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Asthma Plan

(2018)

 

Please read this plan and fill in the form below if your child has been diagnosed with asthma and may require medication while attending Collectively Kids. We suggest that you leave a spacer and reliever medication at the centre in case of an emergency (or just medication as we do have spacers on site).

In asthma the tubes that carry air into the lungs are unusually sensitive and can easily get inflamed and swollen. Breathing becomes an effort, even painfully difficult. It is preferable to act immediately when a child presents with symptoms of asthma for the child’s comfort and because their condition may deteriorate very quickly.

Signs and symptoms of asthma include:

· Persistent hacking, dry cough

· Breathlessness

· Wheezing.

These symptoms may be exacerbated by allergens, exercise or laughter, a ‘cold’ or cold weather.

If your child exhibits these symptoms, or regular asthma medication is required, teachers will medicate as per details on the signed permission slip in the incident folder.

It is important that you update information as required and that all medication is safely stored in  (not left in bags).

Asthma Plan

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Please fill in this form if your child has asthma. Ensure that you record the number of puffs, breaths and frequency in the space provided.

 

I give permission for my child ……………………… to be treated with her/his prescribed reliever as per the following instructions when s/he presents with symptoms of asthma including breathlessness, wheezing or a persistent dry cough.

………………………………………………………………………………………………

………………………………………………………………………………………………

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Parents/caregivers are to be notified immediately and further medical intervention sought if:

· The symptoms get worse very quickly, or

· The wheeze, cough or chest tightness continue or return very quickly after using the

   reliever.

Immediate action is needed if there is severe shortness of breath, inability to speak comfortably and/or blueness of lips. Call an ambulance and advise ‘asthma emergency’.

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Signed                                                           

             

Name                                                             

            

Date                                 

                                                                      

For office use only:

Form checked and information processed (date and initials)

Form filed in medicine and incident folder and one in enrolment folder (date and initials)

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