The student cannot do normal school activities See emergency medical care in most locations, call 911 Call the PCP ____________ ______________________ NOTE: Wheezing may be absent because air cannot move out of the airways. Poor Response to Test Dose of Albuterol/Xopenex The student does not feel better 20-30 minutes after taking the rescue inhaler. The student has severe symptoms (coughing, extreme shortness of breath, skin retractions between the ribs or at the neck). The student has trouble walking or talking. The student’s lips or fingernails are blue. The student is struggling to breathe.