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Birth DateAddressStudent Name: Birth Date: Address: School Asthma Action Plan (page two) Metered Dose Inhaler (MDI) Instructions 1. Store at room temperature. 2. Shake the MDI for 5 seconds before
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How to fill out school asthma action plan
How to fill out school asthma action plan
01
To fill out a school asthma action plan, follow these steps:
02
Start by obtaining the school asthma action plan form from your child's healthcare provider or the school nurse.
03
Make sure you have all the necessary information about your child's asthma, including triggers, symptoms, and emergency contacts.
04
Fill out the personal information section of the form, including your child's name, age, and any relevant medical history.
05
Indicate your child's asthma severity level, which is typically classified as intermittent, mild persistent, moderate persistent, or severe persistent.
06
Provide a detailed list of your child's asthma triggers, such as exercise, allergens, or respiratory infections.
07
Describe your child's usual asthma symptoms, including coughing, wheezing, shortness of breath, or chest tightness.
08
Specify your child's medication regimen, including any preventer or controller medications, as well as quick-relief or rescue medications.
09
Include instructions on how to administer each medication, including dosages and frequencies.
10
Provide emergency contact information, including phone numbers for parents, guardians, and the child's healthcare provider.
11
Review and double-check the completed form for accuracy and completeness.
12
Submit the filled-out school asthma action plan to the school nurse and keep a copy for your records.
Who needs school asthma action plan?
01
Children with asthma, particularly those who attend school, need a school asthma action plan.
02
This plan is commonly recommended for students with a history of asthma or those who experience asthma symptoms while at school.
03
It helps ensure that appropriate actions are taken in case of an asthma episode or emergency during school hours.
04
With a school asthma action plan, teachers, school staff, and the child's peers can be better prepared to assist and support students with asthma.
05
Even if a child's asthma is well-managed, having a school asthma action plan in place can provide added peace of mind for both parents and school personnel.
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