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It’s back-to-school season. You’ve thought of the lunches, the new pencils and those lovely first-day-of-school outfits. But, is airway safety on your back-to-school checklist? There are many airway emergencies that can happen at school that providers, families, school nurses and teachers should be aware of and prepared to address.

Allergies in school


Kids are taught that sharing is caring, right? Well, this can be a recipe for disaster at lunchtime with many children having allergies that could result in anaphylaxis. To prevent allergic reactions, students with known allergies should make teachers, nurses and other school personnel aware of what they’re allergic to. Students with allergies should always carry the correct medication to keep them safe, and school staff should know how to administer this medicine correctly. To keep everybody safe, children should be reminded that, yes, sharing is caring, but at lunchtime, only eat the food that was packed for you!


The Department of Education has a list of warning signs to look for when a child is having a moderate to severe allergic reaction. The symptoms include:



  1. Runny nose
  2. Itchy or watery eyes
  3. Itchy throat
  4. Coughing or wheezing
  5. Rashes or hives
  6. Tissue swelling




  1. Swelling of the face, lips, tongue, mouth and airway
  2. Wheezing and shortness of breath
  3. Tightness in the chest
  4. Dizziness
  5. Blue or gray color around the lips
  6. Nausea or vomiting
  7. Itchy skin, hives or other rashes appearing quickly


Now, you may be wondering what to do once these symptoms are identified. Well, the Department of Education also compiled a checklist of actions to take when treating a child with allergies. These actions include:

  1. Administer an epi-pen if the student has one prescribed. After that, immediately call 911.
  2. Try to have the student sit in any position that is comfortable for them to allow them to easily breathe.
  3. Stay calm and reassure the student that everything will be all right. Acting hastily could cause the child to become even more distressed.
  4. Pay close attention to the breathing patterns of the child.
  5. If unresponsive, lay the student on his or her left side to reduce the risk
    of blocking the airway.
  6. If the child is not breathing, start CPR until the student starts breathing or until the emergency medical team arrives.
  7. If the child has to go to the hospital, immediately notify the parents of the student’s emergency.

Asthma in school

Many students may suffer from asthma, which can be triggered by various catalysts such as nervousness or overexertion in an activity like gym class or recess. Parents can prevent asthma disasters by sending children to school with an emergency health care plan and proper inhaler. To stop the attack, school personnel should administer the child’s quick relief inhaler if applicable.

The Department of Education has detailed the early, moderate and severe signs for an asthma attack which include:



  1. Coughing
  2. Shortness of breath when walking
  3. Tickle in the throat


Moderate to severe symptoms:


  1. Tightness in chest
  2. Wheezing or grunting
  3. Unable to talk without stopping to breathe
  4. Gasping, rapid breaths
  5. Flaring nostrils
  6. Feelings of fear or confusion
  7. Bluish color of lips and skin
  8. Changes in alertness


If the student does not have an inhaler, ask the student to sit upright and breathe slow, deep breaths. After that, call 911 and the parents/guardians of the student immediately.

Choking hazards in school

There are many opportunities for a child to choke in school. When children are young, they put objects in their mouths that they shouldn’t, or they may not know how long to properly chew their food to prevent choking. According to Act Fast’s choking guide, this is the list of foods that students choke on the most at school:


  1. Hot dogs and sausages
  2. Nuts and seeds
  3. Whole grapes
  4. Popcorn
  5. Hard or gooey/sticky candy
  6. Chunks of peanut butter or cheese
  7. Raw vegetables such as carrots
  8. Rice cakes


The Act Fast list of objects that children tend to choke on, especially at school are:


  1. Latex balloons
  2. Coins
  3. Chewing gum
  4. Marbles and ball-shaped objects less than 1-3⁄4” in diameter
  5. Toys with small parts that can break off or be squeezed to fit into a child’s mouth
  6. Clothing buttons
  7. Small batteries
  8. Pen or marker caps


You can never be too careful

Taking the necessary steps to protect your child from the crises associated with allergies, asthma and choking can save their lives. Parents, teachers, nurses, providers and all school personnel should be aware and equipped with the proper knowledge and resources to save the lives of children both in and out of school environments.


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