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Letter to Babysitter
Emergency Treatment Sheet
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Babysitter Sheet

The following can be given to your babysitter. For a version suitable for printing, click here.

_____________________ has asthma. Normally, he/she is able to do all the activities that other children his/her age are able to do. However, please be aware that an asthma attack may occur.

This sheet is a list of what to look for and what to do in case ______________________ has an asthma attack.

Signs and Symptoms that asthma has been triggered:

  1. COUGHING -- Especially if it is persistent
  2. WHEEZING -- A high-pitched musical sound
  3. RAPID BREATHING -- More than ______ per minute
  4. DIFFICULT OR IRREGULAR BREATHING
  5. ANXIOUS OR SCARED EXPRESSION
  6. HUNCHED OVER BODY POSITION -- Shoulders coming up toward the ears
  7. RETRACTING -- A sucking in at the base of the neck or between the ribs with each breath.

If these symptoms appear, please do the following:

  1. Be calm
  2. Have ___________________________ sit down
  3. Try to get him/her to slow his/her breathing down
  4. Get a glass of tap water, not too cold
  5. Get ___________________________to sip the water.

If these measures do not stop the coughing, wheezing, or irregular breathing within five to ten minutes, or if the symptoms worsen, then follow these steps:

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We are available at:

In the unusual event that we are not available and the symptoms are not coming under control within 30 minutes, or are getting worse:

Call Dr.   at:

The following medications are to be given at the times indicated in the amounts indicated:

  1. ____________ at ___________AM/PM
  2. ____________ at ___________AM/PM
  3. ____________ at ___________AM/PM
  4. ____________ at ___________AM/PM

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