Health and safety legislation places duties on employers for the health and safety of their employees and anyone else on the premises. In schools this includes responsibility for the Head of School and teachers, support staff, pupils and visitors (including contractors). The First Aid policy described is for the use of all staff within St. George International School & Preschool. Nurses and all school staff must be familiar with this document.

Glossary of Terms:

Appointed person: someone who takes charge when someone is injured or becomes ill, looks after the first aid equipment and ensures that an ambulance or other medical professional help is summoned when required. Appointed persons are not first aiders. They should not give first aid treatment for which they have not been trained. However, it is good practice to ensure that appointed persons have emergency first aid training/refresher training, as appropriate.

First aider: A qualified person who gives immediate help to casualties with common injuries or illnesses and those arising from specific hazards at school; when necessary, ensure that an ambulance or other professional medical help is called.

Paediatric first aider: A person who administers emergency treatment to any injured or sick children before professional medical care is available and who has a current paediatric first aid (PFA) certificate.

The purpose of this medical policy is to provide clear guidelines to follow in situations relating to the medical health and safety of students both on and off the school site.


The nurses in St. George International School & Preschool have access to, and are able to use, a defibrillator onsite. The nurses are fully trained in its use and are able to administer emergency first aid using this equipment. No member of staff must use this equipment, unless specific training has been given, and in agreement with the Head of School and Head of Preschool.

Aims and Objectives

Our aims are that the health and medical needs of students are met fully and in a timely manner. Furthermore, that the children’s emergency needs are able to be met quickly, without hesitation from well trained and supported staff.

Appointed Persons

Several full-time, fully qualified medical nurses are based on the school’s sites and are the designated persons in charge of all first aid, and medical issues, that may arise. There are many other staff trained in first aid within the school. Staff working closely with students with diagnosed health problems are given additional training as and when necessary.

All staff are able to administer basic first aid and have completed certificated basic training which supports this our shared best practice.

How to contact the school nurses at St. George International School & Preschool:

For Primary School, Lower Secondary School and Upper Secondary School:

By Telephone:

  • Nurse 1: 089 999 2799
  • Nurse 2: 088 441 0006

By email:

  • Nurse 1:
  • Nurse 2:

The school nurses’ working hours are from 07:30 until 18:00 hrs – Monday to Friday.

For the Preschool:

  • Nurse 1: 088 487 2024
  • Nurse 2: 089 999 2824

By Email:

  • Nurse 1:
  • Nurse 2:

The preschool working hours are from 07:30 until 18:30 hrs – Monday to Friday

* Please note that only one of the nurses will be on site after 16:30 hrs, due to rotated working hours.

All staff must know:

  • The location of the nearest first aid boxes.
  • How to contact the ambulance service directly (112).
  • How to contact the school’s nurses.
  • Never cause distress and panic if a child requires emergency first aid.
  • Remain calm and reassure the pupil.
  • If severe distress is evident then talk to the child in a reassuring and calm tone.
  • Call the emergency services if deemed necessary.
  • Never wait and delay treatment to an emergency situation.
  • Never administer emergency first aid, unless you are qualified to do so, and know exactly what you are doing and are qualified to act.

New students

  • All parents have to present a copy of the vaccination records and a note from the doctor, which states that the student is healthy and fit to enter the school and if the student has a medical or chronic condition, they have to present a medical note, signed and stamped, by a doctor, containing the name of the illness/disease and the emergency medication needed. For conditions which need medical supervision and ongoing treatment then reception will send parents the forms to fill in and return to the school.
  • It is the responsibility of the nurse, accompanied by any emergency medication they might need to administer all medications to the children of the school. If another member of staff is to administer then specific authorisation must be given by the Head of School. School reception must inform the parents of every new student of the procedure for administering medicine in school.
  • If the student has a medical condition - the nurses are informed in the beginning of the year from the medical information which is submitted by the parents during the admission process along with the medical vaccination records before the first day of school. If during the school year occur any medical issues then the parents inform Reception and Reception immediately informs the nurses and respectively the Head of School, Head of Primary, Head of Lower Secondary, Head of Upper Secondary or Head of Preschool. Doctor’s or medical practitioner’s documentation is absolutely necessary for verification.
  • If a student has not had all required vaccinations, the school nurse will advise parents to seek medical advice and ensure that all correct procedures are followed, with the necessary documentation. As student will not be admitted until such documents are provided (specifically health documentation for preschool children).
  • If a student is re-registered for a new school year, it is mandatory that the parents update the vaccination records. Reception will notify the parents to provide any information regarding new medical conditions recently discovered or new vaccinations and will submit all newly received information to the nurses.
  • The documentation required is listed by the admissions personnel at the entry stage, and upon signing the school’s official documentation. A list of required documentation is given upon the application and entry process. Specifically, for the Preschool: all documentation is required (including medical documents) on the first day of entry; the preschool nurse will check all official documentation. This will need to be verified for the child’s first school day. For Primary, Lower Secondary and Upper Secondary School: This documentation is required until the end of the first school week. For the school year 2020/2021 this period is extended until 15.10.2020.

    1. Medications and Storage

    • All medicine is to be kept in the nurse’s room in a safe and lockable cupboard.
    • The nurse is responsible for checking and replacing any missing items from the first aid kits.
    • First aid kits are available for all staff to use for minor injuries.
    • First aid kits must be sterile, clean and fit for purpose.
    • First aid kits must be regularly checked, and dates of use logged, and products expiring or expired disposed of safely.
    • A First aid kit must be collected from the school office to take on trips off site. This must be checked prior to departure and a record of uses (if applicable) on the trip made.
    • It is the school nurses’ duty to check and maintain contents of all first aid kits on each floor, and in the medical room, or any site where first aid is required in the school building, including the internal and external playgrounds. The contents of all first aid kits in the preschool building are checked and maintained by the preschool nurses.

    2. Administration of medicine

    • Non-prescribed medication, including creams and lotions, home-remedies, and homeopathic medicines cannot be administered to students by themselves, or by any member of St. George International School & Preschool staff.
    • School and Preschool nurses must not administer herbal, homeopathic remedies or given treatments when requested by the parents of children of the school. These cannot be prescribed even with parents’ written consent.
    • Prescribed treatment can only be given for chronic and severe health conditions (e.g. asthma), emergency first aid and specific, agreed medicines which are essential to a child’s health and living needs. These have to be submitted and signed by a medical professional, always.
    • For children with chronic health conditions then a register of these children must be easily accessible to the nurse in the cabinet (nurses’ office) and kept secure.
    • Prescribed medication can only be administered by the school nurse or teacher (if the nurse is not available) and if the parent has agreed written consent for this to take place. The Head of School must always be informed of such instances and written request must be given.
    • If a student informs the teacher he/she has been given medicine by their parents to take in school or the teacher finds medicine in a student’s school bag and if they have not been informed about it by the parents, then they must send the student and the medicine to the medical room. The school nurse will contact the parents immediately to ask information about the medicine. All medicines in such instances will be returned to the parents and explained that this is not in line with St. George International School & Preschool’s procedures. A follow up may be required and notified to the class teacher and SMT.
    • If a child is sick, except for chronic conditions, then the nurses have the duty to act in accordance with the Health Protection Plan.
    • All incidents are to be recorded on iSAMS.
    • It is the form/class/subject teacher’s responsibility to ensure that the student visits the medical room at the correct time to administer medication, for chronic and first aid conditions.
    • Any chronical illness medication (ventilators etc.) must be provided by the parents and accompanied by a letter stating exactly how and when they are to be administered and include the doctor’s prescription. Parents are also asked to come to school to instruct the nurse what to do in certain circumstances. Emergency medication will be labelled with the student’s name and be kept in a lockable cupboard. This is again recorded on iSAMS.

    3. Student refusal to take medication

    • In case a student refuses to take the medication, the parents should be advised by phone immediately by the school nurse, and confirmation in writing sent home that day by email, as a record of the incident. Recorded on iSAMS.
    • A signed and dated entry should be made in the accident book.
    • All such instances to be recorded and reported in iSAMS.

    4. Illness

    • If a student feels ill, a member of staff takes her/him to the nurse. The nurses have the duty to act in accordance with the Health Protection Plan. This is recorded and logged in iSAMS.

    5. Accidents

    Small accidents (cuts and bruises)

    • All small cuts and bruises should be cleaned with water or a sterile disinfectant by the school nurse. In most cases where bleeding is absent, cleaning with water will suffice.
    • Individually wrapped sterile plasters will be used only in case of bleeding. In this case, use disinfectant on a sterile dressing to clean the wound from the centre outwards. Only apply the plaster when no more traces of dirt are visible in the wound.
    • Do not apply the plaster if there is a known allergy to such products; use a wrapped sterile bandage instead.
    • In case of a head injury, a phone call will be made by the nurse (or in her absence by the form/class/subject teacher) to inform the parents and Appendix E documentation completed.
    • The parents will be informed in the case of head injury to the skull or temple regions. As a concussion can reveal itself later; all bumps to the head should be communicated to the parents, via telephone or email, and the parents must come to collect the child(ren). The child is then checked by a medical professional and can then be returned to school. This places the School in best practice and looks to protect its staff from liability issues which could arise.
    • The nurses need to inform themselves about the result from the medical check and need to record it in iSAMS and inform the SMT of the School or the Preschool respectively.
    • In case of small accidents, the nurse has to inform the parents, log and record the incident in iSAMS, inform duly the SMT of the School or the Preschool, record the case as a log in the incident book and send a formal notification to the parents through Reception.

    6. Serious Accidents or emergency

    • In case of serious accidents, the nurse should be contacted immediately, and the nurse should reach the place of accident and offer first aid.
    • A member of staff needs to inform Reception immediately in order to call an ambulance, to call the parents to ask them to meet the ambulance at the hospital, which will be accompanied by a member of the staff from St. George International School & Preschool.
    • A member of the staff will stay at the hospital until the parents/guardians arrive.
    • An entry in iSAMS is completed as soon as possible. An email to the parents is submitted by the school nurse, or SMT if the nurse is not available, without delay - explaining the situation and a brief summary of the incident.
    • In case of a school bus accident on the way to school, or home, then the nurses and Reception must be informed immediately and Reception will inform the parents. If they do not have to go to hospital, then all students and staff must visit the school nurse on arrival at school.
    • A school nurse will always be present on all school trips (for the School and Preschool). This is to provide first aid and care if necessary. All orders and documentation must be completed with the names of designated persons for such.
    • Parents will be informed by the nurse after the check-up.

    Advice for serious injury and how to administer basic first aid:

    Knowing what to do in an emergency is vitally important. If someone is injured, the following steps will keep them safe as possible until professional help arrives:

    • Keep calm.
    • If people are seriously injured call for an ambulance immediately (112) and contact the nurse.
    • Instruct someone else to call 112, and the nurse, if you are administering first aid and the situation is deemed serious.
    • Make sure that you and the injured person are not in danger.
    • Assess the injured person carefully and act on your findings using the basic first aid steps below.
    • Keep an eye on the injured person’s condition until the nurse or emergency services arrive.
    • Talk to the person receiving first aid and reassure them that help is coming.
    7. Unconsciousness Bleeding

    If the person, or child, is unconscious with no obvious sign of life, call for an ambulance immediately (112) and then the nurse. If you or any bystander has the necessary skills, give them mouth-to-mouth resuscitation while you wait for the nurse.

    Control severe bleeding by applying firm, constant, pressure to the wound using a clean, dry dressing and raise it above the level of the heart. Lay the person down, reassure them, keep them warm and loosen tight clothing.

    8. Burns and Broken bones

    For all burns, cool with water for at least 10 minutes. Do not apply dry dressings, keep the patient warm.

    9. Allergic reaction – Anaphylaxis

    • Anaphylaxis is a life-threatening allergic reaction to different triggers like food, medicine, pollen, animals etc.
    • If a parent knows student suffers from anaphylaxis a medical form has to be filled, by a doctor and is presented to St George International School and Preschool.
    • The nurses are informed about the student with a risk of anaphylaxis medical condition from the documents, which the parents present during the admission process before the start of the academic year. The nurses inform the form/class/subject teacher about the student and his condition.
    • Any emergency medication (Epipen) must be provided by the parents and accompanied by a letter stating exactly how and when they are to be administered and include the doctor’s prescription. Parents are also asked to come to school to instruct the nurse what to do in certain circumstances. Emergency medication will be labelled with the student name and kept in a lockable cupboard. It is the sole responsibility of the parents to provide such medication with valid expiration date.
    • Students with allergies are more at risk than others, asthma in addition to allergies may be at increased risk of having a life-threatening anaphylactic reaction.

    Anaphylaxis reactions can involve more than one system of the body.

    Respiratory system: itchy, watery eyes, difficulty breathing, difficulty swallowing, tightness in the throat or feeling like the throat or airways are closing, change of voice, hoarseness or trouble speaking, sneezes to the triggering of asthma with coughing and wheezing.

    Cardiovascular system: lightheaded or faint (loss of consciousness), fast heartbeat or pulse, weak pulse.

    Gastrointestinal system: abdominal pain, nausea, vomiting, a metallic taste in the mouth.

    Skin reactions: warmth, itchy, red, bumpy rashes (hives).

    What to do if a pupil has an anaphylactic reaction:

    Call the nurse and contact the office to call an ambulance (112).

    The nurse has to take the child to the medical room for immediate treatment and care; parents to be notified.

    We do not use an EpiPen.

    10. Head lice

    • The school nurse checks all students in Primary, Lower Secondary and Upper Secondary School at the beginning of each month for head lice, as part of the school’s protocol.
    • For the Preschool this check should be completed in the first week of term as the nurse must send a health declaration form within 5 working days of the preschool opening.
    • If a case of head lice is found in one of the preschool classes and the child/ren has/have siblings in school, then the next classes which need to be checked are the ones of the siblings. The nurse informs the SMT of the School or the Preschool of any confirmed cases of head lice.
    • All checks should be put in a Protocol and registered in iSAMS.
    • The nurse informs the parents of students concerned and asks them to take the child/ren from the school. Until the arrival of the parents, the child/ren remain in the medical room, isolated from other children.
    • Following the phone conversation, an email is sent to the parents by Reception with guidance how to treat the problem.
    • Where there is a case of head lice, Reception informs also the parents of the respective class about the situation by email.
    • Reception also emails the School’s or the Preschool’s SMT to inform them the parents have been contacted by email.
    • When the child returns to school or preschool, the nurses check again and in case there are no lice the child is accepted. In case there are still lice the child is not accepted in school or preschool and the procedure for contacting the parents is followed.

    11. Impetigo, Scabies and Hand, foot and mouth disease, Strep Throat or Pneumonia, Conjunctivitis

  • The nurses are informed about confirmed cases in the beginning of the school year from the medical documents, which are provided by the parents. If during the year any medical conditions arise then the parents are obliged to inform Reception and provide the respective medical documents. Reception is obliged to immediately inform the nurses and the SMT of the School or the Preschool as they case may be.
  • The nurse must check all students in a class where a confirmed case was reported and the classes of any siblings.
  • An email informing parents of that there has been a confirmed case in the school is to be sent out by Reception and describing symptoms to parents of affected classes via email on the same day.
  • Students will be allowed to join the class again after they are treated and after receiving a note from the doctor stating that they are ready to return to school.

  • For the Preschool - if the student does not present a note from the doctor when re-joining school (teacher must check book bag/communication book), the student needs to be sent to the medical room to be checked in order to stay in school. The school nurse is to inform Reception and Reception to request from the parents a note from the doctor stating that the student is well and able to return to school.
  • For the School - the doctor issues a medical note certifying the need to be away from school for medical reasons. This note is needed to excuse the student's absences from school, but GPs have no obligation to issue a note that they are healthy and ready to return to school.
  • 12. Intestinal worms

  • An email informing parents of intestinal worm’s case and information on symptoms is sent by Reception on the same day.
  • 13. Diarrhoea, vomiting, fever in school

  • If a student has diarrhoea, vomiting or a temperature higher than 37.3°C in school - in that case it shall apply the Health Protection Plan.

  • For the Preschool - if the student does not present a note from the doctor when re-joining school (teacher must check book bag/communication book), the student needs to be sent to the medical room to be checked in order to stay in school. The school nurse is to inform Reception and Reception to request from the parents a note from the doctor stating that the student is well and able to return to school.
  • For the School - the doctor issues a medical note certifying the need to be away from school for medical reasons. This note is needed to excuse the student's absences from school, but GPs have no obligation to issue a note that they are healthy and ready to return to school.
  • 14. Medical Checks

  • The School nurse has to check all students on the first day of each term. All data is entered into iSAMS.
  • If any student is unwell then the nurse contacts the parents to collect them early and records the case in iSAMS.
  • If a student starts school late, the teacher will send the student to nurse, to be checked, on their first day of school. The results from the check are registered in iSAMS and as per the particular case the medical protocols are followed.
  • 15. Medical Records

  • All medical records (vaccination records, medical documents) are to be kept with the registration file with the nurses, and a copy should be in the First Aid Room. For the students from the school - the medical notes from the doctors are kept by the class masters and are used for excusing the students’ absences. At the end of the school year the class masters hand them over to the Head of Administration, who keeps them for 1 calendar year. The medical notes of the children from the Preschool are kept with the preschool nurses.
  • A log is kept by the Nurse in iSAMS. This contains an entry with date, hour, name, class, symptoms and action taken for every student that visits the nurse. This is mandatory and a full record for the academic year is to be available for inspection at all times.
  • An Accident Report is completed, in case of a serious accident, by the adult witness of the accident and is recorded in iSAMS.
  • An e-mail is sent to the SMT of the School or the Preschool, the class teacher and Reception in case of a serious accident or if they are leaving early.
  • Equipment & Locations

    St. George International School & Preschool has accessible First Aid Kits, each clearly marked with a Green cross on a White background. They are located throughout the school and preschool buildings, playgrounds, and vehicles, and their locations are listed in Appendix B. There is at least one Kit on each floor of the main school and preschool buildings, all near hand washing facilities. A portable Kit is kept in the medical room to be taken on off-site school activities by qualified First Aiders. Locations are verified regularly when contents are checked.

    Each First Aid Kit is stocked with the appropriate supplies. See Appendix C. The contents are checked on a regular basis by the nurses and replenish the supplies in case they have been used. Any member of staff who uses the contents of a First Aid Kit informs the nurses by email. The First Aid Kit is then immediately replenished.

    Specific Risks

    Certain activities and events are known to carry a higher risk of injury than others, such as Physical Education, Extracurricular Activities, Science, out-of-school trips, special events, and road safety. Specific areas may also be made more hazardous by site cleaning, repair or building work, or storage of cleaning materials, etc. For the Preschool Risk Assessments are prepared by the Head of Preschool. For Primary School the Risk Assessment is prepared by the Head of Primary. For secondary students – the Risk Assessment is prepared by the Heads of Lower and Upper Secondary with the support of the Heads of Departments in Science, Physical Education and IT. The out-of-school trips are assessed by the Head of Administration and the activities after 15:30 hrs are assessed by the Manager Extracurricular Activities. The Risk Assessment regarding special events and road safety is prepared by the Manager Security and Operation.

    When applicable, the portable First Aid Kit is taken from the nurses, accompanied by a qualified First Aider. Lunchtimes and breaks are also higher risk periods, and it is important that playtime and other supervisory staff include at least one qualified First Aider on these occasions. The school policy is to have at least one first Aid Kit and at least one qualified First Aider on each floor of the school building. Certain staff or students may also present medical conditions of which fist Aiders should be aware. The nurses are responsible for ensuring that all first Aiders are aware of persons with special health needs, e.g. diabetics, epileptics, asthmatics, and the treatment they require.

    Procedure in Event Requiring the Use of First Aid

    If an injury or illness occurs to a student while under the supervision of a member of staff, the preferred course of action is to have the responsible staff member bring the student to the Health Office for care. A Nurse is available to provide First Aid at all times during regular school hours. The Nurses current phone numbers are listed above. The type of care provided depends on the type of injury or illness suffered by the student. The Nurse provides best possible care and determines if the student is to be sent back to class, home, or hospital. First Aid may also be delivered at the site of the injury by other trained staff who will call for additional help (e.g. Nurse or ambulance) if necessary. Whoever treats the injury/illness must log the necessary report as soon as possible after the event for the Health Office records.


    In the case of extreme emergencies, 112 should be called immediately to activate the emergency response service. Following the call to 112, stabilising measures are to be taken, including the use of First Aid.

    Documentation & Communication

    All members of staff and volunteers will be informed of this policy through staff meetings, email communication, and through copies of this policy (in English and Bulgarian) being posted in each school building and on each floor of the main building, including the Health Office, and being included in the staff handbook. New staff will cover this policy during their induction. Students will be informed through assemblies and Form Teachers. All injuries or illnesses in which First Aid is required are documented in the Nurses Activity Book, as required by Bulgarian law. They are also documented in iSAMS. They will contain a list, not excluding:

    • Student name
    • Date
    • Grade
    • Arrival time in Health Office
    • Departure time in Health Office
    • What the health issue is, which is/has being/been addressed
    • Symptoms
    • Evaluation
    • Assessment
    • Plan
    • Disposition
    • Communications
    • - Parent

      - Teacher

      - Head of School

      - Other

    Records of all incidents and accidents will be retained by the school for at least three years.

    Laws & Regulations

    The policy was prepared in accordance with Ordinance No. 3 of 27.04. 2000 for medical service in preschools and schools; Law on Health and Safety at Work; First Aid Rules for Health Damage at Work, approved by Order No. RD-09-410/1994.

    The medical rooms are furnished according to Annex 1 of Ordinance No. 3 of 27.04. 2000 for healthcare facilities in preschools and schools.

    The medical rooms must be equipped with a special cabinet to provide emergency care with medicines and tools according to Annex 2 of the same regulation.

    The medical rooms shall be provided with all the necessary documentation according to Annex 3 of the above-mentioned ordinance.

    All pedagogical and non-pedagogical staff receive a copy of this policy through their official e-mail and must confirm by signing the official order that all staff have read and understood the policy and procedure and are obliged to follow all legal requirements.

    First aid policy is also sent to new colleagues, asking them to confirm that they have read it. The first aid policy becomes part of the declaration that new teachers / employees sign on entering the job. The declaration is provided to the teacher / employee by a Payroll Specialist and is stored in the personal file of the teacher / employee.

    A copy of the policy is also sent to the Managers of the outsourced organisations that carry out certain activities in the school and preschool building.

    A copy of the First-Aid Policy is kept in the medical rooms and on the schools’ secure servers. Failure to observe the First Aid Policy will result in sanctions according to the provisions of the Labor Code of Bulgaria.

    All records must be kept and logged on the iSAMS system.

    Updated: September 2020

    Next revision: Ongoing, and annual review, September 2021

error: Content is protected !!