Carry out a risk assessment. For each activity that the individual is to participate in, ensure that you appreciate the actual potential risk but do not exaggerate this.
A risk assessment should be viewed in a positive manner and, rather than lead to restrictions on the individual, should identify the possible risks and the ways in which staff can help the individual to participate. Once these risk areas are identified and highlighted in a care plan, the individual and the staff can heighten their awareness and be prepared to employ the care procedure in the event of a syncopal episode.
It is essential that a care plan be produced for all young people with syncope, even if they are not being formally assessed for a Special Educational Needs statement. One may have been drawn up by the parent/guardian, but it is a good idea for a member of staff to go through this and create one if there is not one already in existence. Involving all parties in the process of drawing up a care plan can be an empowering and reassuring experience.
The care plan must be circulated amongst ALL members of staff/carers. This includes playground and lunchtime supervisors, supply teachers, first-aiders, school nurses, SEN staff and any newcomers.
They should not however be displayed in places where other pupils can access them for reasons of sensitivity and confidentiality, unless permission has been given to the contrary.
A care plan should include:
- Photo of the individual
- A brief description of the condition
- A description of an anoxic seizure (if applicable)
- Known triggers and warning signs
- Procedure for managing a syncopal episode
- Instructions on who to call in an event of an episode
- Parent/guardian contact numbers and addresses
- Outline of any physical limitations and side effects
This will be tailored to the individual’s symptoms and could be produced in a range of formats to suit the target audience; i.e. a laminated poster may be more suitable for display in the school office.
Sample Care Plans
Sample Care Plan for a child with Syncope
Sample Care Plan for a child with RAS
The care plan must be open to frequent review as the needs of a individual with syncope may change. This should be automatically administered and should not rely upon parental reminder.
Blank Care Plans
Blank RAS Care Plan
Blank Syncope Care Plan
Making Changes to Accommodate Additional Needs
It is possible that alterations may have to be made to normal practice in order to fully integrate the young individual. Changes will be determined from discussion with the parent/guardian and the child (if applicable) and should be stated in the care plan.
These may be extremely subtle changes, for example, whereas usually a child in a class may be allowed to go to the toilet by themselves, in a school where there is a child with syncope, a subtle change may be that all children in the class have to go in pairs to visit the toilet.
Whatever adjustments are made, it is essential that the child is not singled out or made to feel different.
In the ‘toilet’ example, the child will not, as a result of the change, be alone when visiting the toilet in case an episode occurs, but at the same time, the change applies to the whole class so they are not made to feel different.
In the case that others cannot be included in the change, the child must, if possible, provide consent to be ‘singled out’ so that they do not feel excluded. This may be the case if, for example, it is decided that a child needs to go to the front of a lunch queue rather than stand for a long time and risk a blackout.
It is necessary to discuss any necessary adaptations that may need to be adopted with the young person and their parent(s)/guardian(s).
Possible Needs of a Child with Syncope
- A designated place to rest and recover following an episode. For some, it may not be necessary for them to return home and they may prefer for a ‘bed’ or comfortable chair to be made available. They can then return to the class when they feel better.
- A system in place so that the individual is never completely alone.
- A system in place for missed work to be collected/retained/copied so the young person can easily catch up on any missing work.
- Dehydration can trigger syncope so allow individuals with syncope to drink water throughout the day.
- If an individual becomes incontinent during a syncopal episode, arrange for a spare set of clothes to be kept in the building.
Don’t allow the pupil to feel isolated or left behind either academically or socially within their learning community. Communication, flexibility, respect and understanding are essential to the ability for the individual to enjoy a holistic educational experience.
Be aware that young people with a medical condition can be perceived as vulnerable, even if they are not. This can often leave them prey to bullies and teasing. A supportive and understanding environment that does not tolerate such behaviour can greatly improve the quality of an individual’s learning experience.