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Guidelines for Managing Asthma

People with asthma have airways which narrow as a reaction to various triggers. The narrowing or obstruction of the airways causes difficulty in breathing and can usually be alleviated with medication taken via an inhaler.

Inhalers are generally safe, and if a pupil took another pupil’s inhaler, it is unlikely there would be any adverse effects. Staff who have volunteered to assist children with inhalers, will be offered training from the school nurse/other appropriate health professional.

Schools are now able to hold salbutamol inhalers for emergency use. For further information and guidance, please see Guidance on the use of emergency salbutamol inhalers in schools, DfE, September 2014.

The emergency salbutamol inhaler should only be used by children, for whom written parental consent for use of the emergency inhaler has been given, who have either been diagnosed with asthma and prescribed an inhaler, or who have been prescribed an inhaler as reliever medication. Appropriate training is available from the school nursing service.

Schools/settings may wish to include a separate appendix within their general medicines policy outlining their procedures around supporting children with asthma including provision of the emergency inhaler if appropriate.

  1. If school/setting staff are assisting pupils with their inhalers, a consent form from parent/carer should be in place. Schools may wish to keep a register of children in school with asthma. Individual care plans need only be in place if pupils have severe asthma which may result in a medical emergency. Schools/settings may wish to request that all pupils with asthma complete and ‘asthma card’ as suggested by Asthma UK.
  2. Inhalers MUST be readily available when children need them. Pupils of year 3 and above should be encouraged to carry their own inhalers. If the pupil is too young or immature to take responsibility for their inhaler, it should be stored in a readily accessible safe place. Individual circumstances need to be considered, e.g. in small schools; inhalers may be kept in the school office.
  3. It would be considered helpful if parent/carer could supply a spare inhaler for pupils who carry their own inhalers. This could be stored safely at school in case the original inhaler is accidentally left at home or the pupil loses it whilst at school. This inhaler must have an expiry date beyond the end of the school year.
  4. All inhalers should be labelled where possible with the following information:-
    • Pharmacist’s original label
    • Child’s name and date of birth
    • Name and strength of medication
    • Dose
    • Dispensing date
    • Expiry date
  5. Some children, particularly the younger ones, may use a spacer device with their inhaler; this also needs to be labelled with their name. The spacer device needs to be sent home at least once a term for cleaning.
  6. School/setting staff should take appropriate disciplinary action, in line with the school/settings Behaviour and Managing Substance Related Incidents policies, if the owner or other pupils misuse inhalers.
  7. Parent/carer is responsible for renewing out of date and empty inhalers.
  8. Parent/carer should be informed if a pupil is using the inhaler excessively.
  9. Physical activity will benefit pupils with asthma, but they may need to use their inhaler 10 minutes before exertion. The inhaler MUST be available during PE and games. If pupils are unwell they should not be forced to participate.
  10. If pupils are going on offsite visits, inhalers MUST still be accessible.
  11. It is good practice for school staff to have a clear out of any inhalers at least on an annual basis. Out of date inhalers, and inhalers no longer needed must be returned to parent/carer.
  12. Asthma can be triggered by substances found in schools/settings e.g. animal fur, glues and chemicals. Care should be taken to ensure that any pupil who reacts to these is advised not to have contact with them.