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School medication policies must contain a clear procedure for staff to follow in the event of a medication error occurring. Staff should be supported and encouraged to be open and transparent when it comes to errors, so the focus should be on what they can do to prevent a more serious situation developing.
In the event of an error staff should:
- Stay calm.
- Check all the information again to be clear on what the error is.
- Report the error to a more senior/experienced staff member.
- Ask the senior staff member to come and check the pupil.
- Contact the pupil’s parent/carer to inform them of the error and agree next steps.
- Arrange for advice to be sought from the pupil’s GP.
- Document the error on the Medication Administration Record (MAR).
- Complete an incident report.
If at any point after the medication has been administered the pupil starts to show signs of being unwell, staff should call 111 for immediate advice and support.
If the pupil loses consciousness, experiences difficulties breathing, or shows any other signs of serious illness staff should call 999.
Short term and long term conditions
Short-term acute conditions, e.g. ear infections
Most pupils will experience this type of illness at some point, and the most likely type of medications they’ll need to manage these are pain relief, antibiotics, anti-inflammatories etc. Pupils may need support with medication for a short time to manage the symptoms, e.g. days or weeks.
Long-term chronic conditions with acute or emergency episodes, e.g. asthma, allergies or epilepsy.
Some pupils may have long-term chronic conditions that they take regular, preventative medications for; however, at times they may experience acute or even emergency episodes that require ‘rescue’ or emergency medications.
For example, a pupil with epilepsy may take regular medication to reduce the likelihood of experiencing a seizure; however, for a variety of reasons (e.g. photosensitivity, hormonal changes, external triggers) they may experience a seizure and may need a rescue medication administered to stop the seizure.
What are common long-term conditions?
Below is a list of the long-term medical conditions that are more common and that pupils are likely to need to take medication during school hours to manage. These are the conditions that staff in schools are likely to need an awareness of. We will discuss what these conditions are, how they can affect pupils, the types of medication pupils may need to manage these conditions, and any emergency situations that pupils may need support with because of these conditions.
This is not an exhaustive list but staff who work in schools are likely to support pupils with these conditions at some stage:
- Severe allergies.
What is eczema?
According to the National Eczema Society, eczema is an inflammatory, dry skin condition which affects 1 in 5 children in the UK. Eczema varies from person to person and can range from mild to severe. Usually, the skin affected by eczema is more easily damaged, and will become itchy, irritated and inflamed when in contact with substances that dry skin out.
Eczema is not contagious; it is often referred to as ‘dermatitis’. There are several different types of eczema which have different causes and treatments. During a flare-up the urge to itch can be overwhelming and can lead to cracked, swollen and bleeding skin which is then at risk of infection.
Pupils with eczema will be vulnerable to skin infections in areas that are cracked, raw or bleeding. Infected eczema needs additional treatment. Infections will cause eczema to worsen and will lead to weeping skin and blisters and can cause high temperatures and lead to the pupil feeling generally unwell.
How can eczema affect pupils?
During flare-ups areas affected can be physically painful and pupils may struggle with the urge to itch. This can affect pupils’ ability to concentrate and focus during lessons.
Eczema in children can often be worse overnight leading to disturbed sleep, leaving pupils tired during the day.
As well as the physical affects, pupils may also experience mental health problems including depression, low self-esteem, low self-confidence and anxiety.
Treatments for eczema
The key to managing eczema is to keep the skin moisturised; this can be done with topical, medicated creams. ‘Topical’ means a medication that is applied to a body surface such as the skin.
The types of medications which could be prescribed include:
- Emollients (medical moisturisers).
- Topical steroids.
- Medicated bandages or wraps.
What is asthma?
Asthma is a condition that causes the small tubes that carry air in and out of the lungs to be inflamed and sensitive. There are many causes of asthma including genetics and environmental factors.
The most common symptoms of asthma are:
- Tight chest.
This is when the symptoms of asthma get much worse. This can happen gradually, building up over a few days, or it can be very sudden.
During an asthma attack a pupil may:
- Cough more than usual.
- Become breathless and find it difficult to walk/talk.
- Breath faster.
- Wheeze more than usual.
- Complain of a tight chest.
How can asthma affect pupils?
According to Asthma UK, three people die every day from an asthma attack. As with most conditions, people can experience mild to severe symptoms. The more severe a pupil’s asthma is the more it will impact their daily lives.
Pupils with asthma may be less able to engage in physical activity. They may be fatigued which can affect concentration and focus during class, and they may not want to join in with activities they usually would. Symptoms can be worse at night and disrupt sleep so pupils may be tired.
Pupils with asthma may experience mental health issues such as anxiety – linked to the risk of an asthma attack. Pupils’ behaviours may be affected in the lead up to worsening symptoms, e.g. they may be agitated, distracted, quiet, withdrawn, or distressed.
Treatments for asthma
There is no cure for asthma; however, there are medications that can be used to control or reduce symptoms, improve lung function, and prevent symptoms worsening. Treatment is usually given via inhalers – devices used to deliver medication which is breathed into the lungs. Or medication can be given as oral tablets.
- Preventer inhalers.
- Reliever inhalers.
- Oral preventer tablets.
- Oral steroids.
What is diabetes?
Diabetes is a serious condition that leads to blood glucose (sugar) levels being too high, usually because the body isn’t producing enough insulin. Insulin is the hormone the body needs to use glucose effectively. There are many different types of diabetes; the most common are Type 1 and Type 2.
Common symptoms include:
- Frequent need to go to the toilet.
- Increased thirst.
- Unexplained weight loss.
- Itchiness and frequent thrush.
- Cuts and wounds taking longer to heal.
- Blurred vision.
- Frequent tiredness.
Hyperglycaemia and hypoglycaemia
Pupils with diabetes are at risk of experiencing ‘Hypers’ or ‘Hypos’ where their blood sugar is too high or too low.
Hypo = Too low.
Happens quickly and can pose a serious risk to wellbeing. Symptoms include feeling shaky, disorientated, headache, sudden tiredness, confused, anxious, irritable, sweating.
Treatment = Give something sugary to eat or drink.
Hyper = Too high.
Symptoms build gradually as blood glucose rises over time. Symptoms include being very thirsty, needing to urinate more often, headaches, blurred vision, feeling sick and stomach ache.
Treatment = Prescribed medication to reduce blood glucose levels.
How can diabetes affect pupils?
Diabetes can affect the ability to concentrate, memory skills and the ability to pay attention. Pupils with diabetes may need to carry snacks with them, and be given the opportunity to snack during lessons or before physical activity to maintain healthy blood glucose levels.
They may also need regular breaks to test blood sugar levels. Pupils may have higher absence levels due to increased risk of infections and regular hospital appointments.
Treatments for diabetes
Diabetes can be treated with lifestyle choices and medications. Pupils with diabetes will usually have to test their blood sugar levels at regular times during the day.
Treatments can include:
- Oral medications.
- Insulin injections.
- Insulin pumps.
What is epilepsy?
Epilepsy is a condition that causes sudden bursts of intense electrical activity in the brain that disrupts the way the brain normally functions, causing an epileptic seizure.
There are different types of seizures, depending on where in the brain the burst of electrical activity has occurred and how widespread it is.
There are also many different types of epilepsy. It can be a lifelong condition, or it can last for a limited amount of time. Epilepsy can be genetic or can be caused by brain injuries, tumours, infections or how the brain has developed.
There are several types of seizure and people can experience more than one type. In some seizures, the person may lose consciousness and fall; in others they may be aware of what’s going on but unable to control movements or respond.
Some seizures can be caused by specific triggers such as flashing lights, stress or tiredness, alcohol or drugs, hormone changes, or illness. While for others there may not be any obvious trigger.
Some people get strange sensations called ‘auras’ before they have a seizure, while others will get no warning or ‘aura’ at all.
How can epilepsy affect pupils?
Seizures can pose a serious risk to a pupil’s health; they can put pupils at risk of injury from falls or related accidents.
Pupils with epilepsy can be more likely to experience problems with learning, memory, information processing, attention and concentration.
They can also experience depression or anxiety related to their condition.
Treatment for epilepsy
There are a wide variety of treatments available for epilepsy including:
- Brain surgery.
- Nerve and deep brain stimulation.
- Specialised diets.
Usually, epilepsy is treated with oral medications which aim to prevent seizures. Some people with epilepsy may also need medication administered in the event of a prolonged seizure – this is known as a ‘rescue medication’.
What is an allergy?
Allergies are when the body’s immune system responds to a normally harmless substance as though it is a threat. The response can be minor and lead to mild symptoms such as localised itching or it can be severe and lead to life-threatening reactions such as anaphylaxis.
Common symptoms of an allergic reaction include:
- Sneezing, runny nose.
- Wheezing, coughing, shortness of breath.
- Rashes, hives.
- Diarrhoea, vomiting.
The most common types of allergies in children are food allergies, eczema, asthma and hay fever.
This is a severe, life-threatening allergic reaction which needs immediate treatment.
Symptoms of anaphylaxis usually occur soon after exposure to the trigger and include:
- Swelling of the mouth, tongue and throat.
- Difficulty swallowing and speaking.
- Coughing, wheezing or severe asthma symptoms.
- Difficult, noisy breathing.
- Stomach cramps and vomiting.
- Dizziness, and loss of consciousness.
Pupils with a known risk of anaphylaxis should be carrying an EpiPen which is an emergency dose of adrenaline. This should be administered as soon as severe symptoms occur and an ambulance called immediately.
Pupils with severe allergies can experience symptoms which can make them feel generally unwell and uncomfortable, which can affect their learning. Some pupils’ allergies may affect them at night, leading to reduced sleep which will affect levels of concentration and attention.
Pupils with allergies may also experience high levels of anxiety; those with food allergies may find mealtimes or activities involving foods very stressful.
Treatment for allergies
Most of the treatment options for allergies are to reduce the symptoms of a reaction, for example:
- Topical medications for skin reactions.
- Asthma medications for respiratory symptoms.
- Antihistamines – Can be used preventatively or once a reaction has started.
- Nasal sprays and eye drops.
- EpiPens for anaphylaxis.
Types of medication
There are many different types of medicines. Medicines can be known by their brand name and their generic name.
- Brand Name = The name given by the manufacturer of the medicine. One medicine can be made by several different companies and each company will have their own brand name for that medicine, e.g. Calpol, Panadol, Hedex, Medinol are all brand names for paracetamol.
- Generic Name = The name given to a medicine based on the main ingredient/drug, e.g. ibuprofen is the generic name of Nurofen.
There are different ways to group medicines. Medicines can be grouped according to:
- The body part/system they affect.
- The type of illness/disease/condition they are used to treat.
- The chemical group in which they belong.
- The way (or route) the medication is administered.
Medicines can also be grouped according to how they are legally classified; the Medicines Act categorises medications according to the controls around how the medicine is supplied.
The legal categories of medicines are:
- General Sales List (GSL) medicines.
- Pharmacy medicines.
- Prescription Only Medicines (POM).
- Controlled Drugs (CD).
Common types of medications
Below are the most common types of medications used and those you are most likely to come across in a school setting. They are grouped according to the type of illness, disease, or condition they are used to treat.
|Type of medicine||Medication use||Examples (Generic names)|
|Antibiotics||Used to treat bacterial infections. Different antibiotics are used to treat different types of bacterial infection.||– Amoxicillin
|Analgesics (Painkillers)||To relieve pain caused by injury, illness, or disease. Vary in strength and type of pain they are most effective at controlling.||– Paracetamol
|Anticonvulsants||Used to treat seizures caused by epilepsy.||– Carbamazepine
– Buccal Midazolam
|Antiemetics||Used to prevent or relieve vomiting.||Metoclopramide|
|Antihistamines||Used to relieve symptoms of allergies.||Chlorphenamine|
|Laxatives||Used to relieve constipation.||– Lactulose
|Hormones||Used to treat hormone imbalances which can affect a variety of bodily functions.||– Insulin