Montessori Kindergarten Ilfracombe positively welcomes all children with asthma. We recognise that asthma is a widespread, serious but controllable condition affecting many children. We believe all children with asthma should be able to join in all aspects of nursery life if their asthma is managed effectively. We encourage children with asthma to achieve their potential in all aspects of nursery life by having a clear policy that is understood by all staff, their employers and children. New staff and trainees are also made aware of the policy. All children with asthma will need a Health Care Plan/Long term administration of medical treatment plan which will also consist of detailing the child’s medical needs, daily care requirements to manage the asthma and what to do in the event of an asthma attack. Staff are trained in the correct administration of inhalers and spacers as part of their full Pediatric First Aid Training.
Aims
Montessori Kindergarten Ilfracombe aims to:
• recognise that asthma is a widespread, serious but controllable condition; Montessori Kindergarten Ilfracombe welcomes all children with asthma
• ensure that children with asthma can and do participate fully in all aspects of nursery life
• recognise that children with asthma need immediate access to reliever inhalers at all times
• keep a record of all pupils with asthma and the medicines they take
• ensure that all staff (including part time and volunteers) who come into contact with children with asthma know what to do in the event of an asthma attack
• work in partnership with all interested parties including the governing body, all nursery staff, parents, employers of nursery staff, doctors, nurses and children to ensure the policy is planned, implemented and maintained successfully
Asthma Medicine
Preventative Inhalers
If a child needs a preventative inhaler, this will be detailed on their Health Care Plan/Long term administration of medical treatment and all staff working with the child will be informed of the plan. The key person or back up key person will be responsible for administering asthma medicine, as they will have the closest bond with the child. Preventative inhalers will be brought through to the kitchen and kept in the Medical box.
Generally, Preventative Inhalers (brown) are administered in the morning and evening, therefore should not be needed at the setting.
Reliever Inhalers
Immediate access to reliever medicines is essential. Reliever inhalers are to be kept in the first aid cupboard in the kitchen and all staff working with that child will be aware of the child’s Health Care Plan/ Long term administration of medical treatment, the location of their inhaler and how and when to administer the medicine. Staff will also be made aware of the possible triggers affecting the child’s asthma, as detailed on the Health Care Plan/long term administration of medical treatment. When going outside or on trips or outings, inhalers will be made accessible at all times by being transported in a clear, sealed container, labelled with the child’s name and details of when and how to administer the medicine. All inhalers must be clearly labelled and be prescribed by a doctor. Each time asthma medicine has been administered, parents will need to sign the relevant medication form.
Record Keeping
• When starting at Montessori Kindergarten, parents are asked to complete a medical form detailing any medical conditions to include Asthma.
• All parents of children with asthma are consequently sent a Health Care Plan/Long term administration of medical treatment to complete. Parents are asked to return it to Montessori Kindergarten Ilfracombe. This will include information about the dose, triggers and where the inhaler and spacer are to be stored.
• Parents are required to update Health Care Plans/Long term administration of medical treatment annually or at any point should their child’s medication or dose change during the year.
• Medical conditions are recorded and all staff informed.
• The Nursery staff will contact parents when an inhaler is about to expire and again once it has expired if it has not been replaced.
In the event of an asthma attack:
• Staff are appropriately trained to recognise an asthma attack and know what to do in the event of an attack.
• Staff will remain calm and reassure the child
• The child will be sat upright and any tight clothing loosened
• The child will be given the relevant inhaler as per the instructions on their Health Care Plan/ Long term administration of medical treatment.
• In the event of an asthma attack the Nursery follows standard Paediatric First Aid protocols, and any action outlined in the child’s Individual Health Care Plan.
. • If there are no signs of improvement in a child suffering from an attack, an ambulance will be called without delay.
HOW TO RECOGNISE AN ASTHMA ATTACK
The signs of an asthma attack are
• Persistent cough (when at rest)
• A wheezing sound coming from the chest (when at rest)
• Difficulty breathing (the child could be breathing fast and with effort, using all accessory muscles in the upper body)
• Nasal flaring
• Unable to talk or complete sentences. Some children will go very quiet.
• May try to tell you that their chest ‘feels tight’ (younger children may express this as tummy ache).
CALL AN AMBULANCE IMMEDIATELY AND COMMENCE THE ASTHMA ATTACK PROCEDURE WITHOUT DELAY IF THE CHILD
• Appears exhausted
• Has a blue/white tinge around lips
• Is going blue
• Has collapsed
WHAT TO DO IN THE EVENT OF AN ASTHMA ATTACK
• Keep calm and reassure the child
• Encourage the child to sit up and slightly forward
• Use the child’s own inhaler
• Remain with the child while the inhaler and spacer are brought to them
• Immediately help the child to take two separate puffs of salbutamol via the spacer
• If there is no immediate improvement, continue to give two puffs at a time every two minutes, up to a maximum of 10 puffs
• Stay calm and reassure the child. Stay with the child until they feel better. The child can return to school activities when they feel better
• If the child does not feel better or you are worried at ANYTIME before you have reached 10 puffs, CALL 999 FOR AN AMBULANCE. If an ambulance does not arrive in 10 minutes give another 10 puffs in the same way.