For full details and advice please read the Allergy and Anaphylaxis Policy available on Firefly.

Symptoms: generally, the symptoms are a marked difficulty in breathing or swallowing, a repetitive cough, feeling of weakness or faintness, sweating or a rash, dizziness, swelling of the tongue or lips, turning blue, feelings of anxiety or confusion or loss of consciousness.

Any pupil with a known allergy (and who has been prescribed adrenaline) must carry 2 adrenaline auto-injectors at all times. Houses or Departments are able to hold spare AAIs (provided by ECHC) for use in emergencies for any pupil who has been medically assessed as being at risk from anaphylaxis. Emergency AAIs are also held by Security, staff at Dorney Lake and are also located in the Porters’ Lodge, College Kitchens, Bekynton, Queen’s Eyot, Music Schools, Athens, Willowbrook Tennis Pavilion, Agar’s Pavilion, all boarding houses.

Treatment: as soon as a severe reaction is suspected an adrenaline injection (AAI) must be administered. A staff member should lay or sit the pupil on the floor (with their legs raised if possible), and ensure the pupil’s AAI is administered without delay (either by helping the pupil to administer it or by administering it themselves if necessary):

• Staff members will remain calm, ensuring that the pupil feels comfortable and is appropriately supported.
• Staff members will ensure that the pupil is given plenty of space, moving other pupils to a different room where necessary
• A staff member must remain with the pupil, calling for a First Aider if necessary. They will not move the pupil or leave them unattended
• Where possible the staff member will remove the trigger (e.g. insect stinger).
• AAIs can be administered through clothes and should be injected into the outer mid-thigh, in line with the manufacturer’s instructions.
• A number of different brands are available in the UK. The devices appear similar but have minor differences in how they are used. Instructions are on the outside of the pen if needed.
• If in doubt, give adrenaline. A dose of adrenaline administered with an AAI into the outer mid- thigh is safe and potentially lifesaving.
• Record the time the AAI was given.
• Administer (or help the pupil administer) a salbutamol inhaler if prescribed as part of their Allergy Action Plan.
• Contact the emergency services. Dial 999 for ambulance and say “suspected anaphylaxis” (pronounced anna-fil-ax-iss).
• Staff should notify Security on 01753 370102 in order that they can direct the ambulance to their location.
• If there is no improvement after five minutes, a further dose of adrenaline should be administered using another AAI.
• If the pupil deteriorates after making the initial 999 call, make a second call to ensure the ambulance has been dispatched.

In the event that a pupil without a prescribed AAI, or who has not been medically diagnosed as being at risk of anaphylaxis, suffers an allergic reaction, the staff member will contact the emergency services (stating you suspect an allergic reaction) and seek advice as to whether an AAI should be administered. An AAI must not be administered in these situations without contacting the emergency services first.

Symptoms: signs of an asthma attack include coughing, wheezing, difficulty in speaking or walking, shortness of breath and a tight chest.

Treatment:

• Keep calm, reassure the pupil.
• Make the pupil comfortable (sit them up, do not let them lay down).
• Let them use their inhaler (in an emergency an inhaler can be requested from Security, Porters’ Lodge or Dorney Lake). They should take one puff every 30-60 seconds for a total of 10 puffs, via a spacer if there is one at the location.
• Encourage the pupil to breathe slowly.
• Contact ECHC on 01753 370839 if the pupil still has difficulty breathing (you may need to call an ambulance in an emergency).
• Alert the Dame to collect the pupil if necessary (if the Dame is unavailable arrange for an adult or responsible pupil to take them back to their House or  ECHC – an unwell pupil should not be allowed to return to their House on their own and should be transported by vehicle rather than walking).

Symptoms: may include hunger, sweating, drowsiness, pallor, glazed eyes, shaking and trembling, lack of concentration, irritability, a headache, mood changes (anger and aggression).

Treatment:

• Keep calm.
• Do not leave the pupil alone.
• Give fast acting sugar, such as the patient’s own Dextrose Gel if available or a sugary drink (if fully conscious).
• Call ECHC on 01753 370839 for further advice.

Symptoms: an epileptic fit usually follows a pattern – the pupil suddenly falls unconscious, they become rigid, convulsive movements begin, breathing may become noisy and they may experience loss of bowel or bladder control.

Treatment:

• Make space and ask others to move away.
• Loosen clothing around their neck and protect their head by putting something soft under it.
• Pad sharp or dangerous objects around the pupil with coats or cushions if necessary.
• Do not put anything in the casualty’s mouth.
• Time the seizures.
• Send for the department First Aider if necessary or contact ECHC for assistance.
• If the pupil stops breathing begin emergency CPR and call an ambulance immediately.
• When convulsions stop, place the pupil into the recovery position.
• If they feel dazed or in need of sleep do not move or wake them, allow them to recover in their own time.
• Alert their Dame who will collect them and take them back to their House (the Dame or House Master will notify the parents). Security can provide transport if required.
• Call for an ambulance if the seizure lasts more than 5 minutes, if they are unconscious for more than 10 minutes, if they have never had a seizure before or if they have sustained an injury during the seizure that requires immediate medical attention (in particular, if you believe they may have sustained a head injury).
• If an ambulance is required the ECHC must be notified in order that they can update the pupil’s record and provide follow-up care.

If a pupil is hit in the eye and experiences pain or mistiness of vision, even if only temporary, they should be referred to a school doctor that same day, since delay in treatment for what may seem just a trivial injury may seriously endanger recovery.

Pupils playing rugby or the Field Game or Wall Game should not wear glasses. When playing football they should wear approved prescription ‘safety’ glasses dispensed and fitted by a registered dispensing optician in line with the Association of British Dispensing Opticians (ABDO) guidance ‘Children’s eye protection in football – a guide for referees, coaches and parents’. Contact lenses are preferable.

It is strongly recommended that pupils playing rackets wear eye protection and this is always readily available to borrow. Eye protection is mandatory for any pupil playing squash.

Symptoms: brief loss of consciousness, slow pulse with pale, cold and clammy skin.

Treatment:

• Lay the pupil flat on the ground with legs raised and supported.
• Give them some space.
• Open a door or window if possible to provide fresh air.
• As they recover, sit them up gradually and offer a glass of water.
• Reassure them (they may be dizzy for a few moments).
• Alert the Dame to collect the pupil if necessary (if the Dame is unavailable arrange for an adult or responsible pupil to escort them back to their House or ECHC – an unwell pupil should not be allowed to return to their House on their own). Security can be called to provide transport if required.
• The Dame or the House Master will alert the parents if needed.

If a pupil suffers a blow to the head and subsequently loses consciousness (for however short a period of time), appears dazed or confused, or suffers any disturbance of vision:

• They should not resume any game or other activity in which they might have been engaged.
• They should be taken to the Eton College Health Centre as soon as possible. They should not be allowed to walk there unaccompanied. It is preferable that someone who saw the incident accompanies the pupil as well so that they can explain what happened.
• Contact the pupil’s Dame immediately to alert them to the situation.
• Complete an accident report on Firefly see section 16) this must be done by the end of the day.
• If suspected concussion occurs offsite, then they should be taken as soon as possible to a medical professional for an assessment.

Symptoms: with a partial blockage the casualty may be coughing, spluttering but will still be able to talk and breathe (although may experience some difficulty). With a severe or full blockage any attempts at coughing will be silent, they may be clutching their throat, unable to breathe, blue skin and lips and experiencing diminishing levels of consciousness.

Treatment:

• If the casualty is coughing forcefully, encourage them to continue doing so as this may be sufficient to dislodge the object in some cases of partial blockage.
• If the blockage appears more severe:
• Send for the department First Aider.
• Lean the casualty forward and support them with one hand.
• With the other hand, give up to 5 forceful back blows with the heel of the hand, between the casualty’s shoulder blades.
• If the obstruction isn’t cleared, call an ambulance.
• Stand behind the casualty, place both arms round them and encourage them to lean forward.
• Abdominal thrusts with one fist placed between the belly button and the bottom of the breastbone, and the other fist clasped on top of the first, pull sharply inwards and upwards. Repeat this up to 5 times.
• If the casualty is still choking, repeat the cycle of 5 back blows and then 5 abdominal thrusts until help arrives or the casualty becomes unconscious.
• If the casualty becomes unconscious, ensure an ambulance has been called and begin CPR immediately. Recheck their airway. Also send for or fetch an Automated External Defibrillator (AED).
• Defibrillators are located:
  • Security Vehicle: ext. 102 or 01753 370102
  • Porters’ Lodge: ext. 104 or 01753 370104
  • Willowbrook Tennis Pavilion
  • Dorney Lake
  • Eton College Health Centre (ECHC)
  • Athens

N.B. If a casualty has been given abdominal thrusts, they must go to hospital as a precaution even if the choking has been resolved. This is because abdominal thrusts could, in some cases, cause internal abdominal damage. If an ambulance is required ECHC must be notified in order that they can update the pupil’s record and provide follow up care.

Symptoms: a break in the surface of the skin, likely bleeding. If the cut or graze involves severe bleeding take the pupil to the Eton College Health Centre immediately or in extreme cases, phone for an ambulance.

Treatment:

• Contact your department’s First Aider who will perform the following:
  • Wearing gloves, clean the wound under running water or with an alcohol-free wipe.
  • Cover the wound completely with a sterile dressing.
  • If possible elevate the wounded area above heart level.

  • Contact the Dame or ECHC. If the Dame is unavailable arrange for an adult or responsible pupil to escort them back to their House or ECHC – an unwell pupil should not be allowed to return to their House on their own.

Symptoms: blood coming from the nose (usually only one nostril is affected unless caused by an injury).

Treatment:

• Sit the pupil down and tilt their head forward to allow the blood to drain from their nostrils.
• Ask the pupil to breathe through their mouth and to pinch the soft part of their nose for 10 minutes.
• Send for the department First Aider.
• Alert the Dame to collect the pupil if necessary (if the Dame is unavailable arrange for an adult or responsible pupil to escort them back to their House or the ECHC – an unwell pupil should not be allowed to return to their House on their own).
• If the bleeding has not stopped after 10 minutes reapply pressure to the nostrils for two further periods of 10 minutes.
• If the nosebleed is severe or lasts longer than 30 minutes contact ECHC.

If a fracture of the neck or back is suspected (one common symptom being pain or `pins and needles’ in the arms or legs), the pupil must on no account be moved in any way until seen by a paramedic or doctor, who may wish to immobilise the neck.

• They should be kept warm.
• Contact the emergency services by dialling 999.
• Contact the pupil’s Dame immediately to alert them to the situation.
• Complete an accident report on Firefly, if required by the end of the day.

If a pupil suffers a serious injury of any description, causing for example prolonged unconsciousness or an obviously broken arm or leg:

• Dial 999 for ambulance.
• They should not be moved (apart from being turned carefully onto their side if unconscious). If a fracture of the neck or back is suspected (one common symptom being pain or `pins and needles’ in the arms or legs), the pupil must on no account be moved in any way until seen by a paramedic or doctor, who may wish to immobilise the neck.
• They should be kept warm.
• Contact the pupil’s Dame to alert them to the situation.
• Complete an accident report on Firefly, if required by the end of the day.