Asthma Management Policy

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1 Asthma Management Policy Policy Number 003 Version Number 1.01 Drafted by Executive Officer Approved Date: Review Date: Responsibility Relevant Policies Relevant Standards and Regulations Bubup Womindjeka Family and Children s Centre Association (Inc.) The Board June 2014 June 2015 Medical Conditions Policy, Health and Wellbeing Policy, Medication Policy, Administration of First Aid Policy, Incident, Injury, Trauma and Illness Policy, Staffing Policy, Emergency and Evacuation Policy, OHS Policy Education and Care Services National Regulations 2011 Regulations: 86, 87, 90, 92, 93, 94, 95, 96, 136, 137 National Quality Standard 2012 Quality Area 2: Children s health and safety 2.1 Each child s health is promoted Each child s health needs are supported 2.3 Each child is protected Plans to effectively manage incidents and emergencies are developed in consultation with relevant authorities, practised and implemented Relevant Legislation Quality Area 7: Leadership and service management Service practices are based on effectively documented policies and procedures that are available at the service and reviewed regularly Education and Care Services National Law Act (2010) Sections 167, 169, 174 Health Care Records Act (Vic, 2001) Sources Asthma Foundation Victoria Asthma and the 2013 Child in Care Model Policy, Version 2, July 2013 Authorisation Bubup Womindjeka Family & Children s Centre Board of Management Rationale Asthma is chronic health condition affecting approximately 10% of Australian children. It is a common reason for childhood admission into hospital. Community education and correct asthma management will assist to minimise the impact of asthma. It is generally accepted that children under the age of six do not have the skills and ability to recognise and manage their own asthma effectively. With this in mind the service recognises the need to educate its staff and families about asthma and to promote responsible asthma management strategies. Scope This policy applies to all Bubup Womindjeka Family and Children s Centre staff, students on placement, volunteers, children and families. Purpose The purpose of this policy is to: raise the awareness of asthma amongst service community provide the necessary procedures to ensure the health and safety of all persons with asthma attending the service Asthma Management Policy Page 1 of 5

2 provide an environment in which children with asthma can participate in all activities to their full potential provide a clear set of guidelines and procedures to be followed for the management of asthma. Our commitment: Asthma management should be viewed as a shared responsibility. To this end each of the key groups within the service gives the following undertakings: Service management will: Provide staff with a copy of the Asthma Management Policy and brief them on asthma procedures upon their appointment to the service. Provide Emergency Asthma Management (EAM) training to staff as required by the Education and Care Services National Regulations Ensure that at least one staff member with current, approved EAM training is on duty at all times. Ensure that the details of EAM training are included on the staff record. Identify children with asthma during the enrolment process and inform staff. At enrolment provide families with a copy of the Asthma Management Policy and an Asthma Action Plan to be completed with and signed by a medical practitioner. File Asthma Action Plans in the child s enrolment record Formalise and document the internal procedures for Emergency Asthma First Aid Ensure that an Emergency Asthma First Aid poster is displayed in key locations Ensure that the First Aid Kit contains a reliever medication (blue/grey metered dose inhaler containing salbutamol e.g. Airomir, Asmol or Ventolin), a spacer device, face mask, concise written instructions on Asthma First Aid Procedure s and 70% alcohol swabs. Ensure that an accredited staff member correctly maintains the asthma component of the First Aid Kit (e.g. provide regular checks of expiration dates on medication) Provide a mobile Asthma First Aid Kit for use at activities outside the service. Encourage open communication between families and staff regarding the status and impact of a child s asthma. Where appropriate offer information sessions on asthma for families Promptly communicate any concerns to families should it be considered that a child s asthma is limiting their ability to fully participate in all activities. Ensure that children with asthma are not discriminated against in any way Educators will: Ensure that they maintain current accreditation in EAM (valid for three years) and are aware of the service s Asthma policies and procedures and other related policies and procedures Identify the children in their care with asthma. Ensure, in consultation with families, the health and safety of each child through supervised management of the child s asthma. Identify and where practical, minimise asthma triggers. Where necessary, modify activities in accordance with the child s needs and abilities. Ensure that all regular prescribed asthma medication is administered in accordance with the information on the child s written Asthma Action Plan. Administer emergency asthma medication if required according to the child s written Asthma Action Plan. If no written Asthma Action Plan is available the Asthma First Aid Plan in this policy should be followed immediately. Promptly communicate to the Director of Education and the family, any concerns that a child s asthma is limiting their ability to participate fully in all activities. Ensure that children with asthma are not discriminated against in any way. Families will: Inform the service, either at enrolment or on initial diagnosis, that their child has asthma. Provide all relevant information regarding the child s asthma and the written Asthma Action Plan, within seven (7) days of enrolment. Notify the service, in writing, of any changes to the Asthma Action Plan. Asthma Management Policy Page 2 of 5

3 Ensure that their child has adequate supply of appropriate asthma medication (including reliever) at all times, along with a spacer(and facemask for children under the age of 5) Ensure that they comply with all requirements and procedures in relation to the Medications Record. Communicate all relevant information and concerns to educators of the Director of Education as the need arises (e.g. if asthma symptoms were present the previous evening) Ensure, in consultation with educators, the health and safety of their child through supervised management of the child s asthma. Children will: Wherever practical, be encouraged to seek their reliever medication as soon as their symptoms develop. Symptoms of an asthma attack as suggested by Asthma Victoria are: Recognising an asthma attack (2013 Child in Care Model Policy, Version 2, Asthma Victoria) Mild Moderate Severe Talk in sentences Shortened sentences Few words per breath Cough Persistent cough Persistent cough Soft wheeze Loud wheeze Wheeze may be absent Minor difficulty breathing Difficulty breathing Gasping for breath/distress Tightness in chest Pale, sweaty, blue lips Child may complain of a sore tummy Muscle exertion Children with asthma may have one or more of these symptoms and may describe their symptoms as sore chest, sore tummy or a frog in the throat. It is important to note that symptoms vary from child to child and that asthma may occur with just one symptom. It is important that educators become familiar with the individual symptoms and triggers of the children in their care as well as their action plans. Asthma can be triggered by any of the following: cold and flu smoking exercise/play changes in air temperature emotions some foods and additives certain medications (ibuprofen, aspirin, echinacea and royal jelly) Allergens - including dust mites, dust, moulds, animals (cats and dogs) and pollens Cleaning asthma devices: Devices (puffers, spacers, and face masks) from the First Aid Kit must be thoroughly cleaned after use to prevent cross infection. In most cases a child will use their own puffer, spacer and face mask. Devices can be easily cleaned by using the following steps: Ensure the canister is removed from the puffer container (the canister must not be submerged) and the spacer is dismantled. Wash device thoroughly in warm water with kitchen detergent Do NOT rinse Allow devices to air dry. DO NOT rub dry Why dry, wipe the mouth piece inside and outside with a 70% alcohol swab When completely dry, ensure the canister is replaced into the puffer container and check the device is working correctly by firing one or two puffs into the air. A mist should be visible upon firing. If any device is contaminated by blood, dispose of it safely and replace the device. Asthma Management Policy Page 3 of 5

4 Asthma First Aid Procedure Reproduced from the Child in Care Model Policy If a child or staff member develops signs of what appears to be an asthma attack, appropriate care must be give immediately. Regardless of whether the attack is mild, moderate or severe, treatment should commence immediately as delay may increase the severity of the attack and ultimately risk the child s life. Follow written instructions on the Asthma Action Plan immediately. If no instructions are available then immediately commence the standard Asthma First Aid procedure detailed below: Call emergency assistance immediately (Dial 000) If the person is not breathing If the person s asthma suddenly becomes worse, or is not improving If the person is having an asthma attack and a blue reliever puffer is not available If you are not sure if it is asthma ASTHMA FIRST AID PROCEDURE Step 1. Step 2. Step 3. Sit the person upright Be calm and reassuring Do not leave them alone Give 4 puffs of blue reliever puffer medication Use a spacer if you have one Shake the puffer Put 1 puff into spacer Take 4 breaths form the spacer after each puff Repeat until 4 puffs have been taken Remember: Shake, I puff, 4 breaths Wait 4 minutes If there is no improvement, repeat step 2 above, give 4 more puffs Step 4. If there is still no improvement call emergency assistance (Dial 000)* Say ambulance and that someone is having an asthma attack Keep giving 4 puffs every 4 minutes until emergency assistance arrives Call emergency assistance immediately (000) if the person s asthma suddenly becomes worse In an emergency the blue reliever puffer used may be the child s own, from the First Aid Kit or borrowed from another child. Only staff who have completed training in Emergency Asthma Management may access the blue reliever medication for first aid purposed from the First Aid Kit. The parents/guardians of a any child who becomes ill at the service should be notified, even if the child has a complete recovery from the asthma attack (Regulation 86 The treatment given should be recorded in the Incident, Injury, Trauma and Illness Record (Regulation 87) and or the Medication Record (Regulation 92). It does not matter if a different brand of reliever medication to the child s usual medication is used An overdose cannot be given following the steps outlined above. However it is important to note that some children may experience an increased heart rate or tremors but these will pass quickly Asthma Management Policy Page 4 of 5

5 What if it is the first attack of asthma? A problem that may be encountered when a child suddenly collapses, or appears to have difficulty breathing, and is not known to have a pre-existing asthma or other health problems. In this situation staff should Step 1. Step 2. Step 3. Call and ambulance immediately (000) and state that child is having difficulty breathing. Give 4 puffs of blue reliever puffer medication Use a spacer if you have one Shake the puffer Put 1 puff into spacer Take 4 breaths form the spacer after each puff Repeat until 4 puffs have been taken Remember: Shake, I puff, 4 breaths Wait 4 minutes If there is no improvement, repeat step 2 above, give 4 more puffs This treatment could be life saving for a child whose asthma has not been previously recognised and it will not be harmful if the collapse or breathing difficulty was not due to asthma. Reliever puffers are extremely safe, even if the child does not have asthma. The family of a any child who becomes ill at the service should be notified, even if the child has a complete recovery from the asthma attack (Regulation 88(2)) In an emergency the blue reliever puffer can be accessed from the First Aid Kit by a trained staff member or borrowed from another child. Relevant Forms/Documents Asthma Action Plan Asthma First Aid Plan Risk Minimisation and Assessment Plan Asthma First Aid Poster Version History Date Version Author/s Details December 1.00 Director of Education New policy 2013 June Executive Officer Revision for new name Asthma Management Policy Page 5 of 5

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