Weekly review week 6 Drug Education

This week we build upon some concepts explored that will be explored in the Communicable and
Chronic Disease topic. Building upon general drug education and awareness instruction to students,
this review looks at why you need to know about drug administration and will prepare you for the
Communicable and Chronic Disease topic.

Schools need to have policies which set out procedures for administering medication to students
and regularly train staff in these policies. You should know what this policy is before you start at your
school.

School policies should address who can administer medication, when and how. A school and its
teachers owe a non-delegable a duty of care to their students to provide a safe environment and to
take reasonable care for their safety. As part of this, teachers are obliged to attempt to assist
children who are injured or sick. This non-delegable a duty of care, i.e. you cant pass on your legal
duty to another, is covered by many different legislations, e.g. Laws, ranging from Registration
Standards, Work Health & Safety Acts, Civil Liability Acts through to Poisons Act, so medication
administration is a complex task.

From time to time schools need to administer medication to their students, be they prescription only
substances or over the counter pain relief, and occasionally schools are called upon to administer
emergency medical assistance such as the use of auto-injector adrenaline e.g. EliPens, are asthma
relieving medication like Salbutamol i.e. Ventolin.

Schools face a delicate balancing act in this regard. Care must be taken when administering
medication and schools should ensure that policies are in place addressing who can administer
medication, when and how. Training of staff on those policies is also a must. As a bottom line
personally I would encourage ALL school staff to have a current first aid and CPR certificate.

Two examples of areas in which issues may arise are the administering of painkillers, such as
Panadeine, which contain codeine and are subject to strict requirements regarding their use, and the
treatment of anaphylaxis using EpiPens. Medication that contains codeine may fall under the
Poisons Act, depending on the amount of codeine in the medication. If you need to administer
codeine based medication I would suggest in addition to a medical order and parent permission you
seek school authority, e.g. Principal, permission to administer, and perhaps requesting a Registered
Nurse, i.e. a Community Nurse, comes to the school to administer this medication. I recall many an
occasion as a nurse visiting schools to administer scheduled medication and in particular pain relief
to children with sever autoimmune disorders or undergoing cancer treatments.

The duty of care of schools to provide a safe environment for the students under their care extends
to strategies required to deal with students who inform the school that they suffer from severe
allergies. Schools can be held liable for supplying, or failing to restrict the supply, of certain foods to
students with allergies. (See Comcare v Commonwealth (2007) 163 FCR 207 see
http://www8.austlii.edu.au/cgi-bin/viewdoc/au/cases/cth/FCA/2007/662.html ). More leeway is
given to schools and teachers in the case of an emergency such as an allergic reaction, although this
does not negate the duty of care.

Taking the case of anaphylaxis, most education-related guidance supports the use of EpiPens by
teachers (whether they are trained or untrained) in situations of suspected severe allergic reactions,
notwithstanding that EpiPens, and other products such as Anapen, are prescription only adrenaline
auto-injectors listed in Schedule 4 of the Tas Poisons List.
Depending upon what State you are in will determine how your school and hence you deal with life
threatening emergencies. In Tasmania the government provides mandatory guidelines for public
schools in relation to anaphylaxis, including the implementation of policies, the obtaining of detailed
information from parents or carers and development of an individual action plan where there is a
known risk to a student of anaphylaxis. (Please see the Tasmanian Public Schools website for more
information https://documentcentre.education.tas.gov.au/Documents/Specific-Health-Issues-
Procedures.pdf ). See this site for an independent school policy http://stbrigidsnn.tas.edu.au/our-
school/school-policies/Anaphylaxis%20Policy.pdf/at_download/file

In some States ALL permanent, temporary and casual employees (including student teachers) who
work in schools are required to complete anaphylaxis e-training. This training must be repeated at
least once every two years and does not replace pre-existing face-to-face training that is required
when a student with anaphylaxis enrols in a school.

In general guidelines tend to note that:

... Any school staff member must, when necessary, reasonably assist in an emergency… It is
important to know which students have anaphylaxis and where their adrenaline auto-injector is
located. Anaphylaxis always requires an emergency response. You should administer the adrenaline
auto-injector and call an ambulance.

For specifics on teaching children about drugs, legal; illegal and products that can be used as a drug
though not their primary purpose i.e. glues and solvents, we need to start early and talk about
common drugs like prescription medications but also household products like detergents and their
use and storage. This is a great site for a general understanding of what to teach and why
https://www.betterhealth.vic.gov.au/health/HealthyLiving/talking-to-children-about-drugs

Darren + Debra