Around 12 o'clock three of our students decided it would be fun to have asthma attacks and pass out. The first one was in my class. The kids said, "Mr. Ben, she's knocked out" or some version of that in French. Well, good, I thought let's get her inside. So we half drag her unconscious body into the hallway to try and cool her off. It's loads of fun (not) watching a teenage girl struggle to breath on the floor while you don't have a clue what's going on and are trying to figure out what's going on by speaking your second and not-mastered language.
So with the help of other students I hear that she has asthma. Well, good, we know what were dealing with. I get my teammate who has asthma for advice . . . We get her inhaler and force a few pumps down her hoping she's breathing enough to get the medicine into her system. So as I sat on the floor with my hand under the girl’s neck to open her breathing passage, thanks CPR class from at least three years ago, and wondered if she was going to wake up, I paused to say a quick prayer in between checking for breathing and a pulse. Not really my idea of fun, but to be honest it did make school much more interesting today. So she woke up after maybe one more pump from the inhaler.
I went back to my class to watch them finish their little test. So about 15 minutes later . . . girl number two, also down on the ground breathing irregularly and unconscious. Great, so let the Inquisition begin: Does this girl have asthma? Reply: We don't know . . . Yes . . . Well, where's her inhaler? . . . She doesn't have one . . . They give me a random . . . My thought process, if she's about to die I'll give it to her, but otherwise I'm not thinking that's a good idea . . . then turns out she does have an inhaler . . . At this point this girl is convulsing a bit . . . So act number two of trying to get a pump of medication into some half-dead person's mouth . . . We get a puff into her mouth, she starts to open her eyes but they aren't focusing at all, just moving all over the place. Eventually they focus, good news, and she starts to wake up. I deposit her in the air-conditioned room.
About 10 minutes later (there is another one) this time downstairs . . . so I run down for girl number three, also passed out, so back to holding the back of her neck so her airway will be open. This one comes around pretty quickly, praise Jesus.
So three crises averted. Got to play tennis this afternoon at a small playground. The court wasn't real (way too short, and asphalt) . . . however there was some guy there who saw me play and gave me an invitation to play in a tournament tomorrow night . . . good stuff .
Dear any nurses or doctors reading if you have suggestions for how to deal better with passed-out asthmatics please let me know.
Ben Roberts
Teacher, English Language Institute, Ouagadougou, Burkina Faso
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Comments
There are many ways to deal with this.... Obviously an Epinephrine would be ideal as it dilates the bronchial tubes. It gets a little sketchy giving advice as you are not certified to administer any of this (thus advice becomes a little sketchy in terms of legalities). Keep airway open, if the child's breathing is coarsely shallow (very little air movement)and under 8 breathes/min (or entirely absent) I would provide rescue breathing (whether with a pocket mask or preferably a bag-valve mask) to get it up from 12-20 (again depends on color of the child and so forth).
Good job on keeping airway as open as you could. If you decide to try the inhaler, you may need to provide a rescue breathe to actually get the medication down into their lungs. ALWAYS use their inhalers if they have one. I know you are in Africa and all, but be careful as you can still have serious legal problems should you do something that harms them further.
Prayer always seems to help, but we are also called to act. Again this is just some advice to use, be safe man.