EMANUEL SCHOOL: MEDICAL AND FIRST AID POLICY

Transcription

1 EMANUEL SCHOOL: MEDICAL AND FIRST AID POLICY In accordance with Health and Safety legislation it is the responsibility of the Governing Body to ensure adequate and appropriate medical and first aid provision at all times when there are people on the School premises and for staff and pupils during off-site visits and activities. In order to ensure adequate medical provision it is the School policy that: The School will employ a qualified School Nurse during school hours in school term time to provide medical assistance to staff and pupils and manage medical and First Aid provision in the School. The School Nurse or a qualified First Aider is always available during normal school hours together with appropriate equipment to ensure someone competent in basic first aid techniques can rapidly attend an incident at all times when the school is occupied. Appropriate First Aid arrangements are made whenever staff and pupils are engaged in off-site activities and visits. Responsibilities The School Nurse is responsible for: Ensuring First Aid needs are assessed and addressed. Ensuring sufficient numbers of suitably qualified First Aiders are available at school during school hours Identifying First Aid training needs and arranging attendance on external courses Maintaining a record of all first aid training undertaken by school staff Providing first aid support during school hours Liaising with the Health and Safety Committee on first aid issues Organising provision and regular replenishment of first aid equipment Accurately recording all accidents in the Accident Book and maintaining appropriate documentation. Qualified First Aiders are responsible for: Responding promptly to calls for assistance Providing first aid support within their level of competence Summoning medical help as necessary Reporting details of treatment given for recording in the Accident Book Teachers of PE are responsible for: Ensuring appropriate first aid cover is available at all sports activities. Ensuring first aid kits are available at all practice sessions and matches All staff are responsible for: Acting in capacity of responsible adult in the event of an emergency Carrying out risks assessments for any off-site trips, and ensuring adequate first aid provisions are taken. (First Aid Kits are available from the school nurse.)

2 Medical records All staff are required to complete a medical questionnaire as part of the recruitment process and certify their physical and mental capacity to undertake their teaching or support role in the School followed, in the case of teachers and certain support staff, by a referral to the School doctor for a medical report. The School Nurse will be advised of any medical issues arising which might necessitate emergency treatment in the future. Staff are expected to update their medical records should their circumstances change. Pupils have a medical questionnaire completed prior to their arrival at School and this data is reviewed and logged by the School Nurse for future reference. Parents are given the opportunity to update these medical records prior to school trips involving overnight stays. The School Nurse keeps confidential records of all treatment and immunizations that a pupil receives at School and also of all accidents or injuries. The School Nurse maintains the Accident Book in which details of all accidents and injuries, other than very minor ones, are recorded. Qualifying accidents will be reported to the HSE under RIDDOR by the Nurse or Health and Safety Manager. The Accident Book and RIDDOR records are kept in the Medical Room. Medical care Pupils will normally receive medical care from their family GP practice but the School holds medical information as above so that it can provide appropriate care should a pupil fall ill or have an accident at School. The Nurse will care for any pupil who has become unwell or been injured during the school day, and will support any pupil with a chronic medical condition. Any pupil who needs to take medicine during school hours must bring the medicine to school in its original container, with the name of the pupil, name of drug and method of administration clearly marked. The Nurse is responsible for the safekeeping of analgesia, hay fever remedies and any drugs brought in to school by a pupil. The medical room has a lockable cabinet for drugs. Only the Nurse may dispense drugs to the pupils. Pupils with asthma may carry an inhaler with them, and it is strongly recommended to the parents that a spare inhaler is kept in the medical room. Pupils with a nut allergy may store their Epipen in an unlocked and clearly marked cupboard in the medical room. However, if any pupil prefers to keep the Epipen with them, that is also permitted as long as the whereabouts of the Epipen is generally known. Pupils with Type 1 diabetes may keep a spare insulin syringe in the medical room, and the Nurse keeps supplies to treat hypoglycemia. Accidents and injuries In the event of a pupil, visitor or member of staff being involved in an accident, the Nurse will assess the severity of the injury and treat accordingly. Minor bumps and grazes may be dealt with by a member of staff in attendance or by a qualified First Aider and need not be reported or recorded in the Accident Book but if in doubt staff are advised to refer an injury to the School Nurse. Any accident involving a suspected broken bone, a serious cut, a head injury or unconsciousness must be referred by the member of staff in attendance to the School Nurse who will treat the injury and enter it into the Accident Book.

3 If the School Nurse is not available one of the First Aiders should be called upon to assist. If the incident is deemed to be sufficiently serious an ambulance should be called by the Nurse or in her absence by the first Aider or member of staff. It is recognized that body fluids (blood, vomit, faeces and urine) can be harmful or contribute to cross infection. Gloves should be worn when dealing with any injury or illness involving body fluids. Pairs of gloves are included in each First aid Box. The Accident Procedures are set out in Appendix 1 below. Emergency medical treatment If any pupil is seriously injured or becomes too ill to be in school, the School Nurse will contact a parent to take the pupil home or to an Accident and Emergency department. However if the School is unable to contact a parent it is authorized by the parent under the School Terms and Conditions to consent on the advice of an appropriately qualified medical specialist to the pupil receiving urgent medical treatment including anesthetic or operation. First Aid provision The School has a well-equipped Medical Room staffed by a qualified Nurse. It is open throughout the school day to respond to first aid needs as well as provide more general medical care. If the Nurse is away from the Medical Room at any time a notice is displayed giving details of how and where to obtain help. The Nurse carries a mobile phone ( ) to enable contact at any time during the school day. It is school policy to ensure that a number of trained and certificated First Aiders are available to cover the areas of likeliest risk who can be called upon in addition to the Nurse: All PE staff All rowing coaches in sole supervision on the water At least one Schoolkeeper on duty at all times At least one laboratory or workshop technician or teacher A qualified First Aider is someone who holds a valid certificate of competence in Emergency First Aid (or Sports first aid as appropriate) issued by an organisation approved by the Health and Safety Executive, such as St John Ambulance, and must be renewed every three years. The School Nurse arranges for staff to attend the First Aid re-qualification courses as required. The current list of First Aiders is included as Appendix 2 below. It is the School's policy to have a qualified First Aider present during all sports matches or training sessions in sports where the risk of injury is assessed as other than minimal (in which case our standard first aid provision is deemed to be adequate). This includes rugby, rowing, netball, cricket, athletics and swimming as a minimum. First aid provision at away sports matches is the responsibility of the host school but will be checked by the Games teacher accompanying our pupils who will also act as the channel of communication to Emanuel and parents as necessary. The same policy is applied to activities. Higher risk activities such as Duke of Edinburgh expeditions and wall climbing will require on site first aid provision. Other activities and school trips are risk assessed and first aid support provided as appropriate.

4 First Aid Boxes First aid boxes are located in the following places and are clearly labelled with a white cross on a green background in accordance with Health and Safety regulations: 1. Medical Room 2. Common Room 3. Each minibus 4. Sports Hall 5. Laboratories (x3) 6. Art Department 7. Design Technology Department (x2) 8. Music Department 9. Kitchen 10. Maintenance workshop 11. Grounds Department The boxes are checked and restocked as necessary by the School Nurse at least once a term. The contents of first aid boxes may vary depending on particular needs in a location. A further 4 Kits suitable for use on day trips and those involving overnight stays are available from the Nurse. Games/PE staff have first aid kit available for all games practices and matches. Monitoring and Review of the Policy First aid arrangements are continually monitored by the School Nurse and are formally reviewed annually to ensure the provision is adequate and effective. Annual reviews will be carried out by the School Nurse and Health & Safety Manager and reported to the Health and Safety Committee. Date of last review: September 2015

5 Appendix 1 ACCIDENT PROCEDURES - THE MEDICAL ROOM ALL incidents must be reported to the school nurse If a pupil becomes unwell or is injured whilst in your charge, or you come across an unwell or injured pupil, if the pupil is mobile escort them to the medical room to see the school nurse without delay. In the case of serious injury where the pupil is rendered immobile or you feel the pupil should not be moved, send someone to inform the school nurse immediately and remain with the injured pupil until the school nurse arrives. In all cases it is the responsibility of the school nurse to make a professional assessment of the injury and recommend what action should then be taken. Any injury involving broken bones or cuts that need stitching, or unconsciousness however brief, must be reported to the school nurse. In serious cases, an accident report form should be completed by the teacher in charge or by the teacher who found the pupil. The Accident Book is in the Medical Room. If the school nurse is not present, the general office (or reception) should be contacted straight away. They will summon help from one of the school's nominated first aiders, provide emergency aid and call an ambulance if necessary. In all cases of serious injury parents will be informed by telephone immediately and advised of the necessary actions taken by the school or medical services. Staff who accompany pupils to hospital should remain in Accident and Emergency and await the parents' arrival. The school nurse is on site from 8.30 am to 5.00 pm weekly. Her internal number is 414. Her mobile number is

6 Appendix 2 First aiders Principal First Aid provider: School Nurse ext 414 Certificated First Aid providers: Laura Fitzgibbon ext 421 Will Hanson ext 422 Tom Gwynne ext 421 Michele Cook ext 421 Richard Hardy ext 469 Andrew Keddie ext 468 Paul King ext 407 Wilson Lai ext 465 Andrew Leadbetter ext 465 Anna Smuts ext 421 Sara Williams-Ryan ext 413 Laura Holden ext 465 Carly Yeoman ext 417 Callum Oliver ext 417 Boat Club Certified First Aid providers: Keith Brown Richard Marriott Sam Gourevitch

7 Appendix: Detailed Policies 1. Anaphylaxis Policy 2. Asthma Policy 3. Diabetes Policy 4. Head Injury Policy 5. Over the counter remedies at School

8 1. ANAPHYLAXIS POLICY Anaphylaxis is an acute, severe allergic reaction requiring immediate medical attention. It usually occurs within seconds or minutes of exposure to a certain food or substance, but on rare occasion may happen after a few hours. The causes of allergic reaction can include food such as nuts, seafood, eggs, wheat, insect stings and drugs. On rare occasions, there may be no obvious cause. The most severe form of allergic reaction is anaphylactic shock, when the blood pressure falls dramatically and the patient loses consciousness. Fortunately, this is rare among young children below teenage years. More commonly, among children there may be swelling in the throat, which can restrict the air supply, or severe asthma. Any symptoms affecting the breathing are serious. Less severe symptoms may include tingling in the mouth, hives anywhere on the body, generalised flushing of the skin or abdominal cramps, nausea and vomiting. Even when mild symptoms are present, the child should be watch carefully and taken to the medical room. Family s responsibility We ask the parents of allergic pupils to: Notify the school of the pupil s allergies. This should be done before the start of the school term. Provide the medical room with a treatment plan, Epipen and emergency medication, clearly labelled with the pupil s name. Replace such medication after use or upon expiry. Educate the pupil in self-management of his/her allergy, including: Which foods are safe and unsafe The symptoms of allergic reaction How and when to tell adults about a reaction How to read food labels Provide emergency contact information and inform the school of any changes. Ensure the pupil carries their emergency medication (epipen, inhaler), with them at all times during the school day and for all off-site sports fixtures and trips. They can also be kept in the medical room during the school day. Pupil s responsibility We ask each pupil with a food allergy to be proactive in the care and management of their allergies and reaction, in particular: Not to exchange food with others To know where their medication is kept in the medical room and that they are responsible for carrying their medication with them and to make sure they do so at all times.

9 To tell their friends of their allergies, so they know should an emergency arise. Wear a medical talisman at all times, if they own one. Notify an adult immediately if they eat something they believe may contain the food they are allergic to. To notify an adult immediately if they believe they are having a reaction, even if the cause is unknown. School s responsibility The school responsibilities are: To provide staff with appropriate training To ensure that there are an adequate number of first aiders able to recognise the signs of an allergic reaction and act appropriately. To ensure that the school nurse and Catering Manager are trained in the administration of epipens. Note: The nurse is on duty from to Monday to Friday during term time and will implement procedures to mitigate the risks presented by anaphylaxis. In addition: Photos and names of pupils with severe allergic reactions are posted in the medical room. Staff are advised that if they have any concerns about a pupil presenting with even a minor reaction, to send them, accompanied by an adult or another responsible pupil, to the medical room or to summon the school nurse. Parents will be informed by the school nurse of the expiry date of epipen. Catering department Catering staff are informed of pupils allergies and can arrange the menus accordingly. The catering department does not use any nuts products, nut oil or sesame oil.

10 2. ASTHMA POLICY Background The school recognises that asthma is a widespread, serious but controllable condition affecting many pupils in the school. The school positively welcomes all pupils with asthma. This school encourages pupils with asthma to achieve their potential in all aspects of school life by having a clear policy that is understood by school staff and pupils. Supply teachers and new staff are also made aware of the advice given. All staff who come into contact with pupils with asthma will be provided with advice. Asthma Medicines Immediate access to reliever medicines is essential. Pupils with asthma are encouraged to carry their reliever inhaler whilst in school. Parents/carers are asked to ensure that the school is provided with a clearly labelled spare reliever inhaler. This will be held in the medical room in case the pupil s own inhaler runs out, or is lost or forgotten. All inhalers must be labelled with the child s name by the parent/carer. School staff are not required to administer asthma medicines to pupils (except in an emergency). All school staff will let pupils take their own medicines when they need to. Asthmatic children should not be given ibuprofen. Record Keeping When a child joins the school, parents/carers are asked if their child has any medical conditions including asthma on their medical questionnaire. From this information the school keeps its asthma register, which is available to all school staff. Parents/carers are also asked to contact school to update the information if their child s asthma medicines, or how much they take, changes during the school year. Exercise and Activity PE and Games Taking part in sports, games and activities is an essential part of school life for all pupils. All teachers know which children in their class have asthma and all PE teachers at the school are aware of which pupils have asthma from the school s asthma register. Pupils with asthma are encouraged to participate fully in all PE lessons. PE teachers will remind pupils whose asthma is triggered by exercise to take their reliever inhaler before the lesson, and to thoroughly warm up and down before and after the lesson. If a pupil needs to use their inhaler during a lesson they will be encouraged to do so. Classroom teachers follow the same principles as described above for games and activities involving physical activity.

11 Out-of-hours sports There has been a large emphasis in recent years on increasing the number of children and young people involved in exercise and sport in and outside of school. The health benefits of exercise are well documented and this is also true for children and young people with asthma. It is therefore important that the school involves pupils with asthma as much as possible in after school clubs. PE teachers, classroom teachers and out of hours school sport coaches are aware of what to do in the event of an asthma attack. All staff and sports coaches are provided with advice on asthma. School Environment The school does all that it can to ensure the school environment is favourable to pupils with asthma. The school does not keep furry or feathery animals and has a definitive no-smoking policy. As far as possible the school does not use chemicals in science and art lessons that are potential triggers for pupils with asthma. Pupils with asthma will be encouraged to leave the room until it is safe to return. When a pupil is falling behind in lessons If a pupil is missing a lot of time at school or is always tired because their asthma is disturbing their sleep at night, the class teacher will initially talk to the parents/carers to work out how to prevent their child from falling behind. If appropriate, the teacher will then talk to the school nurse and special education needs co-ordinator about the pupil s needs. Asthma attacks All staff who come into contact with pupils with asthma will have instructions available to them on what to do in the event of an asthma attack. In the event of an asthma attack the school follows the procedure outlined by Asthma UK in its School Asthma Pack (as follows). Management of an acute asthma attack Signs and symptoms Difficulty in breathing There may be wheezing but if the airways are very blocked it may be absent Difficulty talking Skin has a blue-grey tinge Tight chest Dry tickly cough Action Calm and reassure Encourage to take slow deep breaths Help into a comfortable position, possibly sitting down leaning forward over a back of a chair Do not lie down unless she is unconscious and or needs CPR Encourage and help her take reliever inhaler (blue inhaler) Effects should be noticeable within a few minutes It may be necessary to repeat the inhaler dose after 10 minutes If the inhaler has no effect after 10 minutes, or you are at all concerned, dial 999 and follow instructions for calling an ambulance.

12 3. DIABETES POLICY What is Diabetes? Diabetes is a condition where the level of glucose in the blood rises. This is either due to the lack of insulin (Type 1 diabetes) or because there is insufficient insulin for the child s needs or the insulin is not working properly (Type 2 diabetes). About one in 500 school-age children have diabetes. The majority have Type 1 diabetes. They normally need to have daily insulin injections, to monitor their blood glucose level and to eat regularly according to their personal dietary plan. People with Type 2 diabetes are usually treated by diet and exercise alone. Each person may experience different symptoms and this should be discussed when drawing up the health care plan. Greater than usual need to go to the toilet or to drink, tiredness and weight loss may indicate poor diabetic control, and staff will naturally wish to draw any such signs to the parents attention. Staff with diabetes should make their condition known and their treatment plan available. Children and staff should be made aware of what to do if the member of staff is unwell. Medicine and Control for children The diabetes of the majority of children is controlled by injections of insulin each day. Older children may be on multiple injections and others may be controlled on an insulin pump. Most children can manage their own injections, but if doses are required at school supervision may be required, and also a suitable, private place to carry it out. Older children are taught to count their carbohydrate intake and adjust their insulin accordingly. This means that they have a daily dose of long-acting insulin at home, usually at bedtime; and then insulin with breakfast, lunch and the evening meal, and before substantial snacks. The child is taught how much insulin to give with each meal, depending on the amount of carbohydrate eaten. They may or may not need to test blood sugar prior to the meal and to decide how much insulin to give. Diabetic specialists would only implement this type of regime when they were confident that the child was competent. The child is then responsible for the injections and the regime would be set out in the individual health care plan. Children with diabetes need to ensure that their blood glucose levels remain stable and may need to check their levels by taking a small sample of blood and using a small monitor at regular intervals. They may need to do this during the school lunch break, before PE or more regularly if their insulin needs adjusting. Older children will be able to do these themselves and will simply need a suitable place to do so. Children with diabetes need to be allowed to eat regularly during the day. This may include eating snacks during class-time or prior to exercise. Schools may need to make special arrangements for pupils with diabetes if the school has staggered lunchtimes. If a meal or snack is missed, or after strenuous activity, the child may experience a hypoglycaemic episode (a hypo) during which blood glucose level fall too low. Staff in charge of physical education or other physical activity sessions should be aware of the need for children with diabetes to have glucose tablets or a sugary drink to hand.

13 Staff should be aware that the following symptoms, either individually or combined may be indicators of low blood sugar a hypoglycaemic episode: Hunger Sweating Drowsiness Pallor Glazed eyes Shaking or trembling Lack of concentration irritability Headache Mood changes, especially angry or aggressive behaviour. Each child may experience different symptoms and this should be discussed when drawing up a health care plan. If a child has a hypo, it is very important that the child is not left alone and that a fast acting sugar, such as glucose tablets, a glucose rich gel, or a sugary drink (100mls of Lucozade) is brought to the child and given immediately. Slower acting starchy food, such as a sandwich or two biscuits and a glass of milk, should be given once the child has recovered, some minutes later. AN AMBULANCE SHOULD BE CALLED IF THE PERSON BECOMES UNCONSCIOUS. Some children may experience hyperglycaemia (high glucose level) and have a greater than usual need to go to the toilet or to drink. Tiredness and weight loss may indicate poor diabetic control, and staff will naturally wish to draw any such signs to the parents attention. If the child is unwell, vomiting or has diarrhoea this can lead to dehydration. If the child is giving off a smell of pear drops or acetone this may be a sign of ketosis and dehydration and the child will need urgent medical attention.

14 Essential supplies for young people with diabetes Item Parents Responsibility School Responsibility Child/young person s responsibility when deemed competent Diabetes nurse School nurse responsibility Individualised Care plan Formulation of plan and to update information when necessary All school personnel to be aware of plan and what care it includes Formulation of plan and to update information when necessary Formulation of plan and provide training in order for information to disseminated Provide training in order for information to disseminated Dietician to be involved where available Emergency supply box To provide box and contents accessible to child/young person/staff when supplies are low or near expiry date when supplies are low or near expiry date To provide training as to the correct use of the box To provide training as to the correct use of the box when supplies are low or near expiry date Insulin injection and pump supplies To provide all supplies of insulin, pens, needles, reservoirs and cannulas Provision of fridge space for spare supplies of insulin Provide clean and private environment when supplies are low or near expiry date Provision of fridge space for spare supplies of insulin Provide clean and private environment when supplies are low or near expiry date when supplies are low or near expiry date Blood glucose and ketone testing supplies To provide supplies of lancets, blood glucose strips and quality control (QC) solutions Provide correct storage of supplies where necessary and request for training when when supplies are low or near expiry date To provide training in order to initiate blood glucose testing Provide correct storage of supplies where necessary and request for training when

15 further required further required To be aware when replenishment of supplies is necessary Provide clean and private environment Provide clean and private environment when supplies are low or near expiry date Quality control of blood glucose meter To carry this out according to local policy None To carry this out according to local policy To train parents to carry out, following local guidelines To support if required Extra food To provide food for snacks and exercise as required if supplies are low To give permission for child/young person to eat whenever required if supplies are low Information given during treatment if supplies are low Risk assessment To provide information to facilitate risk assessment To initiate and complete risk assessment documentation To participate in risk assessment where possible To provide specialist information as required To provide specialist information as required

16 4. HEAD INJURY POLICY The aim of the Head Injury policy is: To provide a safe environment To ensure all staff have a clear understanding of how to deal with someone who has sustained a head injury To record all head injuries and carry out any relevant risk assessments The National Institute for Health and Clinical Excellence (NICE) defines a head injury as any trauma to the head other than shallow injuries on the surface of the face. Procedure The majority of head injuries are minor and can be seen and treated by a qualified first aider/ nurse. A pupil who sustains a head injury whether it is thought to be a minor injury must be escorted to the Medical room immediately, if able. If no staff are in attendance, witnessing pupils must take on the responsibility themselves to escort the injured pupil to the medical room, or seek immediate adult assistance. If the injured pupil is not able to be escorted, then the school nurse should be informed to assess the pupil at the site of the accident. Staff can take the decision to telephone for an ambulance if they realise the injury is serious, prior to the nurse arriving. If the pupil is symptomatic of a head injury, or has lost consciousness at all, the pupil should be sent to A & E by ambulance with an adult escort. The parents or guardian of the pupil should be informed as soon as possible of the injury and a subsequent need for a visit to A&E. An accident form should be completed for school records. Pupils who have sustained concussion (confirmed by a Doctor s letter) will not be able to play any contact sport at school for 3 weeks from the date of the accident, but they may be able to take part in some light physical exercise. All pupils sustaining a head injury and subsequently sent home will receive a head injury advice sheet. Common signs and symptoms of head injury resulting in concussion requiring admission to A & E: Signs (observed by others) Student appears dazed or stunned. Confusion. Unsure about game, score, opponent. Moves clumsily (altered coordination). Balance problems. Personality change. Responds slowly to questions. Forgets events prior to injury. Forgets events after the injury. Loss of consciousness (for any duration)

17 Symptoms (reported by student) Headache. Fatigue. Nausea or vomiting. Double vision, blurry vision. Sensitive to light or noise. Feels sluggish. Feels foggy. Problems concentrating. Problems remembering.

18 5. OVER THE COUNTER REMEDIES AT SCHOOL. REMEDY DOSAGE/ FREQUENCY USES PARACETAMOL <12 500mg X 1 4 hourly Mild to moderate pain and temperature. >12 500mg X 2 4 hourly CALPOL 6+ IBUPROFEN PIRITON (only in an emergency) 250mg/5ml. 6 hourly : 10mls 12-16: 10-15mls 200mg 6hourly 200mg X 2 2mg/5mls 5ml 6 hourly. Mild to moderate pain and temperature. Injuries with signs of inflammation. Mild to moderate pain. Allergic conditions. STREPSILS 1-3 hourly. Sore throat. ANTACID 1-2 tablets as required To relieve symptoms of indigestion, nausea. CETIRIZINE/ LORATADINE 10mg once a day Hay fever symptoms, skin allergies. BITE AND STING RELIEF CREAM 1-2 applications daily Insects bites and stings. Ibuprofen will not be given to asthmatic children. Strepsils should not be given to diabetic children.