Supporting students with asthma and/or at risk of anaphylaxis at school procedure

Audience

All state schools

Purpose

This procedure outlines the measures state schools must take to manage risks in the school environment and support the first aid response for students diagnosed with asthma and/or at risk of anaphylaxis, so that all students can safely participate in all aspects of school life.

Overview

Asthma and anaphylaxis are treated using standard emergency first aid responses. Minimising exposure to triggers or allergens in the school environment can reduce the risk of a student experiencing an asthma flare-up or anaphylaxis.

Principals have a non-delegable duty of care to students enrolled at and attending their school, which includes enabling students diagnosed with asthma and/or at risk of anaphylaxis to maintain their wellbeing and engage in learning. This requires management at the student and school level. All schools are required to have an Anaphylaxis risk management plan regardless of whether a student identified at risk of anaphylaxis is enrolled. 

A range of school staff and parents/carers have a role in providing a safe environment for students. School staff and parents/carers collaborate to manage identified health risks and plan an emergency response. Schools provide support taking into account what is safe and reasonable in an individual case, and first aid when required. Students who require support at school to manage their health condition must provide the school with an action plan completed by an appropriately qualified health professional.

Responsibilities

Principals

• ensure students diagnosed with asthma and/or at risk of anaphylaxis are safe at school and have their needs met through:
  • risk minimisation and individualised supports
  • storing emergency medication in an unlocked location close to the student at all times
  • first aid for asthma or anaphylaxis when required
• approve anaphylaxis risk management plans and other plans that include strategies to minimise students’ risk of exposure to triggers and known allergens
• approve students diagnosed with asthma and/or at risk of anaphylaxis to carry and administer their own emergency medication as per the requirements in the Administration of medications in schools procedure, where appropriate and in consultation with the parent/carer and the student
• ensure all relevant and supervising staff are:
  • informed of students' health conditions and needs
  • trained as required in asthma and/or anaphylaxis risk management, and to provide asthma and/or anaphylaxis first aid by administering emergency medication, ensuring that sufficient staff across the school undertake the training to meet the needs of students at the school
  • aware of how to maintain student’s privacy and dignity, and protocols for sharing student personal information
• communicate with staff, parents/carers, students and the school community about how to reduce exposure to triggers and known allergens in the school environment
• ensure parents/carers understand that they are responsible for providing information about their child’s health condition, triggers and allergens, up-to-date action plan/s and equipment, medications and consumables for use at school
• delegate the:
  • tasks outlined in the process to one or more staff members
  • purchase of asthma medication, spacer/s and adrenaline auto-injectors for the school first aid kit/s.

Regional offices

• support the work of State Schools Registered Nurses (DoE employees only) to ensure that training is available for school staff as required.

State Schools Registered Nurses

• provide training to nominated school staff regarding health support procedures as appropriate, including asthma management and simulated practical training for school staff to use an adrenaline auto-injector
• support schools to assess and manage risks related to students’ health support needs as required.

School staff

• take reasonable measures to reduce the risk of students being exposed to their triggers and known allergens, which should be reasonably foreseen
• provide assistance to ensure that a student receives appropriate medical attention including emergency first aid when required
• support the implementation of students’ action plans.

Principals, Regional offices, State Schools Registered Nurses and School staff

• familiarise themselves with the Anaphylaxis Guidelines for Queensland state schools and the Asthma guidelines for Australian schools.

Parents/carers

• provide information to the principal about their child’s health condition/s, including up-to-date action plans and other written advice from health professionals (e.g. doctor)
• consult with the school on ways to minimise risks to their child at school
• provide and maintain equipment, medication and consumables, ensuring these are well maintained, in-date and clearly labelled with the student’s name, relevant instructions and dosage of medication
• provide medical alert apparel when appropriate.

Process

The principal is responsible for the overall management of students’ health support needs. One or more delegates  may perform identified tasks in the process, which is summarised in Flowchart 1: Managing student health support needs at school.

All schools are required to develop a school-wide Anaphylaxis risk management plan.

Image 1 – Supporting students with asthma and/or at risk of anaphylaxis at school process summary

Identify students 

Identify students diagnosed with asthma and/or at risk of anaphylaxis

The principal or their delegate/s will:

• gather information from parents/carers, and the student (if appropriate), about student’s health support needs when the student enrols in the school and throughout schooling
  • If no students are identified as being at risk of anaphylaxis, see section Minimise risk to students, on how to develop a whole of school anaphylaxis risk management plan
• request an action plan for any student who is identified as requiring support to manage their health condition or administer their emergency medication at school.

Record student’s information

The principal or their delegate/s will:

• record the following on OneSchool:
  • the student’s medical condition;
  • a copy of the student’s action plan.
• store a copy of the student’s action plan/s with their emergency medication 
• explain to the parent/carer and/or student that action plans will be stored and displayed in staff accessible locations to ensure that staff are aware of who in the school is at risk and how to best support students
• ensure action plans are not stored or displayed in areas used by the general public (e.g. the foyer of the administration building) to protect student’s privacy
• ensure action plans are kept current by requesting the parent/carer provide an action plan to the school every time it is updated
• manage versions of action plans to ensure that staff are using the most current plan.

Plan and minimise risk in the school environment and specific activities

Determine what supports are required for individual students

The principal or their delegate/s will:

• consult with the parent/carer and/or the student to :
  • ensure informed consent is given and maintained for the school to provide the support the student requires
  • explain that in the case of an asthma or anaphylaxis emergency, consent will not be sought in order to ensure the student receives immediate first aid
  • assess risk and determine the appropriate risk minimisation strategies
  • plan a response should an asthma flare-up or anaphylaxis occur
  • ensure medication, consumables and other equipment required for the school to provide asthma or anaphylaxis first aid for the student are provided in a timely way
  • gather evidence to support a request for the principal to authorise the student to carry and administer their emergency medication at school
  • ensure the family and student (if appropriate) agree to share relevant information about the student’s health condition (it is not required to share the student’s name in all situations) with relevant members of the school community where necessary to minimise risk (e.g. to minimise exposure to known allergens).

The principal will:

• determine if the student will be authorised to self-manage their health condition and emergency medication at school. They will:
  • ensure staff are aware of students they supervise who are self-administering and self-managing their medications and health conditions
  • notify staff that even where approval to self-administer emergency medication is granted, staff should be prepared to administer it to the student if required. No student should be expected to be fully responsible for self-administration of their emergency medication, as their symptoms may compromise their ability to do so
  • follow the approval and record management requirements for self-administration of asthma medication and adrenaline auto-injectors in the Guidelines for the administration of medications in schools
  • record in OneSchool if a student has approval to carry and self-administer their medication.

Minimise risk to students

The principal and their delegate/s will:

• develop an Anaphylaxis risk management plan for the school. They will:
  • identify risk factors and barriers to effective management of diagnosed or undiagnosed anaphylaxis and identify appropriate control measures 
  • include information from parents/carers of students diagnosed at risk of anaphylaxis to ensure appropriate risk minimisation strategies have been considered and are in place
  • follow the Managing first aid in the workplace procedure when completing the risk assessment
• minimise exposure to known allergens. They may:
  • request parents and staff support the school’s efforts to reduce identified allergens within the school. However, such requests cannot be enforced and must not be used as a stand-alone risk minimisation strategy
  • determine that certain foods are not available from the school, e.g. tuckshop, fundraising activities.
  • not attempt to prohibit particular food substances in schools (food bans)
  • not make claims that the school, or any part of the school, is an allergen-free or nut-free zone
  • not allow students at risk of anaphylaxis to be physically separated from other students as a risk management strategy
• inform the school community of the strategies the school has implemented to reduce risk.
• manage risks in school curriculum activities and special events in collaboration with the parent/carer. They will:
  • discuss proposed activities and events with parent/carer well ahead of the proposed event dates
  • request State Schools Nursing Service (DoE employees only) support to plan to manage a student's complex needs during a special event if required, well ahead of the event
  • provide coordinators of camps and excursions with details of students' risk management strategies prior to the event
  • encourage parents/carers of students with food allergy to liaise with the event food service provider
  • provide appropriate peer education about food allergy as required
  • consider how student health support needs can be safely managed when planning lockdown and evacuation procedures (e.g. taking a student's emergency medication to the evacuation point)
• ensure processes are in place for students to alert staff if they are experiencing symptoms
• provide first aid equipment. They will:
  • provide one or more adrenaline auto-injectors and one or more asthma reliever medication (DoE employees only) devices and single-use spacers for first-aid, and determine, through a risk assessment process, the purchase of additional devices
  • ensure the availability and timely accessibility of a sufficient supply of asthma reliever medication and adrenaline auto-injectors for first-aid in specified locations at the school, including in the school grounds, and at excursions, camps and special events
  • ensure all staff, volunteers and students as required know where the emergency medication is stored
  • display or store an ASCIA First Aid Plan for general use with the adrenaline auto-injector for general use in the school first aid kit/s
  • display or store a first aid for asthma chart with the asthma reliever medication for general use in the school first aid kit/s
  • replace school purchased equipment, emergency medication and consumables promptly as they are used or close to expiry
• follow the Administration of medications in schools procedure and the Guidelines for the administration of medications in schools for specific storage requirements of emergency medication.

Provide training and support for school staff

The principal or their delegate/s will:

• plan training for school staff who are responsible for students diagnosed with asthma and/or at risk of anaphylaxis as per Flowchart 2: Staff training for student's health support needs at school with the State Schools Nursing Service (DoE employees only) or other provider
• determine the appropriate number of staff to complete anaphylaxis training based on an assessment of risk, at no less than the ratio of 1:25 (trained officer to staff, students and visitors) or 1:10 for schools that do not have timely access to medical and ambulance services to a maximum of all staff
• arrange for school staff to complete as required:
  • the online ASCIA anaphylaxis e-training for Queensland schools
  • a practical, simulated training session using an adrenaline auto-injector training device
  • an approved asthma management course
• maintain a register of staff who have completed training and when refresher training is due.

Provide and review support

Support students

The principal or their delegate/s will:

• implement action plans. They will:
  • ensure all relevant staff, including relief and specialist staff, who are responsible for supervising the student have reviewed the student’s action plan
  • allow students with a health support need to wear medical alert apparel
• provide support for students experiencing an asthma flare-up or anaphylaxis as required, following student action plan/s or the general action plan/s or first aid chart, including the instructions for calling an ambulance as needed
• in any situation where an ambulance has been called:
  • contact the student’s parent/carer as soon as possible
  • record the contact made with the parent on OneSchool
  • record the incident and first aid provided in MyHR WHS
• ensure that student’s equipment, emergency medication and consumables used at school are
  • readily accessible at all times. Do not lock away emergency medication
  • labelled clearly with the student’s name, and a pharmacy label as required 
  • stored according to the manufacturer’s recommendations
  • available for use by the student for school activities held out-of-school hours.

Review plans and support

The principal or their delegate/s will:

• update records in OneSchool, based on advice received from parents/carers
• regularly monitor the student’s equipment, emergency medication and consumables and inform the parent/carer when these require servicing, resupply or are close to expiry date
• review the anaphylaxis risk management plan and monitor the success of the implemented controls at least annually and when the information that informs the plan changes (e.g. a student’s confirmed allergens change, exposure to an allergen occurs)
• review the need for staff training to ensure students can receive timely support through an appropriate distribution of staff across the school campus during class times, break times, and school events.

Definitions

Legislation

• Education (General Provisions) Act 2006 (Qld)
• Work Health and Safety Act 2011 (Qld)
• Anti-Discrimination Act 1991 (Qld)
• Disability Discrimination Act 1992 (Cwth)
• Disability Standards for Education 2005 (Cwth)
• Medicines and Poisons (Medicines) Regulation 2021
• Information Privacy Act 2009 (Qld)
• Human Rights Act 2019 (Qld)

Delegations/Authorisations

• Nil

Other resources

• Managing student’s health support needs at school procedure
• Flowchart 1: Managing student health support needs at school
• Flowchart 2: Staff training for student’s health support needs at school
• Administration of medication in schools procedure
• Managing first aid in the workplace procedure
• Managing risks in school curriculum activities procedure
• Asthma guidelines for Australian schools
• Guidelines for the administration of medications in schools

Online materials

• Anaphylaxis management
• ASCIA Anaphylaxis e-training course

Superseded versions

Previous seven years shown. Minor version updates not included.

1.0 Management of Students with Specialised Health Needs

1.0 Supporting students with asthma and/or at risk of anaphylaxis at school