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Child deaths spark extra asthma training for school nurses

Training in asthma awareness will be offered to 500 school nurses across the North West of England following the deaths of three children from the condition over the past 12 months.

The training is joint initiative between Asthma UK, NHS North West and Respiratory Education UK.

It is hoped it will reduce the small, but often preventable, number of deaths in schools from the chronic respiratory condition.

Since January 2012 at least three children in the North West region have died due to asthma.

Two died in February – Rylan Cosgrove, age nine, from Millom in Cumbria and Joshua Platt, also age nine, from Oldham. Chloe Passmore, of Barley Cop Lane in Lancaster, was 12 years old when she died in March.

June Roberts, a nurse consultant at Salford Royal Foundation Trust and a member of the NHS North West respiratory clinical pathway team, said: “The recent tragic deaths of children with asthma in our region have highlighted how vital it is that children, their parents and schools understand how their asthma medication should be used and what to do in the event of an asthma attack.

She added: “Alongside the 500 nurses we plan to train, NHS North West is also collaborating with public health, local authorities and Asthma UK to work with schools across the North West to raise awareness and share resources that will help carers and teachers of children with asthma.”

The programme is due to be completed by the end of March at which point all 500 school nurses in the region should have received training.

Gill Hall, chief executive of Respiratory Education UK, said: “Only small numbers of children die from asthma each year – but many if not all of these deaths are thought to be preventable. Having a structured policy for the management of asthma in schools is essential.

“This training has been designed and will be facilitated by Respiratory Education UK and comprises a toolkit which includes study days, posters, emergency cards and interactive access and ongoing support,” she said.

According to Asthma UK research, two thirds of children with asthma aged 5 -18 years have experienced an attack while at school.

Readers' comments (13)

  • In Devon in the late 90's as a School Nurse I was part of the Devon Schools Asthma project which had a similar remit, and similar initiatives were carried out across the country with the result that asthma deaths were much reduced. The fact that this is having to be repeated suggests that lessons have not been learned, and proven preventive work, while lip service is paid, is not understood or seen as important, and therefore not resourced or implemented.

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  • Childhood asthma is not something Teachers and School nurses should be messing with .

    All that is needed is to know how to dial 999 and request an ambulance.

    The sooner a suffering asthmatic child is being cared for by professionals who understand the condition the better the outcomes !

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  • ''two thirds of children with asthma aged 5 -18 years have experienced an attack while at school''.

    Surely this shows the importance of all school staff being aware of recognising asthma symptoms and how to treat these quickly rather than just calling for an ambulance . Its very easy to administer or help administer an inhaler to a child (or adult) having an asthma attack.

    With training, staff gain a better understanding of how common asthma is and also how simple and effective the use of blue inhalers can be. School nurses play a very impportant role in supporting both school staff and pupils.

    For too long asthma has been viewed as 'just asthma' and we need to continue to raise awareness of the seriousness of this condition. - not only in schools but after school clubs and other activity centres.

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  • Anonymous | 17-Jan-2013 9:49 pm

    Asthma is not and never has been "just Asthma" it is a serious and potentially life threatening condition.

    A child suffering an asthma attack will often have difficulty in using an inhaler effectivly !

    A statement like "Its very easy to administer or help administer an inhaler to a child (or adult) having an asthma attack".
    Demonstrates a dangerous lack of knowledge and a complete failure to understand how quickly a child suffering asthma can deteriorate.

    If a child has an asthma attack at school an immediate 999 call is required. Whist waiting for the ambulance to arrive the chilhould be reassured and their salbutamol inhaler made available to them to use if they are able.

    Fiddling with inhalers and waiting to see if the medication works is dangerous !

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  • Jenny

    I agree ---Teachers and school nurses do not have the skills or expertise to assess the severity of a childs asthma attack.

    A child having difficulty breathing needs someone to call 999 urgently !

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  • If these "school nurses" where to open their eyes they would find excellent advice on the Astma Uk website !
    Including downloads to assist schools and relieve "school nurses" of their ignorance !

    I dispair

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  • Deaths caused by a failure to call 999 urgently !

    Wonderful policies which keep the childrens inhalers locked up and "safe" also contribute !

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  • all school staff are responsible for the safety and well being of the children in their care. they must all be trained without exception in awareness of conditions such as asthma all aspects of first aid and know when to call an ambulance. a child's condition can deteriorate very fast and be fatal and they need immediate professional care, especially for an asthma attack and their rapid intervention can save lives. the school nurse may not be immediately available if she is engaged elsewhere in another part of the school and some buildings can be large and spread out.

    It is also the teachers role to spot anything unusual in their class like their pupils who are withdrawn. reasons should be investigated by discussing with the child, colleagues, the medical team and the parents. it could help prevent future difficulties for the child and potential episodes of aggression and violence.

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  • We recently had funding to carry out Asthma UK for 'Alert to Asthma' sessions, training school staff to recognise asthma and what to do in event of an attack.

    In our local area school nurses who I hasten to add are generally very experienced paediatric nurses - go into the schools to deliver this training to teachers and support staff.

    The AUK sessions stress the inportance of treating minor attacks with their reliever inhaler and phoning for an ambulance if this is not effective.

    Local school policy is for the children to have access to their inhalers either in the classroom or in school bags/coat pockets.

    Its not always a major asthma attack that happens at school but a gradual deterioration over the day where the child uses the inhaler frequently over the day and teachers are not aware, so by the time the child gets home they are struggling and need hospitalisation.

    We need to make the children aware that its important to tell the teacher if they are using regular or frequent inhaler over the day so they can get help sooner rather than later.

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  • There is no such thing as a "minor" asthma attack. All asthma attacks are serious and potentialy lethal.

    Some children will recover rapidly from an episode of astma if they are able to use their inhaler effectively. Such a child should need no mores than 2 puffs of medication.

    Recovery means absolutly no wheeze or coughing!

    I repeat a breathless child is always an emergency !

    999 should always be called. If on arrival the paramedics discover a child who has recovered nothing has been lost !

    Delay costs lives ----dial 999

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  • A lot of generalising above! School Nurses are certainly not ignorant of asthma issues, and are well aware of the Asthma UK website, many hold Asthma care qualifications and have worked in acute childrens' wards. As we know, their role is not to provide full time first aid at schools, which is why they are involved in training school staff to recognise the signs that a child's asthma is worsening, and to take the correct action.
    School policies generally do encourage the child to carry their inhaler, and individual asthma protocols should be available to staff. Many schools have a spacer device to use while waiting for, not instead of, the paramedics. As you say Jenny, some children do recover quickly if they are able to use their inhalers, and this is, in retrospect, what most people would describe as a "minor" asthma attack. I suggest that to say "all that is needed is to dial 999" is negligent, there is plenty that should be done before the ambulance arrives to reduce the risk of a bad outcome. In some rural areas an ambulance can take over half an hour....lost time if staff are just waiting and watching the child without giving medication. You do actually say that the inhalers should be "made available" which does contradict your first point. Let's be clear - educating school staff is a good thing!

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  • Anonymous | 21-Jan-2013 7:13 pm

    I think you have misunderstood some of my argument !

    I have no objection to school staff having an awareness of Asthma so long as terms such as "minor asthma" attacks are banned!

    Having spacer devises avaiable is sensible but is no substitute for dailing 999!

    I have personal knowledge of a school where childrens inhalers were kept in the Heads office! -children who needed their inhaler had to personally retrieve their inhaler from the office!

    I did not intend to imply that 999 should be dialed in preference to attempting to assist a child to use their inhaler --- but I was attempting to convey the fact that all childhood asthma attacks should be treated seriously and that a 999 call should always be made as a priority !

    Teachers and teaching assistants should never be placed in a position of attempting to determine if a childs asthma is life threatening ------All asthma attacks are potntially life threatening and should be treated as serious emergencies !

    Dial 999 -------save a life !

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  • I must admit I was ignorant of the skills and knowledge of School Nurses (They were known as Nitty Nora's in my day !)

    I was also unaware that the school nurses "trained" teachers in recognising "serious" as opposed to "minor" asthma!

    I think I prefer the advise offered by Jenny!

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