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Life-Threatening Allergies

 

Policy:

          "In accordance with applicable law, it is the policy of Orleans Central Supervisory Union to provide all students, through reasonable accommodations where required, the opportunity to participate in all school programs and activities.  Accordingly, school administrators and staff will work proactively with parents to assure that the needs of children with life threatening allergies are taken into consideration in the conduct of education within the supervisory union.  The superintendent will ensure the supervisory union's management plan is reviewed and updated as needed annually."   

    

PROCEDURE: Life-Threatening Allergy Management in School

 

 BACKGROUND:

        Allergic reactions can span a wide range of severity of symptoms. The most severe and potentially life-threatening reaction is anaphylaxis. This procedure is to be used for students who are at risk for anaphylaxis. When a physician assesses that a child’s allergy will result in anaphylaxis, the child’s condition meets the definition of “disability” and may be covered under the Federal Americans with Disability Act (ADA), Section 504 of the Rehabilitation Act of 1973, if the allergy management affects the student’s ability to access education.

         Anaphylaxis refers to a collection of symptoms affecting multiple systems in the body, the most dangerous of which include a compromised respiratory system and shock. Bee / Wasp stings are a common cause of life threatening allergic reactions. Anaphylaxis may be caused by other environmental allergens, such as latex, but are less common. Foods that most commonly cause life-threatening allergic reactions include, but are not limited to, peanuts, tree nuts, shellfish, milk, wheat, soy, fish, and eggs. Anaphylaxis can occur within minutes of ingestion / exposure or can be delayed for hours. Some reactions are “biphasic” in nature with an initial period of symptoms, a symptom free period of 2-3 hours followed by severe shock-like symptoms. At present the only treatments for severe allergies / anaphylaxis are:

  1. Strict avoidance of the allergen(s)

  2. Emergency administration of epinephrine and/or diphenhydramine in the event of exposure, followed by initiation of the EMS response system. Exposure to allergens may occur by ingestion, inhalation, skin contact, bites or stings. 

PARENT / GUARDIAN RESPONSIBILITIES:
  • Inform the school of your child’s allergies prior to school attendance (or as soon as possible after diagnosis). All life-threatening allergies must be verified by the student’s physician/healthcare provider.
  • Provide your child with a medical alert bracelet/necklace.
  • TEACH YOUR CHILD TO:
    • Practice strategies to avoid exposure to allergens:
      • FOODS
        • Wash hands before and after handling food.
        • Read food labels for ingredients.
        • Do not share snacks, lunches, drinks or utensils.
        • Know allergy-safe zones and behaviors.
      • INSECT STINGS AND OTHER ENVIRONMENTAL ALLERGENS
        • Recognize the first symptoms of anaphylaxis.
        • Communicate the appearance of anaphylaxis symptoms to the school nurse, teacher or other trusted adult immediately.
        • Carry his/her epinephrine auto injector (EPIPEN), if appropriate to age, maturity level, and situation.
        • Self-administer epinephrine auto injector.
        • Report allergy-related teasing and/or bullying to a trusted adult.
  • Work with the school to develop and implement appropriate emergency plans, Individual Health Plans, and/or 504 plan(s).
  • Provide current documentation, instructions, and orders from student’s physician/health care provider regarding your child’s life-threatening allergy.
  • Provide properly labeled emergency medication(s) and replace after use or upon expiration.
  • Inform the school of changes in your child’s allergy status, your home, work and cell phone numbers, medical information and emergency contact information.
  • Volunteer to chaperone your child’s field trips when possible.
  • If the life-threatening allergy is a food item, provide “reserve safe snacks” to be kept in your child’s classroom so there is always something your child can choose from during an unplanned special event.
STUDENT RESPONSIBILITIES:
  • Ask the school nurse, your teacher, or another trusted adult in the school to help you if problems arise relating to your life-threatening allergy.
  • For bee/wasp, and environmental allergies:
    • Be aware of possible exposure within your varying environment.
    • Notify staff member if you observe allergens (i.e. ground bees, wasp nest or high concentration of pollens, animal dander, etc.) within the school building or on school grounds.
  • For food allergies:
    • Use proper hand washing (soap, water, friction) before and after eating and throughout the school day.
    • Do not share or trade foods or eating utensils with others. Take responsibility for avoiding food allergens.
    • Do not eat anything with unknown ingredients.
    • Tell an adult immediately if you eat or are exposed to (inhaled, or touched) the food to which you are allergic.
    • Communicate about your life-threatening allergy to others (school staff, teachers, friends).
    • Tell an adult immediately if you are being bullied or harassed about your life-threatening allergy.
    • Make sure you always have access to your emergency medication, whether it is in the nurse’s office, your classroom, your coach has it, you are carrying it, etc.
    • Work towards greater responsibility and independence in managing your life-threatening allergy. Learn how to self-administer emergency medication.
    • Demonstrate maturity and responsibility when carrying your emergency medication.
    • Be aware of your environment and how it relates to your life-threatening allergy.
    • Know and understand your responsibilities for preventing and managing your life threatening allergy. ​

​

SCHOOL ADMINISTRATION RESPONSIBILITIES
 

  • Ensure that all applicable federal laws (including ADA, Section 504, FERPA, and HIPAA), all state laws and district policies/guidelines that apply are followed.

 

  • Ensure that plans (Emergency, IHP, and/or 504) are developed and implemented to provide a safe learning environment for each student with life-threatening allergies.

 

  • Establish an “allergy management team” to include those most likely to respond in an emergency (i.e. nurse, secretary, teachers, principal, etc.) as well as food service and custodial staff.

 

  • Provide training and education for staff members which includes:

    • reducing life-threatening allergy risks and exposure

    • recognizing anaphylaxis symptoms

    • emergency procedures and location of emergency medications

 

  • Respond immediately to reports of students being teased or bullied about their life- threatening allergies.

 

  • Review and evaluate the emergency response/procedures after anaphylaxis has occurred.

 

  • Ensure that OCSU'S Life-Threatening Allergy Management Procedure is available to the community.

 
 
SCHOOL / STAFF NURSE RESPONSIBILITIES 
  • Work with parents, school staff, and student’s physician/health care provider to develop and implement appropriate Emergency, IHP, and/or 504 plans.
  • Maintain school’s access to up-to-date emergency medications
  • Act as liaison between the school and student’s physician/health care provider regarding the  Emergency, IHP, and 504 plans.
  • Maintain and update, at least yearly, the Emergency, IHP, and/or 504 plans, copies of which become part of the student’s school health record.
  • Communicate any changes to stakeholders ASAP.
  • Provide information and training to student and school staff regarding the Emergency plan, IHP, and emergency medication administration as appropriate.
  • Provide necessary information, training and medications as needed for field trips.
  • Respond immediately to reports of students being teased or bullied about their life threatening allergies.
  • Avoid using  latex-containing first-aid supplies in the school.

TEACHERS' RESPONSIBILITIES:

  • Participate in the development and implementation of a student’s Emergency,IHP, and/or 504 plans.

  • Know the signs and symptoms of anaphylaxis. Implement the activities and accommodations cited in the student’s IHP and/or 504 plans, and be prepared to implement the Emergency plan if needed. Click here for an informational pamphlet:

 

  • Become proficient and maintain proficiency in emergency medication administration.

  • Communicate with your students and their parents regarding their cooperation to provide a safe classroom environment.

  • For food allergies:

    • Consider the ramifications of any food use (curriculum, projects or celebrations) within your classroom.

    • Reinforce appropriate classroom hygiene practices/hand washing before and after eating, and no sharing of food or utensils.

  • Respond immediately to reports of students being teased or bullied about their life threatening allergies.

  • Notify the parents and school nurse in advance of any field trips or other situations that might impact a student’s Emergency, IHP, and/or 504 plan(s).

 

FOOD SERVICE RESPONSIBILITIES:

  • Know all foods/ingredients utilized in the kitchen.

  • Know signs & symptoms of anaphylaxis and emergency protocols related to life- threatening allergies.

  • Employ strategies and practices to avoid cross contamination of foods:

    • Allergen-free prep areas in the kitchen

    • Allergen-free tables in the cafeteria

    • Frequent and careful hand washing

    • Use non-latex gloves in food preparation and service.

    • Maintain a current list of students with food allergies.

    • Respond appropriately to all concerns related to food allergies.

    • Respond immediately to reports of students being teased or bullied about their allergies

 

RESPONSIBILITIES OF CUSTODIAL STAFF:

  • Follow current protocols for the cleaning/maintenance of allergen-free tables/areas.

  • Ensure that school campus is free of nests of, or areas attractive to, bees, wasps, hornets, etc.

BUS DRIVERS' RESPONSIBILITIES:

  • Enforce “No Eating or Drinking” policy on the bus.

  • Know signs & symptoms of anaphylaxis and emergency protocols related to life- threatening allergies.

  • Be trained in first aid, CPR and emergency medication administration.

  • Maintain emergency communication devices (e.g., cell phones, two-way radios, etc.) on busses.

  • Respond immediately to reports of students being teased or bullied about their food allergies.

​

 

 

*****​ OTHER IMPORTANT POINTS *****
 

  • Food Bans do not work because we cannot guarantee the content of all food that comes into the school and the concept itself creates a false sense of security.

 

  • A child with life-threatening food allergy should NEVER eat food of undetermined ingredients.

 

  • Hand washing and effective cleaning of all possible surfaces where an allergen has been used is absolutely necessary.

 

  • After School Activities -- The IHP, Emergency, and/or 504 plans will be available for parents to copy and give to others who provide care and/or assume responsibility for their child.

 

  • Special Events / Non-routine Days - The greatest risk for a life-threatening allergic reaction exists when the normal routine is broken.

 

  • Field Trips:

    • Life-threatening allergy risk exposure will be considered in the planning and implementation of field trips.

    • Parents will be invited/encouraged to attend or chaperone.

    • Bag lunches of children with food allergies will be stored separately to minimize cross contamination.

    • Trained staff will attend and ensure that appropriate plans and emergency medications are available at all times

MEDICATIONS:  ​
  • Diphenhydramine (brand name Benadryl), an antihistamine, which comes in many oral forms: tablets, liquids, liquid-gel capsules, and rapid-dissolve strips
  • Epinephrine (brand name EpiPen, EpiPen Jr, Auvi-Q, and Twinject auto injectors), a form of adrenalin, in doses of 0.15mg for those 33-65 lbs and 0.3mg for those > 66 lbs to be injected intramuscularly.                  
  • Auvi-Q are single dose injectors
  • EpiPen/Epipen Jr. are single dose auto injectors which can be packaged singly or doubly to provide one or two doses respectively.
  • EMS will be called in all instances when epinephrine is administered
​
 
​​CARE PLANS  (copies of which will be included in the student’s health record)
  •  An Individual Healthcare Plan (IHP) is developed by the school nurse, student, parents, and other school personnel to identify a student’s individual health needs and specific strategies to meet those needs.
  • Emergency Plan is developed by the school nurse, physician / healthcare provider, parents, student, and other school personnel to outline emergency steps to implement in the event of a life-threatening situation. It includes the physician’s order for emergency medication(s).
  • Section 504 Plan - The intent of Section 504 of the Rehabilitation Act of 1973 is to provide students with disabilities equal access to educational programs, services, and activities. Students with disabilities may not be denied participation in school programs and activities solely on the basis of disability. Whether students with life-threatening allergies are identified under Section 504 as disabled individuals or not, schools within the Orleans Central Supervisory Union will provide those students with IHPs, and Emergency plans to address their health and safety needs.
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