The issue - Medical emergencies

16th April 2010 at 01:00
Two teachers were suspended after an inquest into the death of an asthmatic pupil said failure to act was `probably' a factor. What duty of care do schools have?

Samuel Linton was left alone and gasping for breath in a corridor at his school when he suffered an asthma attack. By the time his mother was called to take him to hospital it was too late: the 11-year-old died two hours later, five hours after he first started struggling for breath.

Last month, an inquest ruled that the school's failure to act earlier "probably contributed" to Sam's death. Five members of staff, including two teachers, were subsequently suspended from their posts at Offerton High School, Stockport.

Asthma is the most common long-term condition in children, affecting more than a million young people - about one in 10 - in the UK. Sufferers have inflamed airways that narrow still further during an attack, making it hard to breathe.

In 2007, asthma claimed the life of 21 children under the age of 14. The year before, 40 deaths were recorded. The expected figure for 2008 is about 30.

A child is hospitalised with an asthma attack every 19 minutes in the UK. Fast, effective action by the school could be the difference between life and death.

In the event of an attack, teachers need to act fast. Pupils with asthma should carry their inhalers with them, or close at hand, at all times. A spare inhaler should also be kept by staff in an unlocked room or drawer, in case a pupil forgets or loses theirs.

Pupils and staff need to know where this spare inhaler is kept, and be ready to fetch it quickly. Teachers should also know what an attack looks like. Symptoms include: tightening of the chest, coughing or wheezing or breathing hard and fast.

In an emergency, the law require teachers to adopt a "duty of care" towards pupils. This means acting like any "reasonably prudent parent", according to Asthma UK.

The same applies for any medical condition. Teachers do not have a legal duty to dispense medicines, but they are expected to act in the way a responsible parent would act. "Teaching staff are not required to help children manage their medicine or medical conditions under the terms and conditions of their employment," says Catherine Allen from The Key, a support service for school leaders.

"However, anyone caring for children, including teachers and other school staff, has a common law duty of care to act like any reasonably prudent parent. Staff need to make sure that children are healthy and safe."

Headteachers have a contractual duty to ensure that staff receive the appropriate training and are aware of relevant policies and procedures relating to medical conditions such as asthma. It's up to staff to volunteer to manage medicines or medical conditions if they wish. If they do, they should get the appropriate training to take on the role. Non- teaching staff, such as teaching assistants or school nurses, may have responsibility for managing medicines or medical conditions within their job description.

Being ill-informed is no excuse. Asthma UK claims a worrying number of teachers remain ignorant about asthma. "Three-quarters of teachers in England admit to not being confident about what to do in an asthma attack, which is appalling," says Neil Churchill, the charity's chief executive.

Among the failings identified by the jury at the inquest into Sam's death were that his school had failed to implement an asthma policy, failed to train staff to deal with the condition, failed to keep a health care plan, failed to share information about his asthma attacks and failed to monitor his condition on the day of his death.

The charity is now calling for all teachers to be given mandatory asthma training, both during initial teacher training and while at school. The charity's own Alert to Asthma training courses ( run in Scotland, Wales and Northern Ireland, and a pilot is taking place in North West England. However, more funds are needed to roll it out to the rest of England.

The charity is lobbying the Government to make it compulsory for schools to have a clear policy on asthma, which would spell out procedures to follow in the event of an attack. Downloadable health policies are available at Simply having the policy is not enough. Teachers need to be aware of its recommendations, so they can act with confidence in the event of an attack.


- Be aware of which pupils have asthma.

- Make sure you know where their inhaler is.

- Never leave a pupil having an asthma attack.

- Ensure the pupil uses their inhaler immediately.

- If there is no improvement within five minutes, call an ambulance.

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