Anaphylaxis is a severe, rapidly progressive allergic reaction that is potentially life-threatening. The most common allergens in school-aged children are peanuts, eggs, tree nuts (e.g. cashews), cow’s milk, fish and shellfish, wheat, soy, sesame, latex, certain insect stings and medication.
The keys to prevention of anaphylaxis in schools is having knowledge of those students who have been diagnosed at risk, awareness of triggers (allergens), and the prevention of exposure to these triggers. The partnership between Reservoir West Primary School and its parents is important in ensuring that certain foods or items are kept away from the student whilst he/she is at school.
Adrenaline given through an EpiPen® autoinjector to the muscle of the outer mid-thigh is the most effective first-aid treatment for anaphylaxis.
PURPOSE
To make, as far as practicable, Reservoir West Primary School a safe and supportive environment in which students at risk of anaphylaxis can participate equally in all aspects of schooling.
To raise awareness about anaphylaxis and the school’s anaphylaxis management policy in the Reservoir West Primary School community.
To engage with parents/carers of students at risk of anaphylaxis in assessing risks, developing risk minimisation strategies and management strategies for the student.
To ensure that each staff member has adequate knowledge about allergies, anaphylaxis and the school’s policy and procedures in response to an anaphylactic reaction.
INDIVIDUAL ANAPHYLAXIS MANAGEMENT PLANS
The Principal/First Aid Co-Ordinator will ensure that an individual management plan is developed, in consultation with the student’s parents, for any student who has been diagnosed by a medical practitioner as being at risk of anaphylaxis.
The individual anaphylaxis management plan will be in place as soon as practicable after the student is enrolled and, where possible, before their first day of school.
The individual anaphylaxis management plan will set out the following:
Information about the diagnosis, including the type of allergy or allergies the student has (based on a diagnosis from a medical practitioner).
Strategies to minimise the risk of exposure to allergens while the student is under the care or supervision of school staff, for in-school and out of school settings including camps and excursions and the OSHC.
The name/s of the person/s responsible for implementing the strategies.
Information on where the student’s medication will be stored.
The student’s emergency contact details.
An emergency procedures plan (ASCIA Action Plan), provided by the parent, that:
sets out the emergency procedures to be taken in the event of an allergic reaction;
is signed by a medical practitioner who was treating the child and includes an up-to-date photograph of the student.
The student’s individual management plan will be reviewed, in consultation with the student’s parents/carers:
annually, and as applicable,
if the student’s condition changes, or
immediately after a student has an anaphylactic reaction at school
It is the responsibility of the parent to:
provide the emergency procedures plan (ASCIA Action Plan).
inform the school if their child’s medical condition changes, and if relevant provide an updated emergency procedures plan (ASCIA Action Plan).
provide an up-to-date photo for the emergency procedures plan (ASCIA Action Plan) when the plan is provided to the school and when it is reviewed.
The Principal/First Aid Co-Ordinator will be responsible for ensuring that a communication plan is developed to provide information to all staff, students and parents about anaphylaxis and the school’s anaphylaxis management policy.
The communication plan will include information about what steps will be taken to respond to an anaphylactic reaction by a student in a classroom, in the school yard, on school excursions, on school camps and special event days.
Volunteers and casual relief staff who may be working with students at risk of anaphylaxis will be informed of such students and informed of their role in responding to an anaphylactic reaction from a student in their care by the Principal or First Aid Co-ordinator.
All staff will be briefed once each term by a staff member who has up-to-date anaphylaxis management training on:
the school’s anaphylaxis management policy
the causes, symptoms and treatment of anaphylaxis
the identities of students diagnosed at risk of anaphylaxis and where their medication is located
how to use an auto adrenaline injecting device
the school’s first aid and emergency response procedures
STAFF TRAINING AND EMERGENCY RESPONSE
Teachers and other school staff who conduct classes which students at risk of anaphylaxis attend, or give instruction to students at risk of anaphylaxis must have up-to-date training in an anaphylaxis management training course.
At other times while the student is under the care or supervision of the school, including excursions, recess and lunchtimes, camps and special event days, the Principal must ensure that there is a sufficient number of staff present who have up-to-date training in an anaphylaxis management training course.
The Principal will identify the school staff to be trained based on a risk assessment. Training will be provided to these staff as soon as practicable after the student enrols.
Wherever possible, training will take place before the student’s first day at school. Where this is not possible, an interim plan will be developed in consultation with the parents.
The school’s first aid procedures and students emergency procedures plan (ASCIA Action Plan) will be followed in responding to an anaphylactic reaction.
The Anaphylaxis Management DVD will be used at staff meetings to raise awareness of anaphylaxis, remind staff of how to use an EpiPen® (autoadrenaline injecting device) and key management strategies to minimize risks in the school environment.
CAMPS
Where a child, who is known to be anaphylactic is attending a school camp the following will occur.
The child’s Epipen, ASCIA Plan and a staff mobile phone will be taken on camp.
All staff and parents/carers attending the excursion will be made aware that the student is anaphylactic.
All staff attending the excursion will be notified of their defined roles and responsibilities if a child suffers an anaphylactic attack while on an excursion.
If able to, the student must carry their own Epipen or Epipen Jnr at all times on the excursion, otherwise it will be carried in the school first aid kit.
If an issue does arise during an excursion, the child’s ASCIA plan will be followed.
When a child who is known to be anaphylactic is attending a school excursion the following will occur.
The child’s Epipen, ASCIA Plan and a staff mobile phone will be taken on camp.
All staff and parents/carers attending the excursion will be made aware that the student is anaphylactic.
All staff attending the excursion will be notified of their defined roles and responsibilities if a child suffers an anaphylactic attack while on an excursion.
If able to, the student must carry their own Epipen or Epipen Jnr at all times on the excursion, otherwise it will be carried in the school first aid kit.
If an issue does arise during an excursion, the child’s ASCIA plan will be followed.
CLASSROOM/SPECIAL SCHOOL EVENTS
A “No Nut” letter will be sent home prior to the activity requesting that no food that the child may be allergic to be brought to school for that activity. The parents of the student involved are to provide a “party pack” for their child.
All staff involved in the activity are to both know where the Epipen or Epipen jnr is located and how to access it, if required.
Food should be avoided in activities and games, unless otherwise checked and consulted with the First Aid Co-Ordinator and the child’s parents/carer.
If an issue does arise during a special school event or in the classroom, the child’s ASCIA plan will be followed.
During all anaphylactic incidents at Reservoir West Primary School the following will occur:
A first aid trained staff member will stay with the child and monitor.
Epipen or Epipen Jnr will be given to the child.
Staff member may be used as crowd control, if required.
The child’s parents/carers will be contacted.
A staff member will wait at the closest entrance for an ambulance to arrive and to guide the ambulance.
A First-Aid trained staff member or Co-Ordinator will accompany the child to hospital, if hospitalization is required.
Allergy:
the immunological process of reaction to something that the body has identified as an allergen. People genetically programmed to make an allergic response will make antibodies to particular allergens.
Allergic reaction:
a reaction to an allergen. Common signs and symptoms include one or more of the following: hives, tingling feeling around the mouth, abdominal pain, vomiting and/or diarrhoea, facial swelling, cough or wheeze, difficulty swallowing or breathing, loss of consciousness or collapse, or cessation of breathing.
Anaphylaxis:
a severe, rapid and potentially fatal allergic reaction that involves the major body systems, particularly lungs or circulation systems.
Anaphylaxis “action plan”:
a medical management plan prepared and signed by a Doctor; it must provide the child’s name and allergies, and clear instructions on treating an anaphylactic episode. An example of this is the Australian Society of Clinical Immunology and Allergy (ASCIA) action plan.
Anaphylactic children:
those children whose allergies have been medically diagnosed, and who are at risk of anaphylaxis.
Anaphylaxis management training:
training provided by a person designated by the Principal which includes recognition of allergic reactions, treatment and practice with an Epipen® trainer. Training should also include strategies for anaphylaxis prevention.
Epipen® kit:
a container, for example an insulated lunch pack. The kit should contain a current Epipen®, a copy of an anaphylaxis action plan, and telephone contact details for the child’s parents/primary care giver, the doctor/medical service and the person to be notified in the event of a reaction if the parent/primary care giver cannot be contacted. The kit should also contain a container (such as a tooth brush holder) to store a used Epipen® until safe disposal can be arranged.
Intolerance:
Often confused with allergy, intolerance indicates that the body is unable to absorb or breakdown nutrients. Lactose intolerance, which is due to a lack of intestinal enzyme, lactase, is an example of non-allergic cow milk tolerance. Lactase digests the milk sugar, lactose. The large quantities of undigested lactose act as a laxative. The immune system is not involved.
MINIMISING THE RISK
Starting school is an exciting time for many families, but for some it can be particularly stressful, especially for those who have children with life-threatening allergies or anaphylaxis. Anaphylaxis is a generalised allergic reaction which often involves more than one body system (e.g. skin, respiratory, gastro-intestinal, cardiovascular).
In previous years we have had students who have been seriously at risk of anaphylactic shock should they swallow a number of different types of food, but particularly peanuts, tree nuts, nut products or egg. Touching such products or even breathing in the fumes can cause a reaction, but is usually a mild to moderate one, not life-threatening.
The school has received advice from a number of sources on the best way to manage severe allergies. They suggest that the safest practice for any child at risk is to make the individual child responsible for, and fully aware that they must not eat any other food other than that provided from home. The school sees the wisdom of this advice for the long-term management of such a health risk. However, we also understand that young children can make mistakes and behave impulsively.
In order to provide a safe environment at school for all children, particularly those at risk from severe food allergies, the school has formalised a management plan. The philosophy behind the plan is to minimise the risk of a severe allergic reaction. Last year notices were been sent home to families with children in the Prep and Grade 1/2 classes requesting that food containing substances dangerous to the child (peanuts and nuts will cause the most severe reaction) not be sent to school in lunches or snacks. Please note – this is not a total ban of such products. We also understand the situation of parents who have children who like to eat peanut butter or Nutella sandwiches. We are simply asking that consideration be given to limiting the number of times such foods are brought to school. This applies not only to the junior grades, but across the whole school. By reducing the presence of such foods in the school, we will be reducing the likelihood of the child coming into contact with them. By working together we can effectively manage such problems. If your child suffers from allergic reactions or has any other health concern, please inform the school.
MANAGEMENT PLAN FOR ALLERGIC REACTION TO PEANUTS OR NUTS
Family alert school of medical condition.
School discusses child’s problem with parent.
School contacts School Nurse, Royal Children’s Hospital or Doctor for advice.
All staff notified. Photograph of student to be placed where necessary. Art teacher to be made aware that some paint may contain by-products that may trigger an anaphylactic reaction and not to use containers that have previously contained allergens.
School Canteen Manager notified. Products containing peanuts or nuts have been removed from canteen menu. Parents of student to provide a list of foods that their child may purchase and to be displayed with photograph in canteen
Family to provide school with Doctor’s Report and Emergency Treatment information – ‘Individualised Management Plan’
Family to provide any medical equipment or medication required for emergency treatment.
Staff alerted to the whereabouts of the equipment and medication.
All staff members to be trained in the use of the medical equipment. Written consent to be provided by parents allowing staff to use EpiPen® or required medication.
School community alerted and requested to minimise the number of times that food containing allergens is brought to school, especially in Grades P-2 and particularly in the particular student’s classroom.
Classroom of student to have information posters displayed in the classroom.
Other students in that particular class who bring along food to which the child is allergic will eat in another classroom. Please note that every effort will be made to ensure that such children will not see this as a punishment, and that there will be number of children shifted, not just the ones with food containing allergens.
Students throughout the school to be educated not to swap or share food. Posters to be placed in all classrooms.
All teachers to train the students in their class to wash hands and table surfaces after eating such food. Posters to be placed in all classrooms about hand and table washing.
Work with parents to educate the student about foods that cannot be eaten eat or touched. Ensure that the student is aware of not accepting food from other children and that this is enforced at home and at school.
