The Suppoort Staff Little Pocket Book | Welcome to the Support Staff Little Pocket Book

The medical conditions covered here are Allergic Reactions, Asthma, Diabetes and Epilepsy. These are the most common conditions you are likely to come across during the course of your work. Many of these pupils, depending on the severity of the condition, will be considered disabled according to the law.
For further information and advice see: Managing Medicines in Schools and Early Years Settings, DfES 2005
Ref: 1448-2005DCL-EN
http://publications.teachernet.gov.uk/eOrderingDownload/1448-2005DCL ENv3final.pdf

Allergic Reactions
Anaphylaxis is an extreme allergic reaction which needs urgent medical treatment. The cause is usually food, particularly nuts, fish and dairy products, but wasps and bee stings can also cause a reaction. Symptoms of a severe allergic reaction include: a metallic taste; itching in the mouth; swelling in the face, throat, tongue and lips; difficulty in swallowing; flushed complexion; abdominal cramps and nausea; a rise in heart rate; wheezing or difficult breathing; collapse or unconsciousness. Schools should bear this risk in mind at break and lunchtimes and in food technology and science lessons. Staff are not obliged to give injections, unless contractually bound to, but those who volunteer to give injections in emergencies should be trained to use the EpiPen® device for injecting adrenaline. This is preloaded with the correct dose of adrenaline. If there is any doubt about the severity of the reaction, or if the pupil does not respond to the medication, an ambulance should be called. All staff should have at least some minimum training in recognising symptoms and the appropriate measures. Schools should have procedures known to staff, pupils and parents. The Anaphylaxis Campaign can provide more detailed information about particular allergies: www.anaphylaxis.org.uk and www.allergyinschools.co.uk or tel: 01252 542029

Asthma
You can expect three or four children in each class of 30 to have asthma. When children have an attack they need to use their reliever inhaler quickly. You should be aware of the signs of an attack - breathlessness and coughing are the easiest symptoms to spot - and encourage them to sit upright or lean forward slightly and breathe deeply. Get them to loosen their clothing and offer water. If the reliever has no effect after 10 minutes, a doctor or ambulance should be called. Every school needs to have procedures that all staff know. The National Asthma Campaign has a free school pack: www.asthma.org.uk/health_professionals/ordering_materials/school_pack.html or tel: 020 7704 5888.
Quick Guides AM6 Helping Pupils at Risk of Allergic Reactions and Asthma.

Diabetes
About 1 in 550 pupils suffer from diabetes, which means that they cannot naturally control their blood sugar levels. It is controlled by injections of insulin daily. Most children can inject themselves. These injections should be done out of school. If the pupils are on school activities running outside school hours, you should ensure that you know the school policy and your part in it. Pupils with diabetes must be allowed to eat regularly. Schools should have arrangements for this. All staff need to be aware of the signs of a ‘hypo’ in a diabetic pupil. These include – hunger, sweating, drowsiness, pallor, glazed eyes, shaking, lack of concentration, headache, mood changes, especially angry or aggressive behaviour and irritability. If a pupil has a ‘hypo’, a fast-acting sugar e.g. a glucose tablet or sugary drink should be 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 10-15 minutes later. If the pupil’s recovery takes longer than 10 to 15 minutes, or the child becomes unconscious, an ambulance should be called.
Some children may experience hyperglycaemia (high glucose level) and have a greater than usual need to go to the toilet or to drink. 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. Your responsibility is to know the school’s policy and how to implement it.

Further information is available from Diabetes UK at www.diabetes.org.uk

Quick Guides AM4A Helping Pupils with Diabetes

Epilepsy

You should know what to do if a child has a seizure. If epilepsy is dealt with calmly and reassuringly it helps the child, and the rest of the class will develop a healthy and accepting attitude towards epilepsy.

What is epilepsy?

Epilepsy is not an illness. It is described as a tendency to brief disruptions in the normal functioning of the brain leading to ‘fits’. There are over 40 types, but the common ones are:

Major fit (‘grand mal’, ‘convulsion’ or ‘tonic-clonic’). A child may give out a strange cry and fall suddenly. Convulsions may occur; saliva may appear. The child will then recover consciousness, but may be confused. He/she may want to sleep or rest quietly after an attack. It looks alarming but is not harmful to the child. It is not an emergency unless one fit follows another and the child does not regain consciousness. You should then seek medical aid.

Minor fit (petit mal or ‘absence seizure’). Child appears to daydream or stare blankly and sometimes blink frequently. If these fits happen often they can lead to serious learning problems if not treated, as the child is unaware of what is going on.

Psychomotor fit (‘complex partial’ or ‘temporary lobe’). Involuntary movements, such as twitching or lip smacking. The child appears to be conscious but is unable to speak or respond.

Sub-clinical seizures. Often not recognised because unseen. A child’s attainment level may drop significantly for no apparent reason. If you suspect such seizures are happening inform the Head, who should inform the school’s medical adviser and the child’s parents.

WHAT YOU SHOULD DO if a child has a fit:

keep calm, reassure the other pupils in the class;
don’t move the child unless there is any danger from nearby objects;
let the fit run its course;
cushion the head, but do not try to restrain convulsive movements;
do NOT try to put anything between the teeth;
do NOT give the child anything to drink;
carefully loosen tight clothing around the neck;
do NOT call for a doctor or ambulance unless you suspect that the fits are recurring and the child is not regaining consciousness;
as soon as possible turn the child to one side in the semi-prone position in order to facilitate his/her breathing; and
reassure the child during the confused period which can often follow.

Where possible if a child is having a fit in class there should be an agreed procedure for ensuring that the rest of the class are catered for and are not distressed. One primary school uses a warning system where a teacher sends a child to the next class with a red cotton reel – alerting a colleague to the fact that there is a problem in the next classroom and assistance is required. (The school’s emergency plan will depend on the age of the class e.g. in some situations it might be preferable to move very young children out of the situation to avoid any distress.) Schools normally agree a plan of action with the parents, which all staff should be aware of.

The National Society for Epilepsy suggests that the school should know the answers to:

does the child need to sleep after a seizure?
should he/she be sent home?
is the child usually confused afterwards?
should he/she go to the medical room?

PE and off-site Activities
Epileptic children should normally be able to take part in all activities organised by the school, except those specifically agreed with the parents and/or medical adviser.

Epilepsy – a Teacher’s Guide. The British Epilepsy Association. Visit the website of the British Epilepsy Association: www.epilepsy.org.uk/info/teachers
Visit the website of the National Society for Epilepsy:
www.epilepsynse.org.uk
Helpline: 01494 601 400. Online Shop: shopping@epilepsynse.org.uk
Epilepsy Wales: Helpline: 08457 413 774.
Quick Guides AM4 Helping Children with Epilepsy.