for school and daycare

"Rule of Nine"

Adapted from One Minute Asthma www.pedipress.com

Call 911 if you see ANY ONE of the following emergency signs:

 Trouble walking or talking

Child is hunched over

Child is struggling to breathe

Lips or fingernails are gray or blue

After calling 911, call the office and tell them to contact a parent or guardian.

IF EMERGENCY SIGNS ARE NOT PRESENT, but the child is coughing or having difficulty breathing, assess the severity of the asthma signs:

Circle the score that applies to each symptom

Total the score


None 0

Less than 1 per minute 1

1 - 4 per minute 3

More than 4 per minute 5

Sucking in of chest skin

None 0

Barely noticeable 1

Obvious 3

Severe 5


None 0

End of exhale 1

Throughout exhale 3

Inhale and exhale 5

TOTAL SCORE: ________

If score is nine or more

Record the score and give medications as defined by the child's asthma plan or school protocol.

Contact a parent or guardian and advise them to take the child to a physician within the hour.

From the One Minute Asthma Training. Copyright 2002. Pedipress, Inc. All rights reserved. May be copied by school nurse or district. Contact info@pedipress.com for commercial use or sale. Asthma Emergency Plan 1.7 030503

A copy of this plan can be downloaded using the link below:Asthma Emergency Guide