Allergies, epilepsy and diabetes: emergency plans at school

Key rules

• 112: Staff call 112 in any emergency, whatever your region and even with no authorisation on file.
• Rescue medication: Which rescue medication staff may give depends on your region's protocol.
• Written authorisation: Staff should only give prescription drugs with a doctor's plan and your written consent, or if 112 tells them to.
• Training: Staff training is generally voluntary, so ask who will take part.

What you need to set up

For a severe allergy, epilepsy or diabetes, ask the school for three things: a written emergency plan, staff who have been trained, and the supplies kept where staff can reach them. Do this before the first day, or as soon as your child is diagnosed.

In an emergency, staff always call 112

All staff must call 112, give basic first aid and follow any emergency plan, even without a medication authorisation on file. The operator guides them, and that can include step-by-step first aid. Staff stay with your child and contact you and the school management.

Without a signed authorisation, staff should not give prescription drugs on their own. The exception is when the 112 medical service tells them to. This is why the written plan matters.

Which rescue medication staff may give depends on your region

There is no national rule. Each autonomous community sets its own protocol for medication at school. Check the current protocol with your regional education or health department.

• Allergy (adrenaline auto-injector): Many regions allow or recommend that trained staff who are not health workers give it, and call 112 as well. You need a diagnosed severe allergy and a prescribed auto-injector.
• Epilepsy (buccal midazolam): Several regions allow trained, voluntary staff to give it in a prolonged seizure. This needs a prescription or medical report and your written authorisation. Other regions are less clear, so ask.
• Diabetes (glucagon): Several regions let trained, voluntary staff give it in a severe low-sugar emergency. This usually needs a doctor's report and your written consent. Help with insulin is usually limited to reminders and supervision, with a school nurse where the school has one.

Ask the school directly what your region's protocol lets its staff do for your child. If the answer is "nothing", the plan still sets out when to call 112.

Write the plan

Ask your child's treating doctor for a one-page plan. It should contain:

• your child's name, date of birth, photo, school and class
• the diagnosis, and any other allergies or conditions
• each drug, with dose, route and the time or trigger for giving it
• the symptoms staff should recognise
• step-by-step actions, including when to call 112
• contacts for you, the doctor and the hospital
• your consent
• the doctor's signature and stamp, with the date and a review date

Give the plan to the school management and ask them to acknowledge it, ideally with a signature. The form below can help you start.

Get staff trained

Training usually comes from your child's health centre (centro de salud) paediatric team or nurse, the hospital specialist unit, or a diabetes or epilepsy patient association. Some regions have formal programmes, and some have a school nurse (enfermera escolar). Ask the health centre or the regional education or health department, then arrange the session with the school.

Staff taking part is generally voluntary. Ask the school to invite those who agree, and to keep a list of who is trained.

Canteen

If your child eats at school, contact the school secretary or director and the comedor coordinator. They work with the catering company. You will usually need a medical certificate and the school's special-diet form. Regions often ask for this every school year. For a severe allergy, also hand over the action plan and any emergency medication for the canteen.

The documents, checklist and common questions are below.

Choosing between options

What should staff do in an emergency when there is no medication authorisation on file?

• Call 112 and follow the operator: In any serious emergency. Staff call 112, follow the operator's instructions (which may include guided first aid), stay with the pupil, and contact the family and school management.

• Give prescription medication: Only if the 112 medical service tells staff to. Staff do not give prescription drugs on their own initiative.

Staff always have a duty to help a person in serious danger, so they call 112 first. They give prescription medication only on the instruction of the 112 medical service.

Documents you need

• A one-page medication and emergency plan, signed and stamped by the treating doctor, with the date and a review date. It shows your child's name, date of birth, photo, school and class, the diagnosis, each drug with dose, route and time or trigger, the symptoms to recognise, step-by-step actions including when to call 112, other allergies or conditions, contacts for parents, doctor and hospital, and your consent. A school signature or acknowledgement is also advisable.

• A medical certificate from the allergist or paediatrician stating the allergy or the diet your child needs, for the school canteen.

• The school's special-diet request form for the canteen, completed by you.

Checklist

• Ask your regional education or health department for the current school protocol on adrenaline, glucagon and seizure rescue medication, and which of these trained staff may give.

• Arrange the training session with the school management and invite the staff who volunteer to take part.

• Give the signed one-page plan to the school management and ask them to acknowledge it.

• Contact the school secretary or director and the comedor (canteen) coordinator to set up a safe or medical diet with the caterer.

Check the current protocol for your region with its education or health department before relying on any staff giving medication.

Medication and emergency plan form for the school

Fill in the Spanish form below, have the treating doctor sign and stamp it, and hand it to the school with your written consent. Print it on one page. If your region has its own official model, the school can tell you, and you can find it in the annexes of the regional protocol on the education department's website. Use that model if there is one, and attach this plan.

The doctor is usually the paediatrician (pediatra) or the hospital specialist who follows the condition. Many regional forms also ask for the doctor's collegiate number.

Plan de medicación y emergencia

Datos del alumno/a

• Nombre y apellidos: ______________________
• Fecha de nacimiento: ______________________
• Colegio y curso/clase: ______________________
• Foto reciente: pegar aquí

Diagnóstico: ______________________

Alergias y otras enfermedades: ______________________

Medicación

Síntomas que hay que reconocer: ______________________

Qué hacer, paso a paso

1. ---

2. ---

3. Si no mejora o hay riesgo grave, llamar al 112.
4. Avisar a la familia.

Contactos

• Madre/padre/tutor: ______________ Teléfono: ______________
• Segundo contacto: ______________ Teléfono: ______________
• Médico/a que lo trata: ______________ Teléfono: ______________
• Hospital de referencia: ______________ Teléfono: ______________

Autorización de la familia

Yo, ______________________, con DNI/NIE ______________, autorizo al personal del centro a seguir este plan y a dar la medicación indicada a mi hijo/a.

Firma: ______________ Fecha: ______________

Firma del médico/a

• Nombre: ______________________ Nº de colegiado: ______________
• Firma y sello: ______________________
• Fecha: ____________ Fecha de revisión: ____________

Recibí del centro escolar

Nombre y firma: ______________________ Fecha: ____________

Before you hand it in

• Ask the doctor to check the doses and the steps before signing.
• Give the school a new copy whenever the doses change and at each review date.
• Ask staff to keep a copy where they can reach it fast, and to keep medication in its original box.

Frequently asked questions

Can school staff give rescue medication for seizures in every region?

No, there is no national rule, and only some regions allow trained staff to give buccal midazolam (a rescue medicine placed between the gum and cheek) in a prolonged seizure. Regions with joint education-health guidance include Madrid, Catalonia, Andalucía, Valencia, Galicia and the Basque Country.

Will a school nurse or teacher give my child's insulin?

Usually not: insulin support at school is normally limited to reminders and supervision, with a school nurse where the region has one.

Do school staff have to attend training on my child's condition?

No, staff participation in training is generally voluntary. Some regions run formal programmes. Ask the school management which staff have volunteered and whether the training session can include the people who supervise your child most.

Do I have to renew the canteen diet request every school year?

Yes, regions often require the special-diet request and medical certificate again each school year. Some regions also offer a menu from the caterer's dietitian. Ask the comedor coordinator at the start of the year what the school needs.