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Asthma Management

1.Purpose

Asthma is a chronic health condition affecting approximately 15% of children; it is one of the most common reasons for childhood admission to hospital. While an average of two people die in Victoria each week from asthma, many of these deaths are thought to be preventable.

The City of Stonnington is committed to ensuring the safety and wellbeing of children in care. This policy and procedure aims to:

  • Provide an environment in which children with Asthma can participate in all activities to the full extent of their capabilities.
  • Provide a clear set of guidelines and expectations to be followed with regard to the management of asthma.
  • Ensure staff effectively respond to asthma and implement appropriate treatment such as administering asthma medication.
  • Encourage and enhance community awareness relating to asthma and asthma management through education and policy implementation.

2.Policy

CIty of Stonnington recognises that children attending childcare may be diagnosed or at risk of asthma, Childcare Services is committed to ensuring the environment is provided so that all children are able participate equally.

It is generally accepted that children under the age of six do not have the skills and ability to recognise and manage their own asthma effectively. Stonnington Childcare Services recognises the need to educate its staff and parents/guardians in relation to asthma and to promote responsible asthma management strategies.

Stonnington Childcare Services is committed to enhancing community awareness and education of asthma and asthma management strategies, this will assist in minimising the impact of asthma.

3.Scope

This policy applies to children enrolled at the service and their parents/guardians and all staff working within Childcare Services, including students/volunteers and agency relief staff engaged by the City of Stonnington.

DEFINITIONS

Asthma - People with asthma have sensitive airways in their lungs. When exposed to certain 'triggers' their airways narrow, making it hard for them to breathe. Symptoms of asthma include dry, irritating, persistentcough, particularly at night, early morning, with exercise or activity, chest tightness, shortness of breath and wheezing.

Asthma Emergency: The onset of unstable or deteriorating asthma symptoms requiring immediate treatment with reliever medication.

Asthma Triggers – Common triggers that may induce Asthma symptoms are colds/flu, exercise, allergens, dust, changes in weather and/or chemical/strong smells.

Puffer: Common name for a metered dose inhaler.

Reliever Medication: This comes in a blue container and is used to relax the muscles around the airways to relieve asthma symptoms e.g. Airomir, Asmol, Epaq or Ventolin.

Spacer device: A plastic device used to increase the efficiency of delivery of asthma medication from a puffer. It may be used in conjunction with a facemask.

Asthma Action Plan – A written set of instructions prepared in partnership with the medical practitioner that will assist in managing the child’s Asthma. The Asthma Action Plan will outline worsening symptoms and treatment.

4.Responsibilities

Childcare Services Co-ordinator

  • Provide staff with a copy of the Asthma Management Policy, briefing them on procedures upon their appointment to Stonnington Childcare Services.

Team Leaders

  • Identify children diagnosed with asthma during the enrolment process and provide parents with a copy of the Asthma Policy.
  • Provide an Asthma Action Plan to all parents of children diagnosed with asthma upon enrolment. The completed Asthma Action Plan is to be returned within 7 days.
  • Store Asthma Action Plans in the child’s enrolment record and provide a copy to the staff in the child’s room.
  • Ensure that all staff are informed of the children diagnosed with asthma that attend the centre.
  • Ensure that an emergency Asthma First Aid poster is displayed in key locations.
  • Regularly provide information to all families via newsletter, brochures and/or organise information sessions on asthma.
  • Encourage open communication between parents/guardians and staff regarding the status and impact of a child’s asthma.
  • Promptly communicate any concerns to parents should it be considered that a child’s asthma is limiting his/her ability to participate fully in all activities.
Staff responsible for the children
  • Staff are aware of the children in their care with asthma and have a copy of their Asthma Action Plan, they ensure that other staff are made aware of children diagnosed with asthma.
  • Ensure, in consultation with the parent/guardian, the health and safety of each child through supervised management of the child’s asthma.
  • Identify and, where practicable, minimise asthma triggers.
  • Where necessary, modify activities in accordance with a child’s needs and abilities.
  • Ensure that all regular prescribed asthma medication is administered in accordance with the information on the child’s written Asthma Action Plan and that the Medication Form is completed in accordance with the Medication Policy.
  • Administer emergency asthma medication if required according to the child’s written Asthma Action Plan. If no written Asthma Action Plan is available the asthma emergency procedures listed below should be followed immediately.
  • Ensure that Medication Form is completed and parents informed as soon as Asthma medication is administered; on collection of the child ensure that parents sign medication form to acknowledge the administration of the Medication.
  • Promptly communicate to the Team Leader any concerns that a child’s asthma is limiting his/her ability to participate fully in all activities.
  • Ensure that children with asthma are treated the same as all other children within the centre.

Parents/Guardians

  • Inform staff, either upon enrolment or on initial diagnosis that their child has a history of or has been diagnosed with asthma.
  • Provide all relevant information regarding the child’s asthma and an Asthma Action Plan completed in consultation with the child’s medical practitioner.
  • Notify the staff of any changes to their child’s asthma status and provide a new Asthma Action Plan signed by the doctor in accordance with these changes.
  • Provide an adequate supply of appropriate asthma medication (reliever medication) including a spacer device for their child whilst they are in care.
  • Ensure that they comply with all requirements and procedures in relation to completing and signing Medication Forms.
  • Communicate all relevant information and concerns to staff as the need arises e.g. if asthma symptoms were present last night.
  • Ensure, in consultation with the staff, the health and safety of their child through supervised management of the child’s asthma.
  1. Procedure

Emergency Treatment of an Asthma Attack

Children with a known asthma condition:

  • If a child develops signs of what appears to be an asthma attack, appropriate care must be given immediately. Regardless of whether the asthma attack is mild, moderate or severe, treatment should commence immediately as delay may increase the severity of the attack and ultimately risk the child’s life.
  • If the child has written instructions on their Asthma Action Plan follow these instructions immediately.
  • If no instructions are available then immediately commence the standard asthma emergency protocol detailed below.

Step 1: / Sit the child upright and remain calm to reassure them.
Step 2: / Without delay shake a blue reliever puffer (inhaler) and give 4 separate puffs through a spacer. Use one puff at a time and ask the child to take 4 breaths from the spacer after each puff.
Step 3: / Wait 4 minutes. If there is no improvement repeat step 2.
Step 4: / If still no improvement after a further 4 minutes - call an ambulance immediately (dial 000) and state clearly that the child is “having an asthma attack.”
Continuously repeat steps 2 and 3 whilst waiting for the ambulance.
  • In an emergency the blue reliever puffer used may be the child’s own or borrowed from another child.
  • The parents/guardians of any child who becomes ill at the centre should be notified, even if the child has a complete recovery from the asthma attack.
  • The treatment given should be recorded on an Accident, Injury and Illness Form and also a Medication Form.
  • It does not matter if a different brand of reliever medication to the child’s usual medication is used.
  • An overdose cannot be given following the steps outlined. However it is important to note that some children may experience an increased heart rate or tremors but these will pass quickly.

Children who staff are not aware have pre-existing asthma:

  • A problem that may be encountered is when a child suddenly collapses, or appears to have difficulty breathing, and is not known to have pre-existing asthma or other health problems. In this situation staff should:

Step 1: / Call an ambulance immediately (dial 000) and state that the child is having breathing difficulty.
Step 2: / Administer 4 separate puffs of a blue reliever puffer via a spacer if available. Use 1 puff at a time and ask the child to take 4 puffs from the spacer after each puff.
Step 3: / Keep giving 4 separate puffs of a blue reliever puffer every 4 minutes until the ambulance arrives.
  • The parents/guardians of any child who becomes ill at the centre should be notified as soon as possible.
  • In an emergency a blue reliever puffer can be borrowed from another child.
  • 000 Emergency Services operators will provide advice and guidance to staff over the phone before the ambulance arrive if required.
  • This treatment could be life saving for a child whose asthma has not been previously diagnosed and it will not be harmful if the collapse or breathing difficulty was not due to asthma. Reliever puffers are extremely safe, even if the child has not previously been diagnosed with asthma.
  • The treatment given should be recorded on an Accident, Injury and Illness Form and also a Medication Form.
  1. References

The following legislation relate to this policy:

Education and Care Services National Law Act 2010

Education and Care Services National Regulations 2011

Health Records Act 2001

The following references were used in the development of this policy:

Education and Care Services National Regulations 2011

The Asthma Foundation of Victoria. 2009

The Asthma Foundation of Victoria. 2007 Asthma and the Child in Care Model Policy.

Victorian Legal Aid and Department of Human Services. January 1999. Legal Aspects of Child Care. A Guide for Workers in Child Care Centers, Preschools andParents. – 6thedition. children.vic.gov.au/data/assets/pdf_file/0004/16555/ecs_legalcare_1999.pdf

7.Forms/Checklists

Enrolment Form

Action Plan - Asthma

Incident, Injury, Trauma and Illness Record

Medication Form

Version Control: 2 / Date Issued; April 2011 / Date Reviewed: 22 February 2016

G:\Child Family Serv\Childcare\Policies & Procedures Manual\Policies and Procedures\CCS PP - Asthma Management.doc