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ITHACA CREEK STATE SCHOOL
Administration of Routine and Emergency Medication and Management of Health Conditions
INTRODUCTION
Management of student health conditions, including the administration of medication, is a courtesy provided by the school consistent with their duty of care to:
· Maximise the participation in school activities of students who require medication or special procedures for managing a health condition: and
· Optimise the health, safety and wellbeing of staff and students at the school site.
School staff can assist with medication under the carer provisions of the Health (Drugs and Poisons) Regulation (1996) provided the written request is received from the student’s parents or legal guardian. Staff must follow the directions on the original pharmacy label attached to the medication container.
Opportunities should be provided for students who require medication, or who have a health condition to participate in the full range of school activities according to the advice of their medical practitioner. This applies to classroom activities and activities such as excursions, camps, swimming, sport, physical education, outdoor education and public displays.
Unless students are approved to self-administer their medication, all other medications require secure, in some cases locked, storage and only administration only under the supervision of a staff member. Medication required for emergencies, such as an anaphylactic reaction or asthma attack, must be accessible at all times. (Refer to individual management plans for specific students as to the location of these medications).
DEFINITION OF MEDICATION
This policy applies to medication prescribed by a medical practitioner, and which is considered essential to be administered at school for a student to achieve optimum health and to participate fully in school life.
Medication is likely to be associated with a health condition such as epilepsy, diabetes, asthma, anaphylaxis, cystic fibrosis, Attention Deficit Hyperactivity Disorder (ADHD), but may include other conditions diagnosed by a medical practitioner.
School staff must not administer over-the-counter medication, including analgesics, homeopathic or prescribed medications unless they meet the accountability of a written request from a parent/caregiver accompanied by written advice from a medical practitioner and with the medication in the original labelled container. The exception is the reliever puffer, such as Ventolin, that is included for the emergency treatment of asthma under the guidelines. The containers for these are often blue.
Expectation of Parents
It is reasonable to expect parents/caregivers to undertake the following in relation to administration of medication and/or management of health conditions.
· Request the school in writing to administer prescribed medication or to assist the management of a health condition.
· Notify the school in writing of any requests and/or guidelines from medical practitioners including potential side effects or adverse reactions
· Provide the medication in the original labelled container to the nominated staff member.
· Ensure the medication is not out of date and has an original pharmacy label with the students name, dosage and time to be taken.
· Advise the school in writing and collect the medication when it is no longer required at school.
Requirements for Effective Implementation
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School accountability
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Requirements
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Informing the school community
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· Staff and parents/caregivers are consulted about, and informed of school procedures for the administration of medication and the management of health conditions.
· Students undertake a component in the Health and Physical Education program that addresses health conditions and their management.
· Students and staff are informed of the warning signs, triggers and emergency responses for health conditions requiring medication or other management, of which the school has been advised.
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Staff training
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· Staff have access to sources of information about medication and health conditions.
· First aid training that incorporates specific first aid responses for health conditions is provided and accreditation maintained for school personnel willing to be first aid providers.
· Basic skills and information are provided to all staff about medication or other management procedures for health conditions known to be present in the school.
· Training is provided by a medical practitioner or authorised training provider.
· Willing and available staff members receive training on the administration of medication for the health conditions where parents/caregivers have notified the school. Training should address storage, dosage and administration.
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Participation in school activities
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· All school activities, including excursions, camps, physical education, swimming, sport and outdoor education, include a planning component addressing the needs of students requiring medication or management of a health condition. This plan should be addressed within the school’s risk management approach.
· An individual management plan is developed for students who require medication or management of a health condition at school.
· Protocols that incorporate safety and security considerations are developed for students approved to self-administer medication and/or self-manage a health conditions.
· School take reasonable action to remind students about taking their medication where necessary.
· A first-aid qualified staff member and a first aid kit accompanies all school excursions.
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Security and accessibility
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Considerations for schools are:
· Access to medication by, and risk to, other students minimised.
· Medication carried by students is securely stored.
· Some medication requires locked storage and temperature control.
· Medication for emergency situations is stored so that ready access is assured.
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A recording system is maintained
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· Written requests from parents/caregivers with associated guidelines and procedures from the medical practitioner are recorded and able to be retrieved quickly.
· Medication is administered directly from the original pharmacy label.
· A register is maintained for the purpose of recording all occasions when school staff administer medication including:
o Student’s name
o Date and time
o Name and strength of the medication
o Dosage
o Method of administration
o Person who administers medication
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Respecting privacy and dignity
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· The actions and attitudes of school personnel and school protocols support students capable of self-administering medication.
· Schools promote the normalising and acceptance of health conditions.
· The school culture discourages discrimination against students requiring medication.
· Registers of medication and other information related to a student’s health should be treated and stored as confidential information.
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Self-administration of Medication
Contemporary management of chronic health conditions encourages students to administer their own medication, to recognise the signs and symptoms of the condition and to participate in the full range of activities offered by the school.
In schools, self-administration may apply to students who are assessed by their medical practitioner and parents/caregivers and approved by the principal as capable of administering their own medication while participating in school activities.
Self-administration of medication may include:
· Monitoring blood sugar levels and the injection of insulin for diabetes;
· Inhaling medication such as “Ventolin” for asthma;
· Orally administering anti-convulsant medication for epilepsy; and
· Orally administering enzyme replacements for cystic fibrosis.
Students approved to carry their own medication should demonstrate practices of secure storage of medication that may be potentially harmful to other students and safe disposal of injecting equipment.
Recommended procedure for approval
· The parent/caregiver provides a written request, with guidelines and procedures from the medical practitioner, for the student to be responsible for administering their own medication.
· The principal determines if the student to be responsible for administering their own medication.
· The principal determines if the student is capable of assuming this responsibility.
· The student and the school agree on where medication is stored and where and how it is administered.
Teachers can assist students to manage their health condition by incorporating their medication needs in the routine management of the class and school.
Individual Management Plans
Most procedures for the administration of medication and management of health conditions can be adequately addressed by universal guidelines. However, students with more complex requirements may require individual management plans.
These plans should be reviewed annually, signed by a parent/caregiver and revised when medication and/or health status change. Teachers, parents, medical practitioners, nurses in schools and, where appropriate students, may be consulted in the development of the plan.
The following information, provided by the medical practitioner where applicable, should be included in the plan.
· Telephone numbers for parent/caregiver, medical practitioner and ambulance
· Requirements – medication, dosage, when and how medication is administered
· Triggers, reactions, warning signs and symptoms of a possible emergency
· Instructions from a medical practitioner regarding emergency first aid treatment
· Limitations or guidelines for specific activities such as swimming, sport, outdoor education, camps and physical Education Queensland
Some students have several health conditions and the integration of treatment for these conditions may require an individual management plan.
Where individual adjustment of medication is required, written advice from a medical practitioner and parent/caregiver must be provided. This advice should outline dosage adjustments against set criteria, such as level of insulin required for a particular blood sugar reading.
Emergency First Aid for Asthma, Diabetes, Anaphylaxis and Epilepsy
In emergency situations, trained school personnel may be required to administer medication to preserve the life, safety and health of a student. These emergencies may occur for students with diabetes, epilepsy, anaphylaxis and asthma. The possible medication requirements include administering inhaled medication such as “Ventolin” for asthma, rectal administration of “Valium” for epilepsy, and injection of glucagon for diabetes and an injection of adrenalin for anaphylaxis. Injections for diabetes and anaphylaxis are usually administered by a pen device and are not intravenous.
The designated first aid personnel in the school should be trained in the recognition and management of an emergency for students and staff with health conditions. The information and training provided to school personnel who administer medication in an emergency should include instructions on the administration method, possible complications and upper dosage limit of medication.
Emergency response protocols should address the following:
· Authorised school personnel know where the medication is stored, and to whom it belongs.
· The medication is readily accessible at all times.
· Ensuring the student has been correctly identified before administering any medication.
· School personnel are informed of, or can quickly find out, the correct dosage.
· School personnel are trained in administering the medication, where necessary.
· A process is established for who is to contact the parent/caregiver, ambulance and medical practitioner and when contact is to be made.
· If an ambulance is called, the ambulance officer should be advised of what medication, if any, has been administered.
· Information should be recorded about
o What time the emergency occurred
o Who took action
o What action was taken
o Who else was there
When a medical practitioner has provided first aid guidelines for a student these must be followed. When there are no specific medical practitioner guidelines the following first aid procedures should be implemented as best practice.
Emergency First Aid Response For Asthma
Asthma Foundation of Queensland recommends the following procedure for students who are showing signs of distress resulting from inability to breathe freely. Firstly, check that the student has not inhaled a foreign body that is obstructing the throat. If the likely cause is an asthma attack then proceed as follows.
1. Sit the person down and remain calm to reassure the person.
2. Give four puffs of a reliever, Ventolin, Asmol, Airomir or Bricanyl, immediately. If possible, use a spacer. The medication is best given one puff at a time through the spacer.
3. Wait four minutes. If there is no improvement give another four puffs of the reliever.
4. If there is no improvement, call an ambulance immediately. Repeat steps two and three while waiting.
Emergency first aid response for anaphylaxis
FACTS Qld recommends the following procedure for students with a history of anaphylaxis and who have an individual management plan, or inadvertent exposure to a trigger.
1. For bee stings – remove bee stingers by scraping them out of the skin.
2. For food reaction – remove food from contact with skin or from mouth and wash mouth out. Do not induce vomiting.
3. Check that all conditions have been met according to the management plan.
4. Confirm that you have the right student.
5. Administer the student’s adrenalin.
Emergency First Aid Response For Epilepsy
Epilepsy Queensland Inc. recommends the following first aid response.
1. Time the seizure.
2. Remove any hard objects, place something soft under the head and loosen any tight clothing.
3. Do not restrain the person or force anything into their mouth.
4. Roll the person onto their side to allow excess saliva to drain from their mouth.
5. After the seizure allow the person to rest until they have fully recovered.
6. If the seizure lasts more than five minutes call an ambulance.
Emergency First Aid For Diabetes
Diabetes Australia Queensland recommends the following first aid response.
1. Ask the person if they can do a blood glucose test or if they are unable to do the test do it for them.
2. If the level is less than recommended on the individual management plan treat with quick acting glucose as per the plan.
3. Retest in 15 minutes to ensure the blood glucose level is rising.
4. If the person is unconscious, lay them on their side, ensure their airway is clear, administer glucagon as per the management plan and call for an ambulance.
Important Notes
1. It is recommended that the distance from the school, camp or location of a school activity from the ambulance service be considered for a student with anaphylaxis or other health condition requiring an urgent response. In some instances, particularly for a student with anaphylaxis, schools should negotiate priority status with the ambulance service.
2. Schools should have an asthma reliever puffer such as “Ventolin” (salbutamol) or terbutaline, in their first aide kits. The containers for these are often blue. The Delegate of the Chief Health Officer, Queensland Health issued and authority on 8 October 1998 for school use of asthma medications in emergency situations. This authority is included as Attachment 1 in DOEM HS-20.
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