POLICY STATEMENT Children’s Services Unit

MANAGING ASTHMA, ANAPHYLAXIS and DIABETES

POLICY ADOPTED: May 2012

Policy Objective: To ensure the safety and wellbeing of children attending Bland Shire Councils Children’s Services who are at risk of severe allergy; anaphylaxis and/or diabetes.

Policy Statement: Bland Children’s Services recognises the potentially serious consequences of children diagnosed with asthma, allergies and diabetes; and therefore aims to provide an environment that is safe and allows any child with these conditions to participate in the daily routines and programs of the respective services. All relevant staff will be trained to administer the required medications for children in care with asthma; anaphylaxis and diabetes.

Statutory Legislation & Considerations Children (Education and Care Services National Law Application) Act 2010 Section 173 Education and Care Services National Regulations 2011: 90-91

Definitions: In this policy “staff” refers to staff employed by Bland Shire Council Children’s Services and educators registered with the Bland/Temora Family Day Scheme.

ASTHMA: One in ten children have current diagnosed asthma. Asthma is different for everyone – individuals can have different triggers, symptoms and medications for their asthma and these can also change.

Educators who will are responsible for the administering of asthma reliever medication will hold an approved asthma management qualification. Educators will also:

 Ensure reliever medication is stored in a location that is known to all educators, is easily accessible and not accessible to other children.  Children and adolescents have an important role in managing their own asthma. Therefore, in the case of a school aged child enrolled in Vacation Care, reliever medications will be left in the child’s bag and the child advised to inform the educators if self medicating.  Check with parent/guardian that the reliever medication is provided with the child on each day of attendance and ensuring expiry date is current and recorded with medication. NB If medication is not provided the child will be refused attendance.  Follow the child’s asthma action plan in the event of an asthma attack.  Ensure reliever medication, for each child at risk of asthma, is carried by a trained adult on excursions that these children attend.  Ensure each child’s reliever medication is collected and taken to muster point during Fire Evacuations and/or practice.

Whenever a child with asthma is enrolled at our service, or newly diagnosed as having asthma, communication strategies will be developed to inform all relevant Educators, including students and volunteers of:

Managing Asthma, Anaphylaxis and Diabetes Policy Page 1 of 6  The child’s name, and room they are educated and care for in  where the child’s medical management plan will be located  Where the child’s preventer/reliever medication etc. Will be stored  Which educators are responsible for administering treatment

Medication A child enrolled in the service diagnosed with asthma must bring their reliever medication and a spacer for use in an emergency.

Preventative and reliever medication will be administered according to the child’s asthma management plan which may include preventative medication.

Medications and devices must be clearly labelled (with a prescription label) including your child’s name and date of birth and that the medication is in date (do not store in a plastic bag).

Medications and devices cannot be used for any child other than those that they are prescribed for.

ANAPHYLAXIS:

Anaphylaxis is a severe and sudden allergic reaction. It occurs when a susceptible person is exposed to a specific allergen (such as a food or insect sting). Reactions usually begin within minutes of exposure and can progress rapidly over a period of up to two hours or more. Anaphylaxis is potentially life threatening and always requires an emergency response. Anaphylaxis can occur at any age, but is most common in children and young adults.

Anaphylaxis may be triggered by foods such as peanuts, tree nuts, eggs, wheat, cow’s milk, soy and seafood. Other substances that can trigger severe allergic reactions include medications (especially antibiotics), bee and other insect stings.

These allergies may include a condition known as anaphylaxis, therefore our services will facilitate effective care, health management and management of emergencies in children who have food allergies, and children who are at risk of anaphylaxis by;  Minimising the risk of an anaphylactic reaction occurring while the child is in the care of the Bland Shire Children’s Services.  Ensuring that educators receive anaphylaxis training approved by ACECQA so they can respond appropriately to an anaphylactic reaction by initiating appropriate treatment, including competently administering an adrenaline auto-injector .  To raise the awareness of the Children’s Services community about anaphylaxis and its Management through education and policy implementation.

Bland Shire Children’s Services is committed to:  Providing, as far as practicable, a safe and healthy environment in which children at risk of anaphylaxis can participate equally in all aspects of the Children’s Services program and experiences.  Raising awareness about allergies and anaphylaxis amongst the Children’s Services community and children in attendance.  Actively involving the parents/guardians of each child at risk of anaphylaxis in assessing risks, developing risk minimisation strategies and management strategies for their child.  Ensuring each educator and other relevant adults has adequate knowledge of allergies, anaphylaxis and emergency procedures.  Facilitating communication to ensure the safety and wellbeing of children at risk of anaphylaxis.  Ensuring educators are able to identify each child’s individual signs and symptoms by referring to the Health Management Plan.

Responsibilities: Services Responsibilities:

Managing Asthma, Anaphylaxis and Diabetes Policy Page 2 of 6  To request information on enrolment forms regarding known allergies of children being enrolled.  To discuss these allergies and their treatment with the parents/guardians and ensure that educators have been given relevant information.  Provide a copy of the relevant medical policies to parents/guardians before child commences.  Ensure families provide documentation from their doctor confirming their child’s allergies and their management in the form of an Anaphylaxis plan. This may be sourced from ASCIA www.allergy.org.au  To ensure that educators are aware of the plan and put appropriate strategies in place  To check that medical and personal information in relation to any child with known allergies is updated annually or more often where necessary.  To display an action plan for each child with anaphylaxis after receiving signed permission from parents/guardians.  To ensure that educators have current approved training in anaphylaxis and its management.  To put procedures in place to exclude food which is known to cause an anaphylactic reaction in any child enrolled in the Bland Children’s services.  Ensure that no child who has been prescribed an adrenaline auto-injector is permitted to attend a Service or excursion without that adrenaline auto-injector.  To advise parents that the Service is a ‘Nut Free’ Service.

Educators Responsibilities  To be aware of allergies of children in their care and to display a copy of the child’s Action Plan for Anaphylaxis including information regarding children with known allergies, including name, photograph, list of foods which cause allergic reaction and relevant emergency information.  Ensure medication and/or adrenaline auto-injector is stored in a location that is known to all educators, is easily accessible and not accessible to other children.  Check with parent/guardian that the adrenaline auto-injector is provided with the child on each day of attendance and ensuring expiry date is current and recorded with medication. NB If medication is not provided the child will be refused attendance.  Follow the child’s anaphylaxis action plan in the event of an allergic reaction, which may progress to anaphylaxis.  Ensure adrenaline auto-injector, for each child at risk of anaphylaxis, carried by a trained adult on excursions that these children attend.  Ensure each child’s adrenaline auto-injector is collected and taken to muster point during Fire Evacuations and/or practice.  Provide an Anaphylaxis Alert Note to parent/guardian community.  Discourage and prevent children sharing food while in care and to encourage awareness and acceptance of inclusive practices for the different needs of children.  Ensure food is not contaminated or cross contaminated with any product known to cause an allergic reaction with any child currently in care.  Be aware of the risk to an identified child of using allergenic foods in cooking activities.  Ensure eating areas and utensils are thoroughly cleaned with warm soapy water or put through a dishwasher to remove traces of potential allergens.  To follow Services hygiene procedures for educators and children ensuring a contamination free environment.  To seek alternatives for children attending with any nut products.

Responsibilities of Parent/Guardian of Child with Known Allergy  To provide information regarding any known allergies on the Enrolment Form.  To complete an Anaphylaxis Management Plan Form.  To provide medical information relating to their child who has a known allergy.

Managing Asthma, Anaphylaxis and Diabetes Policy Page 3 of 6  Provide a recommended emergency action plan from the child’s doctor.  Provide required medication and sign long-term medication permission form as per Medical Conditions Policy.  To update the Emergency Action Plan when necessary.  To provide clear and consistent information to educators regarding the requirements of their child in relation to allergic reactions.  To assist educators to manage situations where food is shared by children (eg birthdays), it would be helpful if parents/guardians provide food that can be stored at the Service and used as alternative treats for their child when necessary.

Responsibilities of Other Parents/Guardians  To be aware of the information regarding children with known allergies displayed.  To abide by the Anaphylaxis Alert Note by not providing trigger foods.  To provide nut free food during attendance at the Service.

Recommended Practices: It is essential that each Service: 1) Identify children at risk due to allergy and anaphylaxis. 2) Obtain documentation and information about the child’s allergy from a medical Professional. 3) Consider elimination of the allergen if recommended by medical professional and if possible display and follow the Action Plan for Anaphylaxis. 4) Ensure educators receive approved ACECQA training on Anaphylaxis.

DIABETES:

When a child is enrolled in the service identifies as having diabetes(Type 1 or 2), staff need to know enough about diabetes to ensure the safety of those students. Parents/guardians have a responsibility to advise the school of their child’s medical condition and the particular requirements for the management of their child’s diabetes. For children with special requirements, a written individual management plan incorporating medical recommendations should be developed with the service in collaboration with the parents/guardians and diabetes educator/medical practitioner. About diabetes: Diabetes is a condition where there is too much glucose (sugar) in the blood. Glucose is the main source of energy for our bodies and comes from the food we eat. Insulin is a hormone made in the pancreas, which acts as a key to allow glucose (sugar) to pass from the blood stream into the body cells to provide energy for day to day living. Diabetes develops when the pancreas is either unable to make insulin or the insulin produced is unable to work effectively. Without insulin doing its job, glucose builds up in the blood stream leading to high blood glucose levels. Type 1 diabetes: Type 1 diabetes previously known as insulin dependent or juvenile diabetes, occurs when the pancreas is unable to produce insulin. People with type 1 diabetes require insulin injections for life, a healthy eating plan and regular physical activity. Most children with diabetes have type 1 diabetes, but it can have its onset in adult life. Signs and symptoms: When type 1 diabetes develops blood glucose levels may rise up to five to ten times the normal level. Excess glucose spills over into the urine, drawing water with it and causing frequent urination and dehydration. Thirst increases as the body tries to compensate and an unquenchable thirst results. Excessive tiredness and mood changes are common. Common Signs and Symptoms of Type 1 diabetes  Going to the toilet frequently to pass urine  Excessive thirst and drinking a lot of fluids  Weight loss  Tiredness

Managing Asthma, Anaphylaxis and Diabetes Policy Page 4 of 6  Mood changes Other Signs and Symptoms  Skin infections  Oral or vaginal thrush  Abdominal pain  Excess hunger  In babies and young infants, signs and symptoms may be less easily detected.

Type 2 diabetes People with type 2 diabetes produce insufficient insulin and the insulin produced does not work effectively. Type 2 diabetes often responds to a healthy eating plan, appropriate exercise and weight reduction, but sometimes tablets and then later, insulin may be required. Management of diabetes in children at our service will be supported by the child having an emergency action plan and communication plan which will be developed in collaboration with the parents/guardians and diabetes educator/medical practitioner to inform all relevant educators, including students and volunteers, of;  The child’s name, and room they are educated and care for in  The child’s risk minimisation plan  where the child’s emergency action plan will be located  Where the child’s medication etc. will be stored  Which educators are responsible for administering treatment

Educators will be aware of the signs and symptoms of both low and high blood sugar.

EXCEPTION TO AUTHORISATION REQUIREMENTS FOR AN ANAPHYLAXIS; ASTHMA OR DIABETES EMERGENCY

In the case of an anaphylaxis or asthma emergency;

 Medication may be administered to a child without an authorisation.  If medication is administered under these circumstances, the service must notify the parent of the child as soon as practicable.  Verbal permission can be gained from a parent or authorised person who is recorded as being allowed to give consent to administration of medication.  If a person cannot be reasonably contacted in the circumstances, permission can be gained from a registered medical practitioner or emergency service.

References: Education and Care service National Law Act 2010: Section 173 Education and Care Services National Law and the Education and Care Services National Regulations 2011. Anaphylaxis Australia @ www.allergyfacts.org.au - accessed May 2018 NSW Asthma Foundation www.asthmafoundation.org.au – accessed May 2018 NSW Ministry of Health – www.health.nsw.gov.au – accessed May 2018 Community Early learning Centre (CELA) – Sample Policies www.cela.org.au Asthma aware – OSHC Asthma Management guidelines – 2018 Immunisation Enrolment Toolkit – For Early Childhood Education and Care services (NSW Government – NSW ministry of Health 2017) Staying healthy In Childcare – 5th edition, National Health and Medical Council Diabetes NSW website, https://as1diabetes.com.au/ - Accessed July 2018 Children’s Asthma in Education and Care Service – families and staff working together, Asthma Australia, www.asthmaaustralia.org.au

Appendices:

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Authorisation: Status Committee N/A Manex N/A Owner Director of Corporate, Community, Development & Regulatory Services Date of Adoption/ Revision Number Minute Number Review Date Amendment May 2012 0 10.10 March 2013 February 2013 January 2016 January 2018 9 October 2018 October 2020

Related Council Policy/Procedure Enrolment and Orientation Policy Medication and Health Statement Policy Dealing with Infectious Diseases Policy Monitoring Illness in Children Procedure

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