1.4.2R ALLERGIES & ANAPHYLAXIS
Anaphylaxis
Anaphylaxis is a severe allergic reaction which requires immediate treatment to prevent sudden death from suffocation or cardiac arrest. Potential life-threatening allergens include peanuts and other legumes, nut products, shellfish, fish, cow's milk, eggs, insect venom, etc.
School Principals, in conjunction with parents, students and the Public Health Nurse (PHN) will develop "School Plans" when an anaphylactic child is under their care. School plans will include ways of minimizing risk for the anaphylactic child, as well as procedures for dealing with an anaphylactic emergency. These plans will be considered in the context of the anaphylactic child's age and maturity. As children mature, they should be expected to take increasing personal responsibility for avoidance of their specific allergens.
1. Administrative Regulations
Ensure that this checklist is used to develop and implement the school's plan:
The parent(s)/guardian(s) will inform the principal of the student's anaphylactic condition and have the child's physician/specialist complete the "Request for Administration of Medication/Pre-Loaded Auto Injection Epi-Pen at School" form (Appendix A). This form must be updated as required.
An Anaphylaxis Action Plan must be completed and in place prior to a student attending school. Registration forms of Kindergarten and new students will be reviewed and those identified as Anaphylactic will be referred to the Public Health Nurse (PHN) so the Action Plan can be completed prior to the child's attendance at school.
After discussion with parent(s)/guardian(s), and when appropriate, students in the class of the student with anaphylaxis should be given information about allergies and be asked to cooperate with the school's expectations to make the school as safe as possible. This will be followed up with classroom education presented by the Public Health Nurse, when required.
All staff in schools shall receive in-service from the Public Health Nurse, or designated staff, in a timely manner. Procedures will be put in place to educate teachers-on-call, substitute education assistants, secretaries, playground supervisors, custodians, bus drivers and volunteers.
All staff will take reasonable steps which are consistent with school board policy to create as safe as an environment as possible for the student with anaphylaxis outside the classroom.
Parent(s)/guardian(s) will complete a "Request for Administration of Medication/Pre-Loaded Auto Injection an Epi-Pen® at School" form (Appendix A), and provide a current Epi-Pen®, which will e stored according to the Action Plan.
2. Responsibilities of the Principal
Arrange a meeting with the parent(s)/guardian(s) of the student with anaphylaxis (and consult with the PHN, as required) to devise/revise the Anaphylaxis Action Plan, preferably before the first day of school/as soon as practicable.
Ensure that the parent(s)/guardian(s) have completed, signed and updated all necessary forms, that the Anaphylaxis Action Plan is implemented and that all medical information is updated.
Ensure that in-service is provided annually to school personnel and others who are in regular contact with children with anaphylaxis. In-service should focus on how to recognize and treat an anaphylactic reaction, school policies to protect children with anaphylaxis from exposure, and school protocol for responding to emergencies. Provide all school personnel and others with the School Responsibilities Checklist. (School personnel and others include: teachers, teachers-on-call, secretaries, bus drivers, education assistants, custodians, student teachers, noon hour supervisors, crossing guards and volunteers.)
Post anaphylaxis action plans in appropriate classrooms (perhaps in attendance folder), in the staffroom and in the office. (The posting of children's pictures should occur only after consultation with parents.)
Maintain an up-to-date list of emergency contacts and phone numbers.
When appropriate, inform all parents/guardians that an anaphylactic student is attending the school/class and ask for their support.
Ensure that Epi-Pens® are stored in a safe (unlocked) but easily accessible location and that staff has been informed of the Epi-Pen's® location.
Establish safe procedures for field trips and extra-curricular activities.
With teachers, develop a school procedure for reducing risk in classrooms and other common areas.
Set up a meeting with the bus driver and parent(s)/guardian(s) to ensure the driver has been "trained" and that the parent(s)/guardian(s) are knowledgeable of the Action Plan and that questions have been asked and answered. This may be done in conjunction with other pre-arranged meetings or educational sessions.
Ensure that the bus supervisor receives a copy of the student's picture and information as contained in the Action Plan.
Ensure parents are aware of bus safety rules.
If the student with anaphylaxis is on the lunch program, the caterer must be made aware of the allergy. If the caterer cannot ensure allergen-free food then the child should not participate in the lunch program.
3. Responsibilities of the Parent or Guardian of a Student With Anaphylaxis
Inform the school of the child's anaphylactic allergies and make an appointment to meet with the principal, prior to attendance in school.
Meet with the principal to develop an Anaphylactic Action Plan. Issues to be discussed:
- if photos will be displayed in the school
- where medication will be kept
- prevention of exposure in classroom, school bus, on field trips and on playground
- where a designated safe eating area will be in the classroom
Participate in the development of the Anaphylaxis Action Plan.
Provide the school with current Epi-Pen® (2 are recommended). Check expiry date and check for damage or discolouration.
Consider a Medic Alert bracelet for the child, to be worn at all times.
The parent may wish to share information with other parents in the school in consultation with principal.
Teach your child with anaphylaxis:
- to recognize and if possible communicate the first signs of an anaphylactic reaction
- to know where medication is kept - if child is responsible have them carry Epi-Pen® in a fanny pack
- to wear a Medic Alert bracelet at all time
- to eat only food approved from home
- to wash hands before and after eating
- to take as much responsibility for their own safety as possible
Take medication home at end of school year or when the child leaves the school
4. Responsibilities of the Classroom Teacher
Follow all school policies regarding reducing risk for the student with anaphylaxis.
Discuss anaphylaxis in age-appropriate terms, using Public Health Nurse or videos as a resource. The goal is to create a positive and helpful attitude toward the student with anaphylaxis.
Create a positive attitude towards an allergen-safe zone. Education of the classmates will decrease the probability of teasing.
Discourage sharing of foods, drinks, and utensils.
Request that the parents of the student with anaphylaxis provide food for their child when there are special occasions.
Do not use food in crafts.
Reinforce hand washing before and after eating.
Ensure desk and food preparation areas are washed with warm soapy water after eating. (This may become a classroom project and might be completed by students in an effort to maintain a clean and safe classroom environment.)
Leave information in an organized, obvious, accessible format for Teachers-on-Call according to the Anaphylaxis Action Plan.
Ensure the student carries the Epi-Pen® according to Anaphylaxis Action Plan (if student carries an Epi-Pen®).
The Epi-Pen® must be taken on all field trips. Supervisors and drivers are to be made aware of the student with anaphylaxis and appropriate response.
Follow plan developed by principal and parent(s)/guardian(s) to ensure a safe eating environment that does not isolate the child.
5. Responsibilities of the Student with Anaphylaxis
The student should:
- know where the Epi-Pen® is kept
- take as much responsibility as possible to avoid allergens
- eat only food permitted from home
- be responsible for reading food labels (older students)
- wash their hands before and after eating
- know the signs and symptoms of an anaphylactic reaction
- tell an adult as soon as an accidental exposure occurs or symptoms appear
6. Responsibilities of the Parent(s)/Guardian(s) Regarding Bus Transportation
Provide transportation for the student until procedures are in place.
Be aware of bus safety rules and discuss bus safety rules with the student.
Discuss with the student the importance of always sitting in the designated area.
The student is encouraged to wear a Medic Alert bracelet and must carry their Epi-Pen® according to the Anaphylaxis Action Plan.
The student should tell the bus driver (and other students) if having signs of anaphylaxis.
The student should understand that the driver will help give the Epi-Pen® in case of an anaphylactic reaction.
7. Responsibilities of the Bus Driver
Be trained to recognize signs of anaphylaxis and use Epi-Pen®.
Assign a seating area to the student with anaphylaxis near the front of the bus (unless other arrangements are agreed to by parent/guardian and principal).
Be aware of student and if problem occurs, stop vehicle when appropriate.
Observe signs and symptoms and give Epi-Pen® as per Anaphylaxis Action Plan. Note time of injection.
Call and report situation to Central Dispatch and request necessary assistance.
Closely monitor the student and stay with the student until help arrives, unless directed otherwise.
8. Precautions for Teachers Outside the Classroom (Field Trips)
A cell phone, the Anaphylaxis Action Plan and student's Epi-Pen® should be taken on all school outings.
In the event of an anaphylactic reaction give Epi-Pen® and call 911.
All adults accompanying students on a school outing should know who has anaphylaxis and where the Epi-Pen® is kept.
Students must not eat or drink on the bus at any time.
Students should only eat foods approved from their home.
Adopted: 2008.01.16
Reviewed: 2008.05.15
Revised: 2008.03.20, 2008.04.07, 2008.11.20