hold Adrenaline Pen firmly
 Remove outer safety cap
 Hold the other end (non-safety cap
end) of Adrenaline Pen 2 cm from
the upper outer thigh
 Jab the Adrenaline Pen into the leg
until you hear it click
 Hold the Adrenaline Pen firmly in
place for 10 seconds
 Remove Adrenaline Pen from leg
 Rub leg
Contact parent/carer to inform
them that their child has had an
allergic reaction.
Supervise closely.
If condition worsens to severe
reaction:






Dial 999
Follow instructions from ambulance control
Stay with child
If no improvement in breathing or alertness
after 5 minutes, give second Adrenaline Pen
Contact parents
Give Adrenaline Pen to ambulance staff
Appendix 6
Symptom and Action Flowchart for Severe Allergic Reaction (Anaphylaxis)
WITHOUT Using Adrenaline Pen
Severe Reaction
Mild/Moderate Reaction








Swollen lips
Flushed, itchy, blotch skin
Abdominal pain and nausea
Swelling round eyes
Fast breathing




Swollen tongue
Hoarse voice, difficulty swallowing
Cough, difficulty breathing, noisy,
laboured breathing
Change in colour, pale, clammy
Feeling faint
Deteriorating consciousness
Collapse
Give Antihistamine Dose: as
stated on pharmacy label
Lie pupil down and raise pupil’s feet.
If asthmatic, give reliever via
spacer (2 puffs).
Another 8 puffs, 1 puff per
minute, can be given.
Contact parent/carer to inform
them that their child has had an
allergic reaction.
Supervise closely.
If condition worsens to severe
reaction:




Dial 999
Follow instructions from ambulance control
Contact parents
Stay with child