Asthma Care Plans
Special Needs School Nursing Team
The Special Needs School Nurses work closely with you, your child and school staff to provide a unique service supporting, advising, educating, and training others to ensure the health needs of children, young people and families with complex and additional health needs are met. As a service, we will often review how we work with you to ensure you are receiving the right care, at the right time.
As part of the Special Needs School Nursing Service we provide and review comprehensive care plans for children with additional health needs in conjunction with families and fellow health professionals. Historically, care plans have been done on an annual basis for every child requiring one, regardless of whether your child’s needs have changed. In order to improve our service and to ensure a consistent, holistic and individualised approach to your child’s health needs, we will be moving to a ‘needs-based’ approach to care planning. This means we can work more closely with you and your child to provide support when your child’s health needs change. This could include a new diagnosis, a change in medication and treatment or a change in your child’s health and wellbeing.
Care plans will be provided as standard for the following conditions:
Children with Epilepsy
Children with Gastrostomies
Children with Nasogastric Tubes
Children with Oxygen
Children with Nebulised solutions
Children with suctioning requirements
Children with Shunts
Children with Stomas
Children with Tracheostomies
Allergy and Anaphylaxis care plans will be provided on the standard Allergy UK care plan format.
Individual Asthma care plans will no longer be issued to any child with non-complicated Asthma as all children follow the same emergency protocol as provided by the Department of Health and detailed within the Supporting pupils at school with medical conditions (2014) guidance. Any child with an inhaler in school will be issued with a standardised emergency procedure document to be kept with their inhaler.
If your child requires an individualised care plan that isn’t listed, this will remain in place and will be reviewed in line with your child’s needs as they change.
When your child’s care plan is next due for review, you will be contacted to update your child’s information and the updated care plan will then be sent to you for signing.
There will be no further update to the plan unless parents/guardians inform the school nurse that there has been a change to your child’s health needs.
It is of upmost importance that you inform the school nurse of all changes to your child’s health including diagnosis and medication as soon as you are aware of them. Please do not rely on other care providers to share information as this can sometimes take a number of weeks to be received. This will ensure safe and effective care can be provided to your child at the earliest possible opportunity. The nurse will speak with you at home or over the phone to complete an individualised health assessment which will assist in identifying any further support or training that may be needed to support you and your child changing health needs and the nurse can then update the care plan accordingly. This will then be sent to you for signing. It is imperative that you sign the form and return it to the school nurse to ensure your child continues to be cared for safely.
If you have any questions or queries regarding this change to our service, please contact the school nurse.
Special Needs School Nurse
Guidance on the use of emergency
Salbutamol inhalers in schools
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 – if not available, use the emergency 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
Department of Health. (2015, March). Guidance on the use of emergency salbutamol inhalers in schools. Retrieved Feb 14, 2019, from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/416468/emergency_inhalers_in_schools.pdf