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Emergency First Aid Oxygen Response in Schools

With the increasing prevalence of asthma in schools, as well as anaphylactic reactions to foods, insect stings, inhaled agents, etc., combined with the increasing reliance on the school nurse for primary care, it is important to consider having oxygen as a part of a school’s emergency response. The NASN Position Statement, “Emergency Preparedness and Response in the School Setting – the Role of the School Nurse,” under Emergency Equipment states, “The availability of essential emergency supplies is an integral component of being able to render appropriate on-site care and manage the emergency condition (2014a; Doyle, 2013).” More specifically, NASN’s Emergency Resources, Equipment and Supplies – With/Without A School Nurse practice tool provides emergency equipment recommendations as a resource to schools and school nurses (2014b). The practice tool lists recommended resources, equipment, and supplies for all schools, with additional considerations for schools with a school nurse. Oxygen is an example of emergency medications and supplies that may be part of the school emergency response plan, along with albuterol and epinephrine auto-injector, for schools with a nurse (2014b). Illinois’ Guidelines for the Nurse in the School Setting (2010) recommends “Give oxygen as tolerated if available,” for two of the initial five major assessments in the ABCDE (breathing and disability):  “Breathing Position student for maximum ventilatory ability. Give oxygen as tolerated if available. Provide mouth-to-mask ventilation if needed.  Disability (neurologic status) Provide reassurance; position to maintain comfort; give oxygen if available (p. 14).” The other letters in the initial assessment include A – airway, C – circulation, and E – Exposure with Environmental control to prevent heat loss. This same guide specifically lists oxygen delivery as an intervention for the complications that may occur with the following conditions: asthma attack/reactive airway disease, respiratory distress, sickle cell anemia, and throat emergencies (2010).