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School trips and diabetes - information for school staff

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Differences in activity levels and food intake on school trips can affect a child’s blood glucose (also known as sugar) level. Extra activity or eating less can make blood glucose levels drop, whereas excitement and eating more can make them rise. But this can be managed with advice from the child’s parent or paediatric diabetes specialist nurse (PDSN), so it’s important to discuss the trip with them as soon as possible.

 

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Staff training

Unless the child can manage their diabetes completely independently, someone who has been trained to help manage their diabetes will need to go on the trip as well.

What to take on a school trip

Things to take on a trip include:

  • insulin and injection kit
  • blood testing kit
  • hypo remedies
  • pump supplies (if appropriate)
  • extra food/snacks in case of delays or the child doesn’t like the food available
  • personal identification card or bracelet
  • copy of the child’s individual healthcare plan (IHP)
  • emergency contact numbers.

Day trips

Depending on what’s planned for the day, you might not need to make any adjustments to the child’s usual school routine. But talk to the child’s parent or PDSN about what will be happening well before the trip to see if any changes are needed.

Overnight stays

With overnight stays, a child taking injections will certainly need insulin injections as well as blood glucose testing (which may include testing at night), even if these aren’t already done in school.

Depending on the length of the trip, children on pumps may need a pump set change.

If the child can’t do their own injections/manage their pump and/or do their own blood glucose levels, they’ll need to be done by a member of staff. School staff should meet with the child’s parent/carer and PDSN well in advance of the trip to discuss what help is required, and who will assist.

Risk assessment

Children with diabetes should enjoy the same opportunities at school as any other child, and this extends to out-of-school visits, including overnight stays and stays abroad. School staff who organise out-of-school visits should be aware of how a child’s diabetes might impact on their participation but there should be enough flexibility to ensure a child can participate.

School staff should consider what reasonable adjustments they might need to make to ensure that a child with diabetes can take part in an out-of-school visit safely. As part of this they will need to consider not only what support they give a child in school already, but any extra care that might be necessary overnight (eg a blood glucose test), or over a longer period of time than the school day (eg a pump set change).

It is best practice to carry out a risk assessment to identify any changes that need to be made. This will need to be done in good time and in consultation with the child (where appropriate), parent and PDSN.

The main risk for a child with diabetes is that they become unwell due to high or low blood glucose levels. If not managed properly, this can lead to the child needing medical help. Activity, food, any change in routine, stress and excitement can all affect blood glucose levels, all of which are likely to happen on a school visit.

But if school staff are aware of these potential risks, action can be taken to mitigate them.

The following general points might be useful in carrying out a risk assessment, but each child will have their own individual needs so consulting with the child (where appropriate), parent and PDSN is vital.

Potential risk: Child becomes unwell on the journey to /from the school visit

Sitting still for long periods/travel sickness can cause high/low blood glucose levels.

Control measures

  • Ensure child’s blood glucose meter, testing strips, insulin and hypo remedies are easily accessible on the journey.
  • Test/allow child to test blood glucose levels as frequently as needed.
  • Ensure the child has easy access to food and drinks and can take them when necessary.
  • Ensure there are regular breaks for food and toileting.
  • If the child has medication to prevent travel sickness, ensure they take this as directed by their parent/PDSN.
  • Ensure any other measures to prevent travel sickness are in place as necessary, eg sitting at the front of the coach.
  • Ensure all staff are aware of the signs of a child becoming unwell with high or low blood glucose levels(hypers and hypos).
  • Ensure there is a written plan in place, agreed by the school, parents and PDSN to manage illness while away.
  • Ensure a copy of the child’s IHP is taken on the visit.

Potential risk: Child becomes unwell while away

Change in routine or common childhood illness (eg cold) can affect blood glucose levels, which can make a child unwell.

Control measures

  • Ensure that the child’s IHP clearly details the care and support a child needs while on a school visit, and this is carried out as stated.
  • Ensure that contact numbers of the parent, at least one other adult and the PDSN are taken on the school visit.
  • Ensure that there are sufficient staff on the visit who are trained in providing the support a child needs with their diabetes.
  • Ensure that there is sufficient time in the activity schedule to allow insulin to be taken and blood glucose to be monitored when necessary, and that activities can be interrupted to treat a hypo if necessary.
  • Ensure that there is facility to check the carbohydrate content of food. This might include asking the centre for the carbohydrate content of their meals, or bringing carbohydrate reference tables.
  • Ensure that the parent supplies sufficient extra snacks to cover any extra activity/in case the child does not like the food provided.
  • Prior to the visit, ensure that the nearest hospital with A&E facilities is identified and plans are put in place to get a child to hospital if necessary. This should include having sufficient staff on the visit to allow a member of staff to accompany the child and stay with them until a parent arrives.
  • Ensure all staff are aware of the signs of a child becoming unwell with high or low blood glucose levels(hypers and hypos).
  • Ensure there is a written plan in place, agreed by the school, parents and PDSN to manage illness while away.
  • Ensure a copy of the child’s IHP is taken on the visit.

Potential risk: Child needs support with their diabetes overnight

Control measures

  • Ensure there are sufficient staff to look after a child at night, whether this is for routine care or in response to an emergency.
  • Ensure there are sufficient staff to cover the following day in case staff have been awake for long periods in the night.
  • Consider the proximity of the child’s room to the staff accommodation in case they need help during the night.
  • Consider where the child’s diabetes equipment will be stored overnight and ensure there is easy access to it during the night.
  • Ensure the schools safeguarding policies are adhered to. 

Potential risk: Equipment becomes lost or damaged

Control measures

  • Ensure that who is responsible for storage and carrying of equipment on the school visit is clearly stated on the child’s IHP.
  • Ensure directions on storage of equipment are made clear and followed.
  • Ensure spares of all equipment are taken on the visit and are easily accessible at all times.
  • Prior to the visit, ensure that the nearest hospital with a diabetes centre is identified in case further supplies are needed.

Potential risk: Incorrect storage of insulin leads to it becoming ineffective

Ineffective insulin illness can affect blood glucose levels which can make a child unwell.

Control measures

  • Ensure that any insulin in use (eg in a pen injector)  is kept at room temperature.
  • Take steps to prevent insulin getting too hot:
    • Ensure that it is kept in a cool bag while travelling.
    • On an overnight visit, ensure that a fridge is available to store spare insulin.

Further information and support

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