AIBU - school and asthma

[tornandhurt]

Honest opinions pls.

DS suffers incredibly with Asthma. Struggling to control (been 2 years now) and at a point where they are considering further investigation into his lungs etc.

He is only 5 and still has little understanding of when he "needs" the pump. Therefore, on the advice of clinic, school have been instructed to give inhaler each and every day without fail at lunchtime.

Have had previous issues whereby a teacher on an outing made the decision not to administer because she thought he was fine (being a sufferer herself) and didn't see the necessity. I spoke to the HT and advised that it was not her place to make that call and they had been given clear instruction....was assured this would not happen again.

FF a few months until yesterday. Collected DS from childminder at 6.15pm. I could immediately hear his breathing was strained. Childminder mentioned she had given him an extra "puff" as she felt the same, but put it down to weather.

Got home and he was getting progressively worse. Checked bag, note in home diary saying "not administered inhaler today as its run out - please provide another."

Couple of issues with this:

• How did they not notice it was running low? *Even getting past the above, why didn't someone think to call me as ask whether there was anyone local to drop one off, or what we wanted to do"

Surely as his parents that's our decision, not theirs?? In fact had they have called me I could have arranged for childminder to administer the missed dose at 3,30 which would have avoided a night awake pacing and giving him a nebulizer!

AIBU to be really hacked off and complaining?

I have asthma, both my children have asthma, DD1 since she was 4yo, DD2 since she was 6mo. It was, as far as I'm concerned, my responsibility to endure the school always had an in date, working inhaler. I used to take them home every half term and swap them for a new one if necessary.

Not giving the inhaler as instructed - the school's fault.
Not giving the inhaler because it's run out/out of date - 100% your fault.

You are responsible for checking the medication however (it sounds like) the school are being unreasonable. Is there a proper action plan in place and written up?

I'd have had strong words with the school regarding ds not having his inhaler a while ago because the teacher felt he didn't need it.

Regarding the inhaler running out, work out how many weeks it should last - 5 puffs a week based on just once at lunchtime. Add on say 20 for extra puffs. Make sure a new inhaler is in place (say a fortnight in advance) for around the time it's due to run out. Or, even better still make sure the school always has a full unopened one at all times.

I really feel for you OP and the PP with asthmatic children - it must be so scary

Ds is a severe asthmatic and needs two meds during the day at school. I make sure school have two of both inhaler and when one runs out I send the next one in so there is always a back up.

It is hard to tell when ventolin is running out.

From your post I would actually be more angry with the childminder - why didn't she contact you if she was concerned?

Both my boys have asthma. I take their inhalers home every half term and replace etc. However, school should have called you. Schools can now keep an inhaler for use in these types of situations, ask them of they have. I also always,without fail have 2 x ventolin in their asthma packs, that way there is always a spare

Also agree childminder should have called you, given extra ventolin as needed. Does she have an asthma plan at hers? I have tapped the asthma cards.from asthma UK to their spacers as a reminder for everyone

Sorry I should have probably added, I do understand its my responsibility. The date I provided the last inhaler though was 1st December 2016 (its written on the box) - hence just another issue - how on earth has it run out!!

That depends how many puffs he is having a day. Ds has a minimum of 5 puffs of ventolin at a time so an inhaler doesn't last him long at all! Atrovent is 2 puffs a day at school so that lasts longer.

Does he have a proper care plan written up for school to follow?

I think you share responsibility to be honest. You should make sure the medication is fully stocked at school but they should also contact you immediately if it's run out. I wouldn't make a complain (as some of the responsibility is yours) but I would contact the school and make it clear that this is essential medication that must be administered everyday without fail. If for whatever reason it cannot be administered they must call you immediately.

I think some people can be complacent asthma because it is relatively common, it's surprising how many people don't realise how dangerous it can become.

Yes they've had his plan from the start and after the last incident I was assured that this wouldn't happen again.

As I say the inhaler shouldn't have needed replacing yet - I always write on the box the date I send it in and mark it on the calendar at home.

I think that's my biggest issue to be honest Crisps. Had they have just called I could of made the decision to either try and get MIL to swing by the school and drop one in or have childminder give the missed dose.

DS has been hospitalised three times, the first of which he ended up in resuscitation when he went from being a little under the weather to gasping within such a short period of time.

Perhaps I should ensure that in future I send two at time so they always have a spare.

Can you get his careplan reviewed/edited then? I assume that's done every year anyway but ds plan also highlights at which points they need to call me.

Inhalers do go wrong sometimes which is why having a spare in school is always handy.

Was he otherwise well? If he is so reliant on ventolin I would be pushing for a change in preventer medications too and getting that side of things sorted. Ds uses ventolin daily (I know that's not normal or desirable but it works!) but has recently it hasn't been holding him as well so his consultant has tweeked his medication and added another. I know it's a side issue from the school but worth considering

Yes Sirzy he's pretty reliant, hence the referrals at the moment to see what's going on.

Was at clinic last week and have another appt Monday coming following an adjustment. Its all trial and error as with most things until you find what works for you, but its not helped when you're trying to follow a plan and doses are missed you know.

If the inhaler is only used for school and only a couple of puffs a day then it shouldnt have run out so quickly.
I would ask the school why its run out, are they using it for someone else too? Sounds like they have no idea how dangerous asthma can become very quickly.

If you have worked out when a new one is due then there is something amiss.

I would have a word about calling you if this happens again. My son rarely has a flare up but he has this week, on inhalers, steroids etc and school are aware he can use the inhaler more than just at lunchtime if he needs it and can come home if he is coughing excessively/chest hurts. School need to know that its not up to them to decide if he 'needs' it or not.

Perhaps I should ensure that in future I send two at time so they always have a spare.

I've known inhalers have well under the 100 (or is it 200) puffs. I don't know if they were is-filled or leaked but it occasionally happened with the brown one (becotide) as well as ventolin.

How is a teacher supposed to know it's running low?

I think you were right to complain the first time and that was fixed (no more missed administrations). I think you're being unreasonable to complain this time. It was your fault.

Hopefully they will get to the bottom of his asthma treatment.
My eldest had a really bad winter one year (3-4 years ago) and was in hospital on O2, nebulisers 2hrly, OOHrs being nebulised etc several times.
After seeing the consultant he went on montelukast and after a course of that hasnt had a single episode since. Hope they find something that suits your ds soon.

(Not saying that I am prescribing that particular drug for your ds just that sometimes it takes a while to get the right treatment that works)

Wettunwindee - but there has been a repeat of this. It ran out, and rather than call me they made the decision not to administer at all, despite having a plan on site and knowing the previous issues. That's my point, I'll accept that in future I should send in a spare, but when they have his needs in black and white, why not just make the call to me?

I think it's well worth reminding them the importance of calling you if there are any problems. Not in a complaining way but more a learning curve type way.

The problem is children who need very regular ventolin, long term, are few and far between. Schools will have ventolin for loads of children and most of them probably never come out of the box in the whole academic year and that is seen as the "norm" for the school. I know our school are often sending home inhalers that have gone out of date and requesting new - I bet your like me and would love the chance for one to go out of date.

It took a lot of planning and meeting before ds started school to make sure they realised his asthma was way beyond what they are used to. We have had the odd blip along the way of course but generally they are great. Even down to having a set member of staff to carry his inhaler bag around the playground! Before each new academic year I meet with the staff for that class and go over everything again with them so I know they understand.

Good luck getting everything controlled

In the bag with inhalers I also have an action plan flow chart and a list of all emergency contact numbers - can you add something like that so the number is easily accessible to remind them?

Thanks Sirzy. Good advice and I'll take it on board. Much appreciated

You didn't say that this was the second time. You said it previously hadn't been administered because the teacher thought it was unnecessary and that this has been addressed.

why not just make the call to me?

Why not send in a spare?

Maybe the teacher was sitting comfortably in a big comfy chair and the phone was just out of reach and they couldn't be bothered to stand up and risk missing their soaps.

Perhaps they were too busy dealing with the million and one other things and the other children without calling you to remind you that the medicine you supply for your child had run out. If you allow it to run out then it does suggest it isn't so imperative.

Perhaps you could have thought ahead and supplied a spare and they also could have called you.

It sounds like although you can admit it was your responsibility on this thread, you won't in real life and want to complain.

All of this would have been avoided had you sent a spare. A member of staff wasting time to call you was sorting out your mistake. In the case of your son, is the ventolin used in the case of attack and is potentially life saving? If so, the lack of foresight sending in a spare put his life in danger. I'm sure you'd have mentioned that if there was a way of putting that on the school's shoulders.

Yes, I think you're being unfair complaining. I'd say you should give a spare and casually mention that if both run out, you'd like to be called. Then email the right person and have it added to the personal medical plan for your student.

The suggestion that "I allowed it to run out" is unreasonable. I already explained that I did not believe it was in need of replacing given when I sent it in and my experience of his dosage. Yes perhaps a faulty one and I have said that the suggestion of sending a spare was a good one.

Yes this may appear obvious to some, but I split the prescription between home, childminder and school to ensure everyone has 1 and I have a couple at home and monitor usage so I thought I was covering all bases.

Your implication that I don't understand how busy the teacher is ridiculous - but I do resent the fact that some think teachers are the only people who have a million and one things to do in a day and as such are above any form criticism.

I also don't consider a member of staff from the office making a quick call to let me know so I could make an informed decision in whether to try and get one to the school there and then or ask that the childminder gives the dose at 3.30 "Wasting time"

I think you need to send two inhalers in So he always has 2 at all times.
In this instant yabu. How are the teachers supposed to know it's running low?
I don't always know if my ventolin is running low!
( ishe on ventolin or Salbutamol inhaler? Know both are the same ingredients but noticed that the Salbutamol weren't as good as the ventolin and didn't last as long).

Agree. In future I'd have two in school, then when one runs out they can advise you to replace. Either than or you just replace at the start of every half term.

BUT - the really dont seem to be grasping the seriousness, do they?

The suggestion that "I allowed it to run out" is unreasonable.

Why you did. It happened sooner than you expected, but you did.

I also don't consider a member of staff from the office making a quick call to let me know

Wouldn't the teacher need to leave the classroom to get to the office though?

I do resent the fact that some think teachers are the only people who have a million and one things to do in a day

Clearly.

they really don't seem to be grasping the seriousness, do they?

Nor does the OP yet she wants to know if she can complain. The two children with epi-pens who need them in my school have 2 on their person and one in the medical room.

No the teacher wouldn't need to have left the class. The pump is given in the medical room directly next to the main school office at lunch time.