Children's Health and Safety- Asthma Management Procedure

Aim

 Wellington Public School Preschool will facilitate effective care and health management of children with asthma, and the prevention and management of acute episodes of illness and medical emergencies.  Our Preschool is committed to a planned approach to the management of medical conditions to ensure the safety and well-being of all children at this service

The aim of this document is to outline strategies for implementation of best practice asthma management within the preschool setting so that:

• All children enrolled at the service who have asthma can receive appropriate attention as required.
• A service can respond to the needs of children who have not been diagnosed with asthma and who have an asthma attack or difficulty breathing at the service.

 

 

Goals

 

Our Preschool is committed to:

·         Raising the awareness of asthma amongst those involved with the preschool.

·         Providing the necessary procedures to ensure the health and safety of all persons with asthma involved with the preschool.

·         Providing an environment in which children with asthma can participate in all activities to their full potential.

·         Providing a clear set of guidelines and expectations to be followed with regard to the management of asthma.

 

Relevant Legislation

 

Education and Care Services National Law 2010

Education and Care Services National Regulations 2011

 

Link to National Quality Standards

Standard 2.1.2 – Health Practices & procedures – Effective illness and injury management and hygiene practices are promoted and implemented.

 

 

Who is affected by this Procedure?

Parents and carers of children enrolled at WPS Preschool and staff at WPS Preschool

 

Key Resources

 

The procedure should be read in conjunction with:

• The Asthma Friendly Children’s Services Guidelines
• Asthma Foundation NSW’s Policies – www.asthmansw.org.au
• Work Health and Safety Act 2011

 

 

General Notes

 

• Children with asthma have sensitive airways. It is important to avoid the things (triggers) which can make asthma worse by causing the airways to narrow.  Triggers include cold or flu symptoms, weather conditions, exercise/play, inhaled allergens (e.g. pollens, tobacco smoke, moulds, animal hair and dust mites), dust, certain medications (e.g. Asprin), some foods and preservatives, flavourings and colourings, emotions (e.g. laughter).
• Symptoms of asthma include shortness of breath/ difficulty in breathing, wheezing or high pitched whistling sound (mainly when breathing out), cough (sometimes associated with vomiting) chest tightness (sore tummy). These symptoms vary from child to child. An asthma attack can be life threatening and must be treated promptly.
• Inhaled medications are the best way of treating asthma in children under 5 years of age. Inhaled medications can be taken using a puffer/inhaler and a spacer.
• There are three main groups of asthma medications;
  • Preventers; Flixotide, Intal Forte, Pulmicort, Tilade, Qvar, Alvesco (white or autumn coloured containers)
  • Relievers; Airomir, Asmol, Bricanyl, Epaq, Ventolin (blue containers)

o    Symptom controllers and Combination Medications; Foradile, Oxis, Serevent, Seretide, Symbicort.

 

 

Implementation Practices

 

Asthma management should be viewed as a shared responsibility. To this end each of the key groups within this service gives the following undertakings:

 

The Teacher will:

• Identify children with asthma during the enrolment process.
• Provide all families with information about Asthma Management Procedures upon enrolment.
• Provide families of children diagnosed with asthma with a copy of the Medical Conditions procedure on enrolment.
• Provide all educators with a copy of the Asthma Management procedure and brief them on asthma procedures upon their appointment at the Preschool.
• All educators attend regular certified asthma training every three years. Ensure that at least one educator with appropriate First Aid/Asthma/Anaphylaxis training is on duty whenever children are being cared for or educated, including off site excursions.
• Provide a Child Asthma Record to all families of children with asthma upon enrolment. The completed Child Asthma Record is to be returned promptly, reviewed annually and kept with the Asthma Kit, located in the kitchen on top of the first aid box.
• If a child enrolled at the service has been diagnosed with Asthma, record their name on the poster in the kitchen and ensure a copy of their Asthma management plan is displayed in the kitchen.
• There is a list of children who are diagnosed with Asthma kept in the casual staff folder. A copy of the child’s asthma action plan is also kept in the folder.
• Ensure that all educators are informed of the children with asthma in their care.
• Ensure that at least one Asthma First Aid poster is displayed in a key location.
• Ensure that the Asthma Emergency Kit contains a blue reliever puffer (e.g. Airomir, Asmol, Epaq or Ventolin), a spacer device and child mask and concise written instructions on Asthma First Aid procedures.
• Provide a mobile Asthma Emergency Kit for use on activities outside the service.
• Identify and, where possible, minimise asthma triggers.
• Encourage open communication between families/carers and educators regarding the status and impact of a child’s asthma.
• Promptly communicate any concerns to families should it be considered that a child’s asthma is limiting his/her ability to participate fully in all activities.

All staff will:

• Ensure that they maintain current Asthma First Aid training.
• Ensure that they are aware of the children in their care with asthma.
• In consultation with the family, optimise the health and safety of each child through supervised management of the child’s asthma.
• Ensure that all regular prescribed asthma medication is administered in accordance with the information on the Child’s Asthma Management Plan.
• Administer emergency asthma medication if required according to the child’s Asthma management plan.  If no plan is available the standard Asthma First Aid Plan should be followed immediately.
• Document the use of medication according to service procedure and notify parents/carers.
• Promptly communicate to management and families, any concerns about the child’s asthma limiting his/her ability to participate fully in all activities.
• Provide families with the contact details of the Asthma Foundation if further asthma advice is needed.
• Regularly maintain all asthma components of the first aid kit to ensure all medications are current and any asthma devices are cleaned after each use and ready to use.
• Provide children with their reliever medication as soon as symptoms develop.
• Medications are administered and witnessed by educators.
• Identify and, where possible, minimise asthma triggers, for example:
  • House dust mite, which is more prevalent in an environment with carpet, rugs, upholstered furniture and fluffy toys.
  • Flowering plants, mildew and mould
  • Domestic chemicals such as pesticides, cleaning agents, bleach and chlorine agents, deodorants, room sprays, perfumes, paints, food preservatives,
  • Hobby chemicals such as glues, solvents and paints,
  • Dust from animals, pets and birds,
  • Dust from pest infestations, especially cockroaches, mice and rats
• Reduce exposure of children and educators to indoor allergens by
  • Regularly vacuuming carpet, rugs, upholstered furniture and fluffy toys
  • Regularly shampooing carpet, rugs, upholstered furniture and washing fluffy toys
  • Treating and preventing growth of mould and mildew indoors and in clothing, linen and bed clothes
  • When using chemical sprays such as pesticides and cleaning agents, spraying when children are not present in the immediate vicinity
  • Controlling pest infestations, especially cockroaches

Families will:

• Inform educators, either upon enrolment or on initial diagnosis, that their child has a history of asthma.
• Provide all relevant information regarding the child’s asthma via the Child Asthma Management Plan as provided by the child’s doctor.
• The Child Asthma Management Plan is to be completed prior to the enrolment of the child and reviewed by the educators and parents each year or more frequently should any changes in treatment occur.
• Notify the educators, in writing, of any changes to the Child Asthma Record during the year.
• Supply current medication (reliever) labeled with child’s name and expiry date. This is to be kept at the preschool for use in emergencies.
• Medication is given to educators who will place it in the Asthma Emergency Kit that is inaccessible to the children.
• No medications are to be stored in children’s bags.
• Communicate all relevant information and concerns with educators as the need arises e.g. if asthma symptoms were present during the night.

 

 

Asthma First Aid

 

The preschool will have an Asthma Emergency Kit available for use in case of:

• An emergency where a child has difficulty breathing
• A child’s first attack of asthma
• A child’s own asthma reliever puffer is unavailable, expired or empty.

AND

• All educators should be aware of how to deliver the Asthma First Aid Plan.

·         Each kit should contain a blue reliever puffer (Airomir, Asmol, Epaq or Ventolin), a spacer device (with mask for under 5’s), and instructions for use.

If a child has difficulty breathing or their asthma deteriorates, administer Asthma First Aid according to one of the following:

• The Child’s Asthma Management First Aid Plan as signed by the family and/or doctor’s written instructions

OR

• The Asthma First Aid Plan. If a child has difficulty in breathing and there is no notification on any written communication from the parents/guardian about them having asthma; call an ambulance immediately, follow the Asthma First Aid Plan and contact the parents immediately. No harm is likely to result from giving a reliever puffer to someone with asthma.

 

 

Asthma First Aid Plan

 

1.    Sit the child upright and remain calm and provide reassurance. Do not leave the child alone.

2.    Give 4 puffs of a blue reliever (Airomir, Asmol, Epaq or Ventolin), one puff at a time, preferably through a spacer device. Ask the child to take 4 breaths from the spacer after each puff. (Shake the puffer before initial use)

3.    Wait 4 minutes.

4.    If there is little or no improvement, repeat steps 2 and 3. If there is still little or no improvement, call an ambulance immediately (Dial 000)

5.    Continue to repeat steps 2 and 3 while waiting for the ambulance.

 

• If the child’s condition suddenly deteriorates, or you are very concerned, call an ambulance immediately.
• In an emergency the blue reliever puffer can be accessed from the Asthma Emergency Kit, or borrowed from another child.
• Record any asthma incident and file the completed form with all incident reports.
• Notify the family and advise them of actions taken.

 

 

Correct Use of the Puffer

 

1. Remove the cap from the puffer
2. Shake puffer well and insert into the end of the spacer
3. Put the mouthpiece of the spacer in your mouth, forming a seal with your lips. Breathe out gently
4. Press down on the puffer canister once to fire medication into the spacer
5. Breathe in and out normally for 4 breaths
6. To take more medication, shake the puffer again, and then repeat steps 3-5. Remember to put the mouthpiece cap back on after you’ve finished

 

 

Checklist for Excursions

 

Educators should be alert for:

• Children with a high risk history of asthma
• Children who show asthma symptoms before departure on an out of preschool excursion
• The need to modify an activity for children with asthma
• Strategies to prevent exercise induced asthma
• A child who denies symptoms of asthma
• The need for early intervention of emergency treatment for asthma symptoms
• Signs of worsening asthma

 

Educators should ensure the following:

• Children’s individual asthma treatment plans are taken on all excursions and kept with the Teacher
• Be familiar with the preferred asthma emergency management required for the children in their care
• Mobile phone is made available and there is suitable reception
• Asthma Emergency Kit accompanies each group and the contents are checked before leaving the service. This should include checking the expiry date and making sure the medication is full.
• Educators accompanying students with asthma must carry their asthma medications and delivery devices with them at all times.
• If children are not all together, make sure Asthma Emergency Kits go with all groups.
• Check emergency services near excursion site.
• There is at least one educator with the excursion group that has completed Emergency Asthma Management training.

Document Availability

This procedure will be readily accessible to all educators, staff, families and visitors, and ongoing feedback on this procedure will be invited.  A copy of this procedure will also be placed in the casual staff folder for reference for casual teachers.

 

Related Policies

·         Medical Conditions Procedure

Review

This procedure will be reviewed annually.  Review will be conducted by School Principal, Preschool Staff, parents/carers and any interested parties.