Asthma Protocol

June 2024

Introduction:

This Asthma Protocol is designed to ensure the well-being and safety of pupils who have been diagnosed with asthma, or who have not been diagnosed with asthma but have a medically prescribed inhaler, within GDST schools. The policy is aligned with the guidance provided by Asthma UK to create a supportive environment for students with asthma.

Information from NHS.UK:

• Asthma is a common lung condition that causes occasional breathing difficulties.
• It affects people of all ages and often starts in childhood, although it can also develop for the first time in adults.
• There's currently no cure, but there are simple treatments that can help keep the symptoms under control so it does not have a big impact on your life.

Asthma Attacks

• Asthma attacks kill three people in the UK each day, but many of these deaths could be avoided.
• Every 10 seconds someone has a potentially life-threatening asthma attack.
• If you're on the right asthma treatment, your chance of having an attack is greatly reduced.
• Asthma can sometimes get worse for a short time – this is known as an asthma attack. It can happen suddenly, or gradually over a few days.
• Signs of a severe asthma attack include:
• wheezing, coughing and chest tightness becoming severe and constant
• being too breathless to eat, speak or sleep
• breathing faster
• a fast heartbeat
• drowsiness, confusion, exhaustion or dizziness
• blue lips or fingers
• fainting

Asthma Attacks

What to do if you have an asthma attack

If you think you're having an asthma attack, you should:

1. Sit up straight – try to keep calm.
2. Take one puff of your reliever inhaler (usually blue) every 30 to 60 seconds up to 10 puffs.
3. If you feel worse at any point, or you do not feel better after 10 puffs, call 999 for an ambulance.
4. If the ambulance has not arrived after 10 minutes and your symptoms are not improving, repeat step 2.
5. If your symptoms are no better after repeating step 2, and the ambulance has still not arrived, contact 999 again immediately. Never be frightened of calling for help in an emergency.

Try to take the details of your medicines (or your personal care plan with you to hospital if possible.

If your symptoms improve and you do not need to call 999, get an urgent same-day appointment to see a GP or asthma nurse.

Awareness and Training:

• All staff members will receive annual training on asthma awareness  from the school nurse, including recognizing symptoms and appropriate responses. This will be carried out on staff study days.
• Designated staff members, such as first aiders, teachers and trip leaders, will undergo more comprehensive training via the GDST Learn e-learning platform in managing asthma emergencies.
• Individual Asthma Care Plans:
• An Individual Health Care Plan (IHCP) must be completed for each pupil with asthma outlining specific symptoms, medications, and emergency procedures. If a pupil has an IHCP from a specialist health care team this should always be used and followed by the school. Additional information may need to be added alongside the plan to ensure it is clear how the pupil should be cared for in the school environment. A template is available here: Pupil Health - 6. Infection Control, Medical Conditions & Individual Healthcare Plans
• Individual Health Care Plans should be shared with relevant staff members including school nurses, teachers support staff and first aiders.
• Care plans should be reviewed annually or when there are changes in the asthma management of the pupil. Parents are made aware of their need to update the nursing team with any changes to their child’s asthma needs. The school nurses will email parents requesting an updated plan annually.
• Inhaler Accessibility:
• All senior school pupils should have their own reliever inhaler with them at all times. Parents will be asked to supply the school with a second Asthma Inhaler to be kept as an emergency spare. The spare reliever inhaler will be kept in the Medical Room with the completed School Asthma Card / Child Asthma Action Plan in case of emergencies.
• Asthma drills should be carried out (similar to an AAI drill).
• Junior pupils should keep their reliever inhaler in their bag (KS2) or in a plastic storage box in their classroom (EYFS,KS1) which must stay close to them at all times. Parents will be asked to supply the school with a second Asthma Inhaler to be kept as an emergency spare. The spare inhaler will be kept at junior reception with the asthma care plan in case of emergencies.
• Each inhaler should be labelled with the name of the pupil it belongs to.
• Parents /guardians are responsible for checking the condition of inhalers, their expiry dates and providing new ones to their child and the school in good time. The school cannot accept responsibility for any loss or damage to pupil’s inhalers.
• Emergency Salbutamol Inhalers
• WHS keeps a supply of emergency salbutamol inhalers for use in an emergency by pupils who have either been diagnosed with asthma and prescribed an inhaler, or who have been prescribed an inhaler as reliever medication. Emergencies include a child not having their own inhaler or spare inhaler with them, or it is empty.
• Emergency inhalers should only be used by pupils who have either been diagnosed with asthma and prescribed an inhaler, or who have been prescribed an inhaler as reliever medication, and for whom both medical authorisation and written parental consent for use of the emergency inhaler has been given. Consent should be updated regularly, ideally annually, to take account of the changes in the child’s condition. A template for parental consent is included as Appendix 2.
• The school’s emergency salbutamol inhalers are readily available in areas where staff are always present;
• Medical Room
• Junior reception
• Senior reception
• Dining room
• Sports Hall
• Sixth form cafe
• Nursery Road sports ground

• Parents will be informed if the emergency inhaler is used, and this should be documented.
• See below for Dept of Health guidance on the use of emergency inhalers in schools.

• https://www.gov.uk/government/publications/emergency-asthma-inhalers-for-use-in-schools
• Inhaler Use / Techniques

www.asthmaandlung.org.uk/symptoms-tests-treatments/treatments/spacers

www.asthmaandlung.org.uk/conditions/asthma/child/medicines/help

www.beatasthma.co.uk/

www.wileyhandsonguides.com/paediatrics/videos/video6.asp

www.wileyhandsonguides.com/paediatrics/videos/video7.asp

www.wileyhandsonguides.com/paediatrics/videos/video8.asp

www.wileyhandsonguides.com/paediatrics/videos/video9.asp

www.wileyhandsonguides.com/paediatrics/videos/video11.asp

www.youtube.com/watch?v=o2VPgYsY43M

• Supervision During Physical Activities:
• . All staff members should be aware of all pupils with medical conditions, including asthma and their asthma management. Teachers must ensure that students have their reliever inhalers with them during physical education classes or outdoor activities.
• Some children may need to take precautionary measures before or during exercise and may need immediate access to their asthma inhalers.
• Considerations for Art, DT and Science Teachers
• Fumes from science experiments can trigger asthma symptoms or attacks. Teachers should check pupils care plans for specific triggers. Fume cupboards should be used wherever possible to avoid this. When a fume cupboard is not available, an asthmatic pupil should be asked to sit near an open window, at a good distance from the experiment(s).
• In Biology lessons asthmatic pupils should be reminded not to sit near to animals, birds or pollen experiments.
• In Technology lessons asthmatic pupils should be reminded to be aware of sawdust and fumes from solder, plus the need to wear eye protection as necessary.
• School Trips / Educational Visits
• Arrangements for pupils to use their reliever inhaler, either routinely or in emergency situations, will need to be taken into consideration when planning school trips / visits. Staff supervising school trips / educational visits should always be aware of any individual pupil’s medical needs and relevant emergency procedures. This will be discussed in the compulsory medical trip revies. A copy of Individual Health Care Plans should be taken on visits in the event of the information being needed in an emergency.
• Medication required on Junior School trips and visits should be given when appropriate. Junior School pupils with asthma inhalers must carry an inhaler with them (or this must be carried by a member of staff) and the trip leader must hold a second inhaler for use in an emergency.
• Senior School pupils are responsible for bringing emergency medicines with them on school visits, however staff must check that pupils have this medication with them before departing on the visit. The trip leader must carry a second asthma inhaler for pupils who require them.
• Competency of staff to administer emergency medicines should be taken into account when preparing risk assessments for educational visits and the appropriate training should be provided by the school nurse where necessary.
• Emergency Response:
• Staff members should be trained to follow the Asthma UK guidelines for managing asthma attacks In the event of an asthma emergency, (see page 2 of this protocol).
• Emergency contacts for students with asthma, including parents/guardians and healthcare professionals, must be readily available.
• Asthma Register
• School Nurses maintain an ‘Asthma Register’ on SIMS which includes the name of all affected pupils, their medication and how it should be taken.
• Allergen Control:
• GDST schools will strive to maintain an environment that minimizes exposure to known asthma triggers, such as allergens and irritants.
• Any changes in the school environment that may affect students with asthma will be communicated promptly to parents/guardians.
• Elevated Local Environmental Pollution Levels
• Communication with Parents / Guardians:
• Regular communication will be maintained with parents / guardians of students with asthma to update medical information and address any concerns.
• Parents / guardians are expected to inform the school of any changes in their child's asthma management plan.
• Care plans should be reviewed annually and updated accordingly.
• Review and Evaluation:
• This Asthma Protocol should be reviewed regularly to ensure its effectiveness and relevance.
• Feedback from parents, staff, and healthcare professionals should be considered in the ongoing improvement of the policy.
• Other Relevant GDST Policies / Protocols and Further Information
• Administration of Medicines Protocol
• Chronic and Long-term Conditions Protocol
• Severe Asthma Individual Healthcare Plan Template
• www.asthma.org.uk/
• www.asthmaandlung.org.uk/

Appendix 1 - ASTHMA MANAGEMENT PLAN

Appendix 2 -