Appendix A - International School of Toulouse

Transcription

Health Policy and Procedures (Secondary)
This document is intended to provide the procedures for supporting Healthy Lifestyles and
Well-Being in the School. It will be reviewed and updated on an annual basis and given to
all staff who must read it and follow the procedures. It will be available to staff via the
website. The document has a primary and secondary section as the specific procedures and
reporting personal are slightly different but the general policy is the same
Although there are some nominated personnel dealing with specific issues it is the duty of all
staff to intervene in the case of student illness or injury, where necessary.
The procedures contain information on the following:
1. Health Information Sheet
2. School Physical Education / Design Technology Medical Certificate
Information Form
3. Canteen Provision
4. First Aid / Illness Provision
5. Health Checks
6. Specific Conditions
7. Notifiable Diseases
8. Qualified First-Aiders
Last updated: 5th March 2010
Last printed: 02/04/2015
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1. Health Information
The Health Information Sheet (appendix SA & SB) has been designed to collect relevant
information regarding students’ health and contact details in the event of illness or
emergency occurring during the school day. This information needs to be updated each
school year.
At the beginning of June each year the Administration Staff will arrange for new forms to be
sent to parents of all current students. Parents will be required to return the completed
forms by the middle of June so that reminders and any further contact can be completed
before the 1st July. During the summer break the Administration Staff will collate the forms
and inform the Head of Secondary of all students where there is a health need or concern.
The forms will be copied and one copy filed in the Student Health Information Files and the
other in the Student’s Individual Personal Record File. All personal information will be stored
in locked filing cabinets.
For new students to the school the Health Information Sheet will be sent out with the
information packs and parents will be required to complete this before students are admitted.
During the summer holiday the information on new students will be added to the sheets
completed in June.
If any Health Form is returned indicating any allergies or health concerns which require
regular medication form SL will be sent to parents and a meeting arranged with the school
doctor to discuss the condition and complete and sign the form. .
The confidential information can only be accessed by the following seven people:
Personnel and Student Information Manager
Secondary Student Support Coordinator
Secondary Year Group Coordinators (3)
Head of Secondary
Principal
The Secondary Year Group Coordinators with the support of their Head of School are
responsible for ensuring that information relating to an individual student’s specific medical
conditions and the actions needed to be taken are known by staff on a ‘need to know’ basis.
No information relating to student health, behaviour or well-being will be passed on to
others by email.
Once a student has left the school or an updated form has been received the old forms will
be shredded.
2. School Physical Education / Sporting Activity / Design Technology / Medical
Certificate information Form
All students who will be participating in school Physical Education / sporting activities /
Design Technology must bring a medical certificate signed by the family doctor practising in
France. This certificate must be renewed at the beginning of each school year.
In June each year the EC1 Receptionist will arrange for new forms (appendix SC & SD) to
be sent to parents and request that these forms be returned to school by the 21st August. By
the first day of the new school year the Administration Staff will check that all forms have
been returned. Where a form is missing a reminder letter will be sent to parents with a
duplicate form and the parents informed that until the form is completed the student will not
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be permitted to participate in PE, Sporting Activities or DT. The forms will be copied and one
copy filed in the Student Health Information Files and the other in the student’s individual
personal record file, all personal information will be stored in locked filing cabinets. The Head
of Secondary will inform the relevant teachers of students whose documentation is not up to
date. Such students will not be allowed to participate in those activities, until up-to-date
medical certificates are provided.
3. Canteen Provision
On receipt of the completed medical form the PSIM will contact any parents who have
indicated that their child has a food allergy or intolerance and arrange for a further form to be
completed see appendix SL. In September, before the start of the new school year the
PSIM will arrange an appointment between the canteen providers, the school doctor, parents
and the Head of Secondary. Parents will be required to provide completed forms - appendix
SL, SM and the necessary documentation from their family doctor. Once the PAI is
completed Secondary Staff will be informed of the children who require special
arrangements in the canteen. Parents should also ensure that children are aware of their
allergy or intolerance and to inform staff in they have any concern about what they are
eating.
4. First Aid / Illness Provision
Secondary
In the event of a student informing the teacher that they are feeling unwell and not able to
participate in the lesson the teacher will send the student to their Year Group Coordinator
who will decide whether the student is ill enough to go home. The teacher will decide if it is
necessary to send another student to accompany the ill student. The Year Group
Coordinator will give permission by writing in the Student Planner which the student will take
to Reception and the member of staff on duty will telephone parents or the person
designated as the emergency contact. Students will be asked to either sit on the sofa or wait
in the Medical Room until collected.
Students feeling ill in break or lunch times should see their Year Group Coordinators.
Ill students are not permitted to leave school unless they have their Student Planner signed
by their Year Group Coordinator. In the event that their Year Group Coordinator is not
available then another Year Group Coordinator or Head of Secondary will sign the planner.
In the event that none of these Secondary staff are available then it should be the member of
staff designated ‘in charge of the school’.
If a student has vomited then this should be reported to the member of staff on duty at
Reception who will arrange for an available member of the site staff to come and clean it up.
The only circumstance in which the School can administer medication is if any student is
showing signs of a fever. His/her temperature will be taken and if 38.5°C or more, then in
line with advice from the School Doctor, Doliprane (in powder form at the appropriate dose
for the age of child) will be administered. Parents will be contacted immediately, asked to
collect their child and informed that Doliprane has been given.
If a student is injured during a lesson, providing they are able, they should be sent to the
Reception accompanied by another student, if the teacher sees fit. The member of staff on
duty at Reception will treat the injury or send for a First-Aider who will take the appropriate
action.
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If a student is injured during a lesson and is not fit enough to go to the Reception then the
teacher should remain with the injured student and send another student to quickly seek
help from Reception.
If a student is injured during break or lunch times, if able, they should go to Reception with a
friend. The member of staff on duty at Reception will treat the injury or send for a First-Aider
who will take the appropriate action. In all cases the member of staff dealing with an injury
will check that the child did not hit his/her head and also check that there is no visible head
injury.
If a student is injured during break or lunch times and is not fit enough to go to Reception
then the teacher on duty should intervene and call for support from the nearest First-Aider
who will take appropriate action.
The member of staff dealing with the incident will ensure that the injury form (appendix SE)
is completed by the appropriate member of staff and then filed in the Secondary Accident
Report Folder kept in the Medical Room. He/She will then complete the record of the
accident / injury in the School Accident / Injury Book. This will be available to the School
Doctor on request.
Any member of staff dealing with blood or other bodily fluids must wear protective gloves,
available in the Medical Room.
First Aid resources will be available in the First Aid Room next to the Reception Desk, the
contents of which will be agreed with the School Doctor on an annual basis. The Facilities
Manager will ensure that adequate supplies are purchased on an ongoing basis. The
Facilities Manager will be responsible for checking that the First Aid kits for school visits and
those in the science and DT rooms are kept fully resourced.
For names of trained First Aiders please see separate sheet.
Whole School
Off-Site-Activities
The school policy for Off-Site-Activities will be followed at all times and all accompanying
staff made aware of the health related procedures.
In order to comply with School Policy the Teacher-in- Charge will, prior to the visit, undertake
risk assessment for all off-site activities and build into the arrangements appropriate
preventative and protective measures which may include: ensuring sufficient supervising / accompanying adults to deal with an incident
and care for the rest of the group. No student or group of students will be
taken on a visit by a single adult.
 selection of personnel with specific competences e.g. ability to administer an
injection
 provision of training and/or information.
 arrangements for First Aid which would include First Aid equipment sufficient
for the activity, any student medication together with written parental consent
and instructions on the administration of the medication
 appropriate briefing of students regarding standards of behaviour required and
instructions to observe
 ensuring that all accompanying adults have read all risk assessments and
confirmed in writing that they have been read and understood.
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5. Health Checks
In September of each year the School Doctor will liaise with the PSIM concerning his/ her
programme of medical visits for that academic year for Secondary students.
Although the Doctor will complete health checks, for other health related matters the School
will advise parents to see their own family doctor.
The PSIM / Administration Staff will arrange the health check appointments, write to parents
(appendix SG) informing them of the appointment day and time, offer parents the opportunity
to attend and request that they complete the Medical Check Form.
The PSIM will prepare student records for the Doctor to review and file any reports including
the dossier medical (appendix H & I) from the Doctor following the medical.
At the end of each visit the Doctor will liaise with the Head of Secondary and inform him/her
of any concerns. The PSIM will pass on this information to the Head of Secondary as
appropriate. The Head of Secondary will then inform Secondary Year Group Coordinators,
as appropriate and where necessary, to discuss any issues arising from the medical which
could affect a student’s learning or Well-Being.
6. Specific Conditions
Asthma
Parents will be asked to provide information about asthma annually on the Health
Information Sheet. If a parent informs school that a child suffers from asthma then the
following will apply:
 For serious cases the Secondary Year Group Coordinator will meet with
parents to establish the frequency of medication and check that the child is
able to self administer where applicable.
 Students will carry their asthma medication at all times including PE lessons.
No student identified as having asthma will be permitted to go swimming
without their medication.
 Parents will be asked to supply the school with a named inhaler or the
prescribed medication and in all cases a copy of the prescription.
 The Health Information Board in the Staff Room will have a copy of information
about asthma in general.
 Staff will be informed that they should ensure that they are aware of the
actions to take in the event a child in their class suffering an asthma attack.
Diabetes
If a child is diagnosed as having diabetes or information is provided on the initial health form
then the following will apply:
 A meeting will be arranged between the parents, student, if appropriate, the
Secondary Year Group Coordinator, the Head of School and the School
Doctor to review and establish the protocol as prescribed by the specialist
doctor.
 The Health Information Board in the Staff Room will have a copy of information
about diabetes and staff will be informed that they should ensure that they are
aware of the actions to take to support the child with this condition. The
Secondary Year group Coordinator will ensure that all members of staff are
aware of the child and condition. This information will be transferred verbally
and not via email.
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 The child will keep necessary snacks, drinks etc both in their classroom and in
the medical room. For Secondary students snacks will also be kept in the
Primary First Aid room close to the canteen.
 In the event of a child being identified as having a condition that could require
an injection the Doctor will train at least three members of the school staff in
the procedures to use.
7. Notifable Diseases
It is necessary in France to notify the School Doctor if students contract diseases such as: Scarletina (Scarlet Fever) (Scarlatine)
 Measles (Rougeole)
 Malaria (Paludisme)
 TB (Tuberculose)
For a complete list of all notifable diseases in France please see www.invs.sante.fr
In the event that a family doctor informs the school that a child has one of the above
diseases the school will inform the rest of the parents and the School Doctor if he/she is not
the School Doctor.
8. Qualified First-Aiders
The Administration Staff will keep a list of qualified First Aiders and update this on an annual
basis in September each year. The list will be posted in the staff room (Appendix SK)
The Administration Staff will liaise with the Facilities Manager and Head of School in
September each year to establish if First Aid courses need to be organised and all staff
offered the opportunity to update or gain their qualification.
Responsibility:
Audience:
Issue Date:
Updated
Review Date:
Function:
Reference:
School Leadership Group
All Staff
September 2008
October 2010
June 2011
Procedures
WRE01
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Appendix SA
4th June 2010
Dear Parents
Health Information Sheet
In order to ensure that the Health Information relating to Students is kept up to date parents
are required to complete the attached form on an annual basis. A new form is enclosed and
I would be grateful if this could be completed and returned to Primary / Secondary Reception
as appropriate and before the 18th June. All the questions must be answered and in
particular details of any medication or medical condition. Failure to provide this information
could result in the school being unable to apply for additional help in exams etc.
Once these have been received then an additional form will be sent to parents who have
indicated that their child has an allergy or medical condition that either requires special diet
or medication.
If any of the information changes either during the summer break or during the academic
year then parents should inform the school in writing.
At the end of June you will receive the health authorisation forms that your doctor will need
to complete and these will need to be returned to school before the 23rd August 2010.
If you have any queries please do not hesitate to contact the school.
Yours sincerely
Tess Perrussel
Personal and Student Information Manager (PSIM)
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Appendix SB
Secondary Health Information Sheet
Name of student: ………………………………………………
Date of birth: ………………………………
Sept 2010 Year Group ………
Sex: Male / Female: ………...…..............
Names of Parents: ……………………………………………………………………………………
Name of Family Doctor: ……………………………… Doctor’s Telephone: …………….…….
Doctor’s Address: …………………………………………………………………………………….
Left / Right handed ……………………………………
Health information
Please note that proof of vaccination against Diphtheria, Tetanus and Polio
vaccination within the last 5 years must be supplied for entry into School, BCG
(Tuberculosis) is highly recommended. Please answer every question even if the
answer is ‘NO’
Does your child have any medical condition? If yes, please give details………………………….
…………………………………………………………………………………………………………….
Has your child had any previous health problems / serious accidents?
If yes, please give details ……………………………………………………………………………
……………………………………………………………………………………………………………
Any concerns re: vision …………………………………… Wears glasses Y/N ……………….
Has your child any food related allergies, intolerances or specific dietary requirements e.g.
vegetarian. If yes, please give details. ………………………………………………………………
……………………………………………………………………………………………………………
Any concerns re: speech/hearing ……………………………………………………………….…..
……………………………………………………………………………………………………………
Does your child suffer from asthma? If yes, please give brief details including details of
medication and frequency of use. ……………………………………………………………………
…………………………………………………………………………………………………………...
Does your child suffer from any allergies? If yes, please give brief details:
……………………………………………………………………………………………………………
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Are there any other health or family related issues which may affect your child’s education?
……………………………………………………………………..…..……………………………….
Does he/she receive any regular medication? If yes, please give details
…………………………………………………………………………..……………………………….
Are there any sports/other activities in which your child cannot participate?
……………………………………………………………………………………………………..……
Any absence from school of more than 1 week in the last two years? If Yes please provide
details.
……………………………………………………………………………………………………………
If there are any health concerns you wish to discuss, please make an appointment
with the Primary Student Support Coordinator or Secondary Year Group Coordinator,
as appropriate.
Declaration of accuracy of information
I / We, the undersigned, ……………….………….…………………………………….., legally
responsible for the child ………………………………….. hereby declare that the information
provided on this sheet is true at the time of signing. I / We will notify the school
immediately of any changes.
Father/guardian’s signature: ……………………………………………….
Date: …………
Mother/guardian’s signature: ………………………………………………
Date: …………
Authorisation and Discharge of Responsibility
I / We, the undersigned, ……………….………….…………………………………….., legally
responsible for the child ………………………………….. hereby authorize the school to take
all necessary measures to safeguard the health of my / our child, e.g.
 administer Doliprane if he/she has a fever and his/her temperature is in excess
of 38.5°C
 call the doctor
 have my child transported to hospital by ambulance, according to the
emergency and seriousness of his/her condition.
 agree for any laboratory examinations, x-rays or surgery which are required in
an acute emergency
I / We understand that the school will notify me / us as soon as possible of any of these
decisions and that my child will be taken to Purpan Hospital, unless otherwise requested.
Father/guardian’s signature: ……………………………………………
Date: ……………
Mother/guardian’s signature: ……………………………………………
Date: …………
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Appendix SC
Sample Letter for PE / Sporting Activity / Design & Technology / Medication Medical
Certificate and School Insurance Information
29th June 2010
Dear Parents
Medical Certificate Information Forms and School Insurance
Each year we need to renew the authorisation which states that all students are fit to
participate in Physical Education in the school, and that students who use the Secondary
Design and Technology Workshop are fit to work with this specialised machinery.
All students participating in Physical Education activities require a signed medical
certificate stating that they are fit to do so.
In addition, students from Year 5 and Year 6 are required to have the second part of this
form completed by a doctor before they are authorised to enter the Design & Technology
workshop area.
The attached form signed by your doctor will suffice.
The School Doctor also requires that the school has up to date information on any
medication that students are prescribed and take on a regular basis. The attached ‘certificat
médical’ should be completed by a doctor and returned to school together with a copy of the
prescription for any medication that your child is prescribed.
Although the school does not administer any medication to students parents of Secondary
Students wishing to authorise their child to self administer medication prescribed by a doctor
should have part 2 of the attached form completed by a doctor and should return this to
school. An example of this would be Doliprane for headaches or other pains. Parents
should ensure that medication is clearly marked with the student’s name and handed to the
Receptionist. Students requiring medication will be able to see the Receptionist as
necessary.
Third party school insurance should also be renewed for each child for the 1st September.
Parents are requested to provide an ‘attestation d’assurance scolaire’ (proof of insurance)
for the new school year.
All forms must be returned to the school office by 23rd August at the latest and
students who do not have the necessary authorisation will not be permitted to
participate in sporting activities or Design Technology. The completed forms can be
posted to school during August but if done so then parents are advised to keep a
copy.
Yours sincerely
Tess Perrussel
Personal and Student Information Manager (PSIM)
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Appendix SD
Certificat médical autorisant la pratique du sport
Je soussigné, Dr ………………………………………….. (nom en majuscule), certifie
que l’état de santé de …………………………………………… (nom et prénom
d’élève), ne présente à ce jour aucune contre-indication à la pratique du sport dans
le cadre de sa scolarité.
Fait le …………………………………….. A ………………………………………………..
Cachet
Signature
Certificat médical autorisant les cours de technologie et le travail sur machine
outil
Je soussigné, Dr ………………………………………….. (nom en majuscule), certifie
que l’état de santé de …………………………………………… (nom et prénom
d’élève), ne présente à ce jour aucune contre-indication à l’utilisation de machines
outil en travaux pratiques dans le cadre de sa scolarité.
Fait le …………………………………….. A ………………………………………….
Cachet
Signature
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Appendix SE
Secondary Injury Report Form
Date: …………………………………..………………..
Name of Student:………………………………………………
Time:……………..
Year Group: …………
Nature of the injury (please provide as much detail as possible)
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Any further actions required:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Signed: …………………………………………
Please print name: …………………………………….
Once completed this form should be copied and given to parents and the original filed in the
Injury Report Folder kept in the Medical Room. The Accident / Injury Book should be
completed with the student’s name, date and the nature of the injury / accident.
……………………………………………………………………………………………………………
Please return this slip to school
Child’s Name: …………………………………………………. Date ……………………………….
I received the notification regarding injury and treatment dated ………………………………….
Comment on further action taken or needed:……………………………………………………….
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Signed: …………………………………………… (Parent / Guardian)
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Appendix SG
Date: ………………………….
Dear Parents of
The school doctor, Dr Audrey Fabresse, will be visiting over the next few weeks. The School
nurse, Mme Maufroy may also be present.
These visits provide an opportunity to ensure that a student’s medical dossier is complete
with their vaccination record up to date, any medical problems with your child are identified
and allow any concerns you may have to be explored. Several children are seen each week.
Each appointment will take about fifteen minutes. Your child’s vaccination record will be
checked and a brief medical examination performed. They may be asked to undress to their
underclothes.
Please complete the attached consent form which has the date of the appointment and
return it to the school one day before the appointment.
If you have not provided a copy of your child’s vaccination certificates please either bring a
copy of the vaccination certificate to the appointment, if you are attending, or see Gaby
Bollin at Reception and she will make a copy and check that it contains all the required
information.
If you have any queries please do not hesitate to contact me. Thank you for your
cooperation.
Yours sincerely
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Appendix SH
STRICTLY CONFIDENTIAL
MEDICAL CHECK
NAME
………………………………………………………………………………….
Consent of Parent or Guardian to the examination (please sign) …………………………..
Proposed date of medical: ……………………………………………………………………
Date of birth: ……………………..
Place of birth: ……………………………………..
Nationality: …………………………………
Members in family:
Year Group: ……………………….
Father: ………………………
Mother: …………………….
Brothers: ……………………..
Sisters: …………………….
Paediatrics
Please provide the following information and dates where appropriate.
Any problems at birth: ……………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Any problems in growth? ……………………..…………………………………………………
………………………………………………………………………………………………………
Illnesses: ……………………………………………………………………………………..……
………………………………………………………………………………………………………
Operations: …………………………………………………………..………………………….
………………………………………………………………………………………………………
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Appendix SI
Dossier Médical
Élève ..............................................................................................................................
Né(e) ...................... à ......................................... Nationalité ....................................
Profession des parents :
Père : ...........................................................................................................................
Mère : ...........................................................................................................................
Calendrier des vaccinations 2008 - Tableau synoptique
Vaccins
Âge
BCG
Diphtérie
Tétanos
Poliomyélite
Coqueluche
Hib
Naissance
2 mois
3 mois
4 mois
9 mois
12 mois
16-18 mois
24 mois
< 6 ans
6 ans
11-13 ans
14 ans
15 ans
16-18 ans
23 ans
26-28 ans
> 28 ans
≥ 65 ans
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Hépatite B
Pneumocoque
Rougeole
Oreillons
Rubéole
Papilloma
virus humain
Grippe
1er BILAN DE SANTÉ
(Examen de prise en charge, à la première entrée à l’école)
ÂGE ....................
Classe ......................
Date ........................
Composition de la famille : ..............................................................................................
Conditions de vie : ..........................................................................................................
Antécédents : Père : .......................................................................................................
Mère : .......................................................................................................
Facteurs pédagogiques : ................................................................................................
Naissance : ....................................................................................................................
Croissance : ...................................................... 1ers mots : ...........................................
Poids : .................
Taille : .................
Maladies :
........................................................................................................................................
........................................................................................................................................
........................................................................................................................................
Interventions chirurgicales :
........................................................................................................................................
........................................................................................................................................
Allergies :
........................................................................................................................................
........................................................................................................................................
........................................................................................................................................
Acuité visuelle
Sans verres : ............................OD : ................................. OG : ...................................
Avec verres : ............................OD : ................................. OG : ...................................
Vision des couleurs : ......................................................................................................
Acuité auditive : ....................... OD : ................................. OG : ..................................
Personne responsable du suivi de l’enfant :
Médecin : ...............................................
Infirmière : .................................................
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Nom de l’élève : ................................................................................................
1er BILAN DE SANTÉ
Examen Clinique
Examens
Dates
Ex. Cardio : ....................................................................................
...................................
Ex. Pulmonaire : ............................................................................
...................................
Ex. ORL : .......................................................................................
...................................
Ex. Ortéo-articulaire : ....................................................................
...................................
Ex. Abdominal : .............................................................................
...................................
Ex. Neurologique : .........................................................................
...................................
CONCLUSIONS TRANSMISES :
À la famille :
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
Aux éducateurs :
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
Éducation physique :
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
CONSULTATIONS COMPLEMENTAIRES DEMANDÉES
Suites données :
...............................................................................................................................................
...............................................................................................................................................
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RAPPORT DE CONSULTATION MÉDICALE
Vaccinations :
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
Certificat de pratique du sport :
Apte
Inapte
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
Constatations :
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
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Appendix SK
List of Qualified First-Aiders – 1st September 2008
Piera Graham
Estelle Ash
Phillip Patrick
Richard Jones
Julie Hall
Lionel Perez
Florence Tomas
Dominique Soriano
Norma Greenland
Fiona Gregory
Oliver Bowles
List of Trained First-Aiders – December 2010
Piera Graham
Lionel Perez
Sue Bain
Matthew Podbury
Carol Cooke
Florence Tomas
Susan Mancey
Aykica
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Dominique Soriano
Gaby Bollin
Gareth Hunt
Appendix SL
CERTIFICAT MEDICAL
D’UN ENFANT PRESENTANT UNE ALLERGIE ALIMENTAIRE
Je soussignè, Docteur ………………………………………………………………………………..
Certifie que l’enfant ……………………………………………………………………………………
Devrait bénéficier a l’école et en restauration scolaire, dans la mesure des possibilities, d’un
régime “vitant le (ou les) aliment(s) suivant(s):
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Le degré de tolérance de l’allergie alimentaire, dans le cas ou le régime ne serait pas
respecté (erreur de fabrication défaut d’information sur les produits…) ne fait pas courir de
risque vital pour l’enfant. Les signes de l’allergie alimentaire sont:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Cas ou il y a risqué vital
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
En cas de reaction allergique liée a la prise, par erreur de l’aliment allergisant, un traitment
par:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
…………………………………………………………………………………est
tenu
a
la
disposition du médecin le plus proche appelé ou du médecin d’urgence ou des parents
contactés.
Fait a …………………………………………
Le …………………………………………….
Signature et cachet du Praticien
20
Appendix PM (Printed on double sided A3)
PROJET D’ACCUEIL INDIVIDUALISÉ (PAI)
Il est important d'adapter le projet d'accueil individualisé à chaque cas individuel et de n'inclure
que ce qui est indispensable à l'enfant concerné. Il convient de l'actualiser chaque année. Avec
l'accord de la famille, toutes informations pouvant être utiles à la prise en charge de l'enfant seront
jointes au projet.
Les informations qui relèvent du secret médical seront adressées avec l'accord des parents au
médecin désigné par la collectivité qui accueille l'enfant ou l'adolescent.
L'ENFANT CONCERNÉ
- Nom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Prénom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Date de naissance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Adresse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Ecole. Etablissement scolaire. Etablissements d'accueil de la petite enfance. . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .
1 -–Référents à contacter
-
Les parents ou tuteur.
-
Père . . . . . . . . . . . . . . . . . Tél. : domicile . . . . . . . . . . . . . .Tél. : travail . . . . . . . . . . . . . . .
-
Mère. . . . . . . . . . . . . . . . . . Tél. : domicile . . . . . . . . . . . . . . Tél. : travail . . . . . . . . . . . . . .
.
- Le responsable de la collectivité. . . . . . . . . . . . . . . . . . . . . . . . . . . Tél. : . . . . . . . . . . . . . . . . . . . .
- Le médecin ou l'infirmier(ère) de la collectivité. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Le médecin traitant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Le médecin spécialiste. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Samu
15 . . . . . . . . . . . . .Pompiers. . . . . . . . . . . . . . . 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 - Besoins spécifiques de l'enfant – Type d’Allergie
- Nécessité d'un régime alimentaire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..............................................................................
- Aménagement de l'éducation physique et sportive: sports à adapter selon l'avis du médecin qui
suit l'enfant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Aménagement des transports : éviter les trajets trop longs et les transports mal adaptés.
- Aménagement lors d'une classe transplantée ou de déplacements : veiller à ce que l'enfant ait
toujours avec lui sa trousse d'urgence
3 - Prise en charge complémentaire médicale
21
- Intervention d'un spécialiste médicale : coordonnées, lieu d'intervention, heures et jours. . . .
..............................................................................
..............................................................................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 - Traitement médical
(selon l'ordonnance adressée au médecin de la collectivité)
Nom du médicament . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..............................................................................
Doses, mode de prise et horaires . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..............................................................................
5 - Régime alimentaire
(Selon la prescription du médecin qui suit l'enfant dans le cadre de sa pathologie)
- Paniers repas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..............................................................................
- Suppléments caloriques (fournis par la famille) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
- Collations supplémentaires (fournies par la famille) - horaires à préciser. . . . . . . . . . . . . . . . . . . .
..............................................................................
- Autre : (à préciser) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..............................................................................
6 - Protocole en cas d'urgence qui sera joint au PAI
A faire remplir par le médecin prescripteur et à rapporter au médecin concerné par l'accueil
- Signes d'appel : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Symptômes visibles : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Mesures à prendre dans l'attente des secours : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
22
Signataires du projet
Les parents s’engagent à maintenir le contact avec le Directeur d’Ecole et à informer de
l’évolution de l’allergie (mise à jour) et les divers Responsable (Administration et Services). Les
Parents ont pris connaissance de la totalité du dossier.
Par ailleurs, lors de l’inscription, les parents doivent prévenir le Directeur d’école.
A Colomiers, le ……………………..
…………………………………………..
Signature des parents ou représentant légal
…………………………………………..
Vu, le Médecin Allergologue
…………………………………………..
Vu, la Direction de la Restauration
…………………………………………..
Vu, le Responsable de l'institution
…………………………………………...
Vu, le Médecin scolaire
23
Document à renseigner par le médecin qui suit l’enfant à destination du médecin scolaire
Protocole de soins d’urgence pour accueil en collectivité d’un enfant atteint de troubles de la
santé évoluant sur une longue période (circulaire 2003-135 du 8 septembre 2003)
Nom, Prénom de l’enfant: ……………………………………………………………………………
Né (e) le: …………….. à ……………………………………………………………………………
Etablissement scolaire: International School of Toulouse
Maladie chronique: (Information susceptible d’être fournie aux services d’urgence en cas
de
nécessité)
………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Allergie: (à complèter par le spécialiste dont l’avis s’appuiera sur un bilan allergologique:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
…………………………………………………………………………………………………………
Signes Cliniques à surveiller
chez l’enfant :
Mineurs : nécessitant une surveillance plus
Attentive, un traitement
Sévères : nécessitant des mesures à
prendre en urgence
Conduite à tenir
(position de l’enfant, médicaments,
Personne à prévenir..)
- Noter l’heure
- Prévenir les parents
- médicaments
Appeler le SAMU 15 ou 112(portable) en
attendant les secours :
ORDONNANCE JOINTE (en cas de prise de médicaments nécessaire pendant le temps de
présence de l’enfant dans la Collectivité d’accueil)
L’administration dies médicaments en cas d’urgences (d’après la circulaire 2003-135 du
8.09.2003, le personnel des collectivités d’accueil est autorisé, es cas de risque vital, à
administrer un traitement médicamenteux oral, inhalé ou par auto-injection):
 pourra être réalisée par le personnel de la collectivité
 nécessite l’intervention d’un médecin ou d’un auxiliaire médical
Date : ………………
Cachet du Médecin, signature……………………
24

Appendix A - International School of Toulouse

Transcription

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