Asthma Guidance for Birmingham Schools.

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1 Asthma Guidance for Birmingham Schools. May 2004

2 RECOMMENDED ASTHMA GUIDANCE FOR SCHOOL STAFF* This guidance is intended to complement the local Birmingham Administration and Management of Prescribed Medicines guidelines (issued March 2004) and DfEE Guidance Supporting Pupils with Medical Needs (issued in 1996). Schools may find it helpful to attach this specific guidance as an addendum to the local guidelines. It is recommended that those schools who have not yet accessed asthma training do so in the light of an increase in numbers of children and young people being diagnosed with this condition. 1. GENERAL INFORMATION Asthma is a common condition affecting 1 in 8 children. The most common symptoms are coughing and wheezing causing difficulty with breathing. There are many triggers for asthma and the most common in school are exercise and the child having a cold. Some children with asthma only require occasional medication. Most children need medication every day and may require additional treatment at school, particularly before exercise. All children with asthma should not have any problems taking part in normal physical activities particularly if the asthma is well controlled with treatment. All children with asthma should have immediate access to their reliever (blue) inhaler in school. Younger children may require some additional assistance when using their inhaler. All children have a right to manage their own asthma in the best possible way and be educated in an environment sensitive to their needs and supported by health and education staff who understand their condition. 1

3 EXAMPLAR SCHOOL ASTHMA POLICY 2. SUGGESTED POLICY STATEMENT This school: recognises the needs of pupils with asthma; expects and encourages parents to give appropriate information to the school on their child s condition; recognises that immediate access to the pupil s reliever inhaler is vital; will encourage and help children with asthma to participate fully in all aspects of school life. In order to achieve the above, the following are recommended : all staff have basic awareness training about asthma and the use of inhalers, and this is updated on a regular basis; all staff have a clear understanding of what procedures to follow if a child has an asthma attack; the school maintains written details of pupils with asthma, which, are updated annually by the school. 2

4 3. COMMON TRIGGER FACTORS WHICH MAY CAUSE AN ASTHMA ATTACK exercise; colds and viral infections; sudden changes in temperature such as damp, cold air; stress/anxiety; pollen / mould spores; chemicals (including cleaning products and toiletries); house dust mite; smoking (passive and active); animal dander e.g. cats, hamsters. 4. MANAGEMENT OF ASTHMA IN SCHOOLS 4.1 TREATMENT OF ASTHMA Most children with asthma will use a combination of inhalers to keep their symptoms under control. These are: Preventer: Usually in brown/cream/orange devices. They need to be used regularly twice a day to gain control of symptoms. They can take up to 7 days to be effective and therefore are of no benefit in the event of an attack where immediate relief of symptoms is required. These inhalers should not routinely be brought into school, as they should usually be used in the home situation before and after the school day. Relievers: Usually in blue devices. These begin to work immediately and should provide relief of symptoms for up to 4 hours. However, if a child needs to use it more frequently they should be allowed to do so, but it is important to let parents/guardians know. These inhalers are very important and should always be in school and immediately accessible to the child. Parents/guardians should be asked to provide a spacer device for use in school if the child uses this at home. Any queries about inhalers or spacer devices can be answered by your School Nurse or will be addressed through the training recommendations. 3

5 4.2 RECOGNISING AN ASTHMA ATTACK During an asthma attack a child may: have a persistent cough which does not settle; have noisy breathing (wheeze); have difficulty breathing; have difficulty talking; complain of a tight chest. See section 4.3 for procedures to be followed in the event of a severe asthma attack where speed of response is vital. 4.3 TREATING AN ASTHMA ATTACK In any asthma attack the child should have immediate access to their reliever inhaler. Mild asthma attacks should not interrupt a child s participation in school activities. As soon as they feel better they can return to normal school activities In the event of an attack: Stay calm and reassure the child; Help the child to: breathe slowly sit upright or lean forward loosen tight clothing; help the child to use their reliever inhaler; repeat use of the reliever inhaler as required until symptoms are relieved; stay with child until attack is over; if child requires repeat medication within four hours allow them to do so, but always notify parents/guardians and advise the child is reviewed by their G.P./Practice Nurse the same day; always inform parents/guardians if a child has needed to use their reliever inhaler in school. 4

6 4.3.2 In the event of a severe asthma attack always call for an ambulance if: there is no significant improvement in the child s condition 5-10 minutes after using their reliever inhaler; the child is distressed and gasping or struggling for breath; the child cannot complete a sentence; the child is showing signs of fatigue or exhaustion; the child is pale, sweaty and may be blue around the lips; the child is exhibiting a reduced level of consciousness; there are ANY doubts about the child s condition. Whilst waiting for the ambulance to arrive stay calm and reassure the child; the child should continue to take puffs of their reliever (blue) inhaler as needed until symptoms resolve; alternatively, if a spacer inhaler is available, give up to ten puffs into the spacer, one puff at a time every 15 to 30 seconds (shaking the inhaler between each puff); ensure the child s parents/guardians are contacted. 4.4 SAFETY AND STORAGE OF ASTHMA INHALERS The medication used for the relief of asthma is very safe. If too much of the reliever medication is taken, the worst that will happen is that the child may feel very shaky this will wear off after a short time. If a non-asthmatic child uses a reliever inhaler they will not harm themselves. Where appropriate, with parental and school agreement, pupils should be responsible for their own inhalers, which should be clearly marked with the child s name. Make sure that inhalers are not stored where there is excessive heat or cold. IT IS ESSENTIAL THAT INHALERS ARE EASILY ACCESSIBLE WHEN REQUIRED * 5

7 5. TRAINING RECOMMENDATIONS Staff who volunteer* to assist pupils in administering asthma treatment should receive full training before undertaking this task (see Appendix 1 of Administration and Management of Prescribed Medicines on Staff Indemnity). It is important to remember that: all staff should receive regular training on asthma, the use of inhalers, how the devices work and the emergency treatment for an acute attack; all new staff receive basic training as soon as possible after appointment; at least two members of staff are encouraged to attend a more in-depth training session on asthma. Asthma training is available to all Birmingham LEA schools from the Nurse Advisers, Special Medical Needs in School. For contact details see contact page. Those schools who have not yet accessed asthma training are encouraged to do so in the light of an increase in numbers of children and young people being diagnosed with this condition. Training will include information on: what is asthma; the common triggers for asthma; management of asthma in schools; emergency treatment of child suffering from asthma; demonstration of correct use of an inhaler; safety and storage of inhalers; opportunity for questions and feedback; your specific school concerns. *Please note that in line with both local and national guidance there is no requirement for any member of a school staff, either teaching or non-teaching to undertake training or to administer medication to pupils. This is undertaken on a purely voluntary basis, unless specific reference is included in the job description of a member of staff. Where a member of staff chooses to assist pupils in this way, Birmingham City Council fully indemnifies its staff against claims for alleged negligence subject to the conditions outlined in the Administration and Management of Prescribed Medicines (see Appendix 1). 6

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