FIRST AID POLICY

Introduction:

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 teacher 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 (SGIS and SGP). 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.

Equipment:

Both SGIS and SGP 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 school Principals of SGIS and SGP.

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 (SGIS):

By Telephone:

  • Nurse Pauli: 089 999 2799
  • Nurse Viola: 088 441 0006

By email:

  • Nurse Pauli: p.burzinska@stgeorgeschool.eu
  • Nurse Viola: v.shopova@stgeorgeschool.eu

The main school nurses - for Primary and Secondary students - working hours are from 08:00 until 18:00 hrs – Monday to Friday.

How to contact the nurses at St George Preschool (SGP):

  • Nurse Ertane: 088 487 2024
  • Nurse Marta and Nurse Marina: 088 487 3236

By Email:

  • Nurse Ertane: sgp.nurse@stgeorgeschool.eu
  • Nurse Marta and Nurse Marina: sgp.nurses@stgeorgeschool.eu

The preschool working hours are from 08:00 until 18:30 hrs – Monday to Friday

* Please note that only one of the nurses will be on site after 6pm, 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 if staff is to administer then specific authorisation must be given by the director. 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 office sends the medical information to the nurse and teachers and the medical vaccination records before the first day of school. 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 SGP 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. School admissions will notify the parents to provide any information regarding new medical conditions recently discovered or new vaccinations.
  • For SGIS and SGP, 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 for each organisation, upon the application and entry process. Specifically, for SGP: all documentation is required (including medical documents) on the first day of entry; the school’s reception and the school nurse together will check all official documentation. This will need to be verified for the child’s first school day. For SGIS: This documentation is required within 7 days from the beginning of the school year.
  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 nurses’ duty to check contents of all first aid kits on each floor, and in the office, or any site where first aid is required.
    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.
    • SGIS and SGP 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 Principal 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, and they require medication, then the nurses have the duty to inform the parents, by telephone or email, inform the parent to collect the child, and be returned home. When the child returns to school then a medical note must be provided, always, to evidence that the child is fit and healthy to return to school.
    • Over the counter medication may be administered by the school nurse or teacher (if the nurse is not available) with parent’s written consent. If parent is unavailable, and depending on the severity then the nurse may administer medication under emergency first aid procedures. The parent will be informed in writing, by email, and requested for collection. SMT will be informed immediate, and always, of the situation and action taken. All incidents are to be recorded on iSAMS.
    • The school nurse must wear medical gloves at all times when medication is administered.
    • It is the form/class/subject teacher’s responsibility to ensure that the student visits the nurse’s office at the correct time to administer medication, for chronic and first aid conditions.
    • Any chronical illness medication (ventilators, Epipen 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.
  2. Student refusal to take medication
    • In the case of student refusing to take the medication, the parents should be advised by phone immediately through 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.
  3. Illness
    • If a student feels ill, a member of staff takes them to the nurse. No children are to be walking by themselves to the nurse’s room, or being accompanied by another pupil alone. Adult supervision is required at all times for medical needs. Only in extreme circumstances when absolutely no adult supervision is available should a child be accompanied by another pupil.
    • If the student reports feeling unwell and cannot stay in school, then the parents are contacted without delay to collect them. This is recorded and logged in iSAMS.
    • If the parents are unable to pick up the student early, they can rest in a prescribed recuperation area or the nurse’s office. If this period becomes prolonged then SMT should be informed to liaise with the parents in order to ensure that the child’s well-being is considered.
    • Should the illness be contagious or after prolonged periods of absence, the school will require a confirmation note from a doctor stating the child is no longer contagious and can attend school. The Office and the school nurse are to follow up any missing medical notes. All documents related to such illness should be readily available and SMT made aware.
  4. Staff and Children Absence
    • If staff are absent from work then a sick note is required and presented to the school principal; this is applicable to all staff.
    • In the event of a child being absent due to sickness, and not being able to attend school, then a sick note is required from their general practitioner (GP) and is presented to the school’s reception with the nurse accepting the documentation.
    • If any member of staff observes child sickness then they are to inform the class teacher and school nurse accordingly.

    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 the 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 and Appendix E documentation completed.
    • The parents and a note will be sent home 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 SGIS and SGP in best practice and looks to protect its staff from liability issues which could arise.
    • In case of small accidents, the nurse has to inform the parents and this logged and recorded in iSAMS, SGP.SMT, recorded as a log in the incident book and notified, formally, to the parents.

    Serious Accidents or emergency

    • In case of serious accidents, the nurse will be contacted immediately and go to the place of accident and offer first aid.
    • A member of staff needs to inform the office immediately to call the ambulance, the parents to ask them to meet the ambulance at the hospital, with a member of staff from St George International School & Preschool.
    • A member of staff will stay at the hospital until the parent/guardian arrives.
    • 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 office must be informed immediately and they will inform the parents, and nurse. 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 SGIS and SGP). 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), 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.
  5. Unconsciousness Bleeding
  6. 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.

    Burns and Broken bones

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

    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.
    • Office has to inform nurse and the form/class/subject teacher about the student with a risk of anaphylaxis medical 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.
    • 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 emergency theatre for immediate treatment and care; parents to be notified.

    We do not use an EpiPen.

    Contagious health problems/diseases

    In case of contagious disease, the office informs the school nurse and the Senior Management Team. The School nurse also informs the Health and Safety Committee, classroom teachers with the lunch hall being disinfected and any other areas required. In case of an epidemic, more that 5% of class or building, the nurse has to inform the maintenance team to organise a proper disinfection by specialised firm.

    Head lice

    • The nurse will check all students at the beginning of each month for head lice, as part of the school’s protocol.
    • The nurse has to carry out class checks for head lice, starting with students in Pre-Nursery and working through all children registered with kindergarten. This check should be completed in the first week of term as the school nurse must send a health declaration form within 5 working days of school opening.
    • If a case of head lice is found in one class and the student has siblings in school, the following classes to be checked are the ones of the siblings. The nurse will inform office of any confirmed cases of head lice.
    • The nurse will inform parents of students concerned and to ask them to treat it that evening.
    • Following the phone conversation, an email will be sent home.
    • Where there is a case of head lice, the office sends the class an e-mail to inform them of the situation.
    • The office also emails the Headmaster, Heads of Primary and Secondary and class teacher to inform them that the message that is sent to parents.
    • The nurse will be vigilant and check classes that have been affected to ensure the treatment has worked.

    Infectious diseases – (required by regulation to be notified within 24 hours to the Regional Health Inspector):

    When notifying of infectious diseases and reporting of such instances (as regulated by Ordinance No. 21/2005), the nurses within SGIS and SGP are required to report on the list below of such instances. These must be reported to: The Sofia Regional Health Inspectorate / RHI / established infectious diseases, within 24 hours. The contagious diseases are referred to, in Annex 1, part of Ordinance No 21/2005, from the ministry of health (subject to mandatory registration, notification and reporting). List of required reported (parasitic) diseases (see Appendix F).

    Internal Procedure for above diseases (ref .12):

    • The office informs nurse, SMT and teachers about confirmed cases.
    • The nurse must check all students in a class where a case was reported and the classes of any siblings.
    • An email informing parents of affected classes that there has been a confirmed case of Infectious diseases in the school is to be sent out describing symptoms.
    • 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 SGP: 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 nurse’s room to be checked in order to stay in school. The school nurse is to inform the office and the office to inform the parents that the student needs a note from the doctor saying they are well and able to return to school.
    • For SGIS: The doctor issues a medical note certifying the need to be away from school for medical reasons. This note is necessary 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.
  7. Impetigo, Scabies and Hand, foot and mouth disease, Strep Throat or Pneumonia, Conjunctivitis
    • Office informs nurse, Heads of School and teacher about confirmed cases.
    • 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 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
    • As specified previously for other infections, disease and illness:
    • For SGP: 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 nurse’s room to be checked in order to stay in school. The school nurse is to inform the office and the office to inform the parents that the student needs a note from the doctor saying they are well and able to return to school.
    • For SGIS: The doctor issues a medical note certifying the need to be away from school for medical reasons. This note is necessary 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.
  8. Intestinal worms
    • An email informing parents of intestinal worm’s case and information on symptoms is sent on the same day.
  9. Diarrhoea, vomiting, fever in school
    • If a student has diarrhoea, vomiting or a temperature higher than 37.1°C in school, the parents will be contacted by the school nurse and asked to collect them.
    • If one isolated episode occurs, the student will be kept at home for 24 hours after the last episode.

    As specified previously for other infections, disease and illness:

    • For SGP: 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 nurse’s room to be checked in order to stay in school. The school nurse is to inform the office and the office to inform the parents that the student needs a note from the doctor saying they are well and able to return to school.
    • For SGIS: The doctor issues a medical note certifying the need to be away from school for medical reasons. This note is necessary 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.
  10. Medical Checks
    • The School nurse has to check all students on the first day of each term.
    • If any student is unwell then the nurse will contact the parents to collect them early.
    • If a student starts school late, the teacher will send the student to nurse, to be checked, on their first day of school.
  11. Medical Records
    • All medical records (vaccination records, note from doctors) are to be kept with the registration file in the office, and a copy should be in the First Aid Room.
    • A log is kept by the Nurse. 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.
    • An e-mail is sent to the Heads of School, teacher and office in case of a serious accident or if they are leaving early.

Equipment & Locations

St. George has accessible First Aid Kits, each clearly marked with a Green cross on a White background. They are located throughout the school buildings, grounds, and vehicles, and their locations are listed in Appendix B. There is at least one Kit on each floor of the main school building all near hand washing facilities. A portable Kit is kept in the Health Office 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. In addition to replenishing supplies on a per event basis, the contents are checked on the regular basis decided by the AP. Any member of staff who uses the contents of a First Aid Kit informs the Health Department. 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. Risk assessments are made by the AP or by class teachers and group leaders. When applicable, the portable First Aid Kit is taken from the Health Office, 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 Health Office is 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.

Emergencies

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

    - Principal

    - 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 health offices in kindergartens and schools; Law on Health and Safety at Work; First Aid Rules for Health Damage at Work, approved by Order No. RD-09-410, prom. SG No. 89 of 1994.

The health cabinet is furnished according to Annex 1 of Ordinance No. 3 of 27.04. 2000 for healthcare facilities in kindergartens and schools.

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

The health office 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 received by the direct managers of the outsourced organisations that carry out certain activities on the school building.

A copy of the first-aid policy is kept in the Office of the school nurse and on the schools’ secure servers. Provided that teachers and employees do not comply with this Statement of First Aid Policy and that it is established accordingly, they will be acted according to the Labor Code in the Republic of Bulgaria. All records must be kept and logged on the iSAMS system.

Updated on: 15th September 2019

To be revised on: 15th September 2020

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