The School Medics

Broadoaks British School Medical Department caters to the health needs of the students and staff. The school nurse’s role is complex and essential in supporting students’ health, well-being, and academic success, addressing physical and emotional needs, and safeguarding; to ensure a positive school experience for everyone. Our medical team comprising two active certified medical nurses supported by several first aid and CPR-trained staff; oversees the following responsibilities on a day-to-day basis in the school campuses -

1. Health Education and Promotion:

The School nurses provide health education to students, teaching them about healthy habits, nutrition, hygiene, and preventive measures. They promote physical activity, mental health awareness, and stress management.

2. Chronic Health Condition Management:

In special cases for some children that have chronic health conditions (such as asthma, diabetes, epilepsy, leukemia, or food allergies) - the school Nurses help manage these conditions by following up on the pupil’s active medications, monitoring symptoms, providing necessary care during the school day, and working with the school and parents (in special cases) to meet the needs of students with long term health conditions (i.e. putting together care plans).

3. Identifying Health Issues:

During routine health exams/checks, the school nurses may be the first to identify chronic health conditions or illnesses in pupils. Early detection allows for timely intervention and support.

4. Coordination with Families and Health Providers:

The school nurses act as liaisons between our families and health care providers. They help coordinate care, ensuring students receive necessary medical attention and follow-up.

5. Emergency Care and Safety:

The school nurses are trained to handle emergencies, from minor injuries to more serious incidents. They play a vital role in maintaining a safe school environment.

6. Employee Wellness Programs:

During the COVID-19 pandemic, the school nurses helped keep schools open for in-person learning while safeguarding students and staff. The school nurses plan out various wellness programs that syncs with health-based school events and programs for staffs to benefit from.

Procedures for Medication Administration

This section covers vital procedures for storing and administering medication in the school. Parents are asked to bring in medications for their ward(s) only when necessary.

Information for ongoing medication is obtained annually every September from parents on a form (medication permission form on zoho) via the school admin office. All information on a child's medical needs is given to the school nurse and displayed in the medical room.

Medication takes two forms:
1. Regular medication for an ongoing condition e.g. asthma, allergy
2. A short course of prescribed medication e.g. antibiotics

NOTE: Children who are to receive signed-in medications are to be brought by their teacher or caregiver to the medical room for administration (the Nurse will call the class to inform them when it is time), if the Nurse must serve medication to a child in class, the child is to be taken to a secluded corner in the classroom away from other children.

In general:

1. Parents must fill out an online medication permission form; stating who they are prescribed for, special instructions, and dosage information; without these, medication will not be administered.

2. Only the Nurse and staff that hold current pediatric first aid training are to administer medicine.

3. Medicine must be in original packaging, stating who they are prescribed for, dosage information, and time. The School cannot be held responsible for any reaction or side effects that a child may suffer as a result of taking the medication as prescribed.

4. All medication and associated ‘devices’ such as inhalers, must be clearly labelled with the child’s name and date of birth, and date received by the service. All administration will be recorded clearly and accurately.

5. Where children have complex medical needs a Health Plan should be developed by a specialist supporting the child and a copy given to the school Nurse. If in doubt about any of the procedures, the member of staff should check with the parents or a health professional before taking further action.

6. Nurse/ paediatric first aider should complete and sign record sheets each time they give medication to a child.

7. Please note that the Nurse cannot give medication if the medication permission form is not clearly completed and signed by the parent or guardian prior to dropping off medication.

8. Vitamins will not be administered in school except it is absolutely necessary e.g. child has a condition
caused by the deficiency of a vitamin.

9. Training must be provided for staff where the administration of medicine requires medical or
technical knowledge.

Any member of staff giving medicine to a pupil should check:

> The pupil's name
> Written instructions provided by parents or doctor
> Prescribed dose
> Dose frequency
> Expiry date
> Any additional or cautionary labels

First Dose
The Nurse and pediatric trained first aider staff should not give the first dose of a new medicine to a child. Parents should have already given at least one dose to ensure that the child does not have an adverse reaction to the medication. In the case of antibiotics, we will only administer them from day four.

Pupils with ongoing Medicine in School
We currently have children in the school who have medication kept in the medical room. This includes EpiPens and inhalers. Epi-Pens and inhalers are named, dated, and labelled and are kept in an accessible, yet safe place within a locked cubby. All qualified first aiders have had Epi-Pen training and are qualified to administer both the Epi-Pens and inhalers. The Epi-Pens and inhalers must only be given to the
children named on the medication and be administered by one of the first aid qualified members of staff. Dates of medication are checked at the start of each term by the Nurse.

Handling Medical Emergencies

When events that could cause loss of life or limb occur, e.g. fracture, serious head or eye injury, burns, choking, serious falls, allergic reactions, anaphylactic shock, or difficulty in breathing; while the school Nurse administers appropriate first aid, the school’s designated emergency hospital and the child’s parents are informed about the emergency, and an ambulance is used to convey the child to the hospital for immediate treatment.

The school Nurse and all Staff of the school are trained annually on practical first aid treatments like CPR and proper user skills of an AED machine. The development of an emergency action plan is put in place with every staff being aware of the basic protocol.

The key principles of first aid:

> STAY CALM: Do not take risks that could cause injury to yourself, the injured person or any other witnesses.

> ASSESS THE SITUATION: A good first aider is aware of their surroundings and ready to act quickly if required.

> MANAGE THE PERSON: This includes comforting the victim through the situation and reassuring them that help is on the way.

Do things step by step by following the ABCs guide in first aid treatment:

AIRWAYS: Check if the child or infants airways is blocked, what position they are in, if you are able to tilt their head back to open their airway.

BREATHING: Observe for any signs of breathing. Put your cheek close to their mouth to feel their breath and look to see if their chest is rising and falling.

CIRCULATION: Check for any external bleeding, if the child or infant's skin colour is blue, pink, or pale, and if their hands and feet are warm or cold.

Recovery Position

Recovery position is the safest course of action to take with a person that is unresponsive, but still breathing normally.
There is a special recovery position technique for an infant less than 12 months and it is different from the technique used for children over the age of 1 year.

For Children Over the Age of One

Move the child to their side with one of their legs bent and tilt their head back
Always ensure to monitor the child once they are in the recovering position, if they stop breathing, you will need to act Cardiopulmonary Resuscitation (CPR).

Infants Under the Age of One

Hold the infant in your arms on their side with their whole body at a slight downward angle, this will help their airway open and stop them from choking.
Always make sure to support the infant's head.
Continue to monitor their breathing while you wait for help to arrive.

Cardiopulmonary Resuscitation (CPR)

For a Child Over the Age of One

a) Give 2-5 initial rescue breaths before starting chest compressions.

b) To give rescue breaths, tilt the Child's head back to open the airway. Seal your mouth over their mouth and pinch their nose. Blow 5 breaths into the child's mouth. Look for
their chest rising, which indicates that you are doing this correctly.

c) To give chest compressions, place one hand in the middle of the child's chest and push down firmly. Then release to allow chest expansion, and give 30 chest compressions.

d) Now blow 2 times into the child's mouth followed by 30 chest compressions.

e) Repeat the cycle until help arrives or the child recovers.

Infants CPR

a) With the infant's head tilted back to open the airway, seal your mouth over their mouth and nose.

b) Blow steadily into the infant until the chest rises. Do this 5 times.

c) Give 30 chest compressions with 2 fingers so the chest is compressed inwards by 1 /3 of the depth of the chest.

d) Blow 2 times into the infant's mouth followed by 30 chest compressions.

e) Repeat the cycle.

First Aid for a Choking Child

If the child shows signs of a mild obstruction in their airway: Encourage the child to keep coughing, but do nothing else.
If the child shows signs of complete airway obstruction, but is still responsive.
Call for help whilst simultaneously providing back blows.
Give targeted back blows to try and dislodge the obstruction.
Support the front of the child’s chest with one hand and lean the child forward so that when the object is dislodged, it comes out of the mouth rather than further down the airway.
Give up to 5 sharp blows between the shoulder blades using the heel of your other hand.
Check to see if each back blow has loosened or removed the obstruction. The aim is to give back blows only until the obstruction is removed. Once the airway is cleared, you do not need to continue to give back blows. If 5 back blows fail to relieve the obstruction, move on to giving up to 5 abdominal thrusts ( Heimlich maneuver).
Keep the child leaning forward as this will keep the object from falling back down the airway.
Stand behind the choking child and place one hand clenched in a fist, in the middle of the child’s abdomen, just below their ribcage.
Pull inwards and upwards into their chest. Do this 5 times or until the obstruction is dislodged
If the obstruction is still in place after 5 back blows and 5 abdominal thrusts, continue alternating 5 back blows with 5 abdominal thrusts until help arrives.
If at any time, the child becomes unresponsive, open the child's airway and begin CPR.

First Aid for Choking Infants

If the baby is breathing- Do nothing, coughing is more effective than any first aid procedures, monitor the baby
If the baby is no longer breathing and is unconscious:
Lie on a flat surface
Call for help
Begin CPR

Managing Chronic Medical Conditions

Where a child has complex medical needs, an Action Plan should be developed by his or her Doctor and a copy given to the school Nurse. All medications, associated devices and equipments such as inhalers and Nebulizers, must be clearly labelled with the child’s name and date of birth. Care and brought in medications administered to children with chronic medical conditions are recorded clearly and accurately on a daily basis which will be shared with the child’s parent.

Children with medical implants and devices such as Pacemakers, insulin pumps and prosthetics are carefully monitored and observed with a daily vital report sent to their parents. An emergency plan in events of a deviation from normal, is put in place for immediate referral to their specialized health facility.

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