Allergy Policy Anaphylaxis (Severe Allergic Reactions)

Transcription

1 Allergy Policy Anaphylaxis (Severe Allergic Reactions) Relevant Legislation Workplace Health and Safety Act 1995; Education and Care Services National Law 2011 Commencement Date May 2012 Review Date Feb Purpose The purpose of this policy is to minimise the risks associated with allergies, in particular anaphylaxis through implementing strategies to improve knowledge, awareness and planning. 2. Scope This policy is applicable when there are students enrolled in the School and its associated services who might suffer an anaphylactic reaction on the ingestion of, or contact with, certain products most notably edible nuts (peanuts, hazelnuts, cashews, almonds) or nut products, eggs, cow s milk, wheat, soybean, fish & shellfish etc). Other common allergens include some insect stings, particularly bee stings, some medications, latex and anaesthesia. 3. Objectives The Hutchins School is committed to: Providing, as far as reasonably practicable, a safe and supportive environment in which students at risk of anaphylaxis can participate equally in all activities; Improving knowledge and raising awareness about anaphylaxis and the School s Allergy Policy within the Hutchins community; Engaging with parents/carer of children at risk of anaphylaxis in assessing risks and developing risk minimisation strategies for the child. ~ Page 1 of 12 ~

2 4. Definitions Allergy 1 An allergy is a general term that describes an abnormal immune response to a usually harmless substance. Anaphylaxis 2 Anaphylaxis is the most severe form of allergic reaction and is potentially life threatening. Anaphylaxis occurs after exposure to an allergen (usually to foods, insect stings, or medicines) to which a person is already extremely sensitive. It results in potentially life threatening symptoms which include: Symptoms/signs include: Difficulty/noisy breathing Loss of consciousness Swelling of tongue and/or collapse Swelling/tightness in throat Difficulty talking and/or Pale and floppy (in young children) hoarse voice Anapen 3 An Anapen is a single use automatic injecting device that delivers a measured dose of adrenaline. There are two types of Anapen: Anapen Jnr for children weighing 10 20kgs Anapen for children and adults over 20kgsNote: An Anapen and EpiPen are both used in the treatment of anaphylaxis. The Pens are similar but staff should familiarise themselves with the operation of both. EpiPen 4 An EpiPen is a single use automatic injecting device that delivers a measured dose of adrenaline. There are two types of EpiPen: EpiPen Jnr for children weighing 10 20kgs (green) EpiPen for children and adults over 20kgs (yellow) 1 The Asthma Foundation of Victoria Australasian Society of Clinical Immunology and Allergy 2010 Anaphylaxis allergy/anaphylaxis 3 AnaAlert at risk_about anapen_education.php 4 The Asthma Foundation of Victoria 2007 ~ Page 2 of 12 ~

3 First Aid The provision of emergency treatment and life support for people suffering injury or illness. Synergetic A database used by The Hutchins School to record information such as student contact details, emergency contact details and medical alerts. 5. Policy Information General Policy Statements Students who have been diagnosed as being potentially anaphylactic in response to any allergen or circumstance must be identified at the time of enrolment. The School requires documented evidence of this from a physician, generally in the form of an allergy/anaphylaxis action plan. The School will retain an action plan provided by parents or carers for each student who has been diagnosed as having the potential to suffer an anaphylactic reaction. The action plan should be developed in accordance with the guidelines established by the Australasian Society of Clinical Immunology and Allergy (ASCIA). Parents or carers are responsible for supplying a copy of the action plan to the school and keeping the action plan up to date. Parents of students who have been diagnosed as having the potential to suffer an anaphylactic reaction in the Early Learning Centre (ELC) and Junior School, are encouraged to supply food that has been prepared in their home to further reduce the risk of anaphylaxis. Action Plan Parents/carers are responsible and required to provide anaphylaxis/allergy action plans and updates of such plans to the School. Action plans provided by parents, will be stored in Synergetic. Action plans should also be displayed at the Junior School reception, Junior/Middle School staff room; Senior School staff room; Boarding House Office, and in the relevant areas within the Children s Services. In the Early Learning Centre, Anaphylaxis Alert Lists and Epipens are stored in the Sick Bay, which is immediately adjacent to the playground area, and available at all times to all staff. In the Junior School a belted bag containing an abbreviated Anaphylaxis Alert List and EpiPen(s) will be carried by a teacher on playground duty before school, at recess and at lunchtime. ~ Page 3 of 12 ~

4 In the Middle and Senior Schools students who are anaphylactic are required to carry their own response provisions as specified in their action plan. Non Submission of Action Plan/student information health summary or updates to the latter The Hutchins School will send out student health summaries annually requesting parents or carers to review the health summaries and provide any updates to the School. The School will also place reminders to parents /carers about providing up to date student health information to the School in communiqués/newsletters. Non submission of an Action Plan may result in students being excluded from certain programs/activities, for example wilderness programs, interstate and international tours. General requirements The following general requirements shall apply in situations where a severe allergen exposure risk applies: 1. Students with food related allergies must be carefully instructed by their parents not to share food, exchange food or touch other people s food. It is suggested that ELC and Junior School students with food related allergies only eat food that has been prepared in their home or supplied by their parents/carers (and kept by the School) for their child s personal use on special occasions (e.g. birthdays etc). Generally speaking *, Middle and Senior School students with food related allergies are expected to observe this requirement themselves, though staff should remain alert to their needs. (* May be subject to the student s capacity to reliably follow instructions, for instance the student s maturity or intellectual capability. Where required this should be addressed in the student s action plan). 2. When going on excursions or tours, the teacher(s) in charge will include in their risk assessment of activities risk minimisation strategies when there are students that have been identified as anaphylactic. The risk assessment will involve: a) identification of any students within that group who have been diagnosed as being potentially anaphylactic in response to any allergen or circumstance; b) where it is identified that an at risk student is involved, a review of the student s action plan; and c) assess the risk and identify the appropriate risk management controls to be put in place using the hierarchy of hazard control (elimination, substitution, isolation, engineering, administrative or Personal Protective Equipment). ~ Page 4 of 12 ~

5 Every effort must be made to allow at risk students to participate safely in the activity. In limited circumstances, however, this may not be possible to achieve. Where that is the case alternative activities for the student concerned should be considered. The School will liaise with external service providers (e.g. camps, excursions, tours etc) attended by students identified as being anaphylactic (action plan supplied by parent/carer) and take reasonably practicable steps to minimise the risk for these students. Teaching staff should refer the Activity Risk Assessment Proforma and contact the Safety, Health and Risk Manager where further assistance is required. Minimising the Possibility of Exposure to Potential Allergens Nuts Exposure to edible nuts and edible nut products remains the most significant risk in relation to anaphylactic reactions 5. The School has taken the following precautions with regard to edible nut products at school. These precautions are to be clearly and regularly communicated to parents, carers and staff: 1. Food brought into the School from home must not contain nuts (peanuts or tree nuts). This includes packets of nuts and products such as peanut butter, Nutella, muesli bars or chocolate bars containing nuts. This policy applies in all situations and covers school lunches, birthday cakes etc. brought in by students as well as food provided by parents for fete days, cake stands etc. This policy does not include food labelled may contain traces of nuts where nuts are not an ingredient, for example a chocolate bar. 2. Agreement has been reached with the School s catering contractor that all reasonable and practicable steps will be taken to ensure food sold from the canteens will not contain nuts in line with the above paragraph. Where contract caterers are involved in the preparation of other meals for the student community the same requirements apply. 3. Peanut butter, Nutella, foods that contain nuts or may contain traces of nuts may be consumed at school by staff or visitors, but only in Staff Only areas, such as the staff room. 5 The Australasian Society of Clinical Immunology and Allergy, 2010, ASCIA Guidelines for Prevention of Food Anaphylactic Reactions in Schools, Presschools and Childcare ~ Page 5 of 12 ~

6 Adults who have consumed such products must ensure that they wash their hands before being in the company of students. Response to anaphylactic reaction On recognition of an anaphylactic reaction members of staff are to: call 000 and request an ambulance, and provide appropriate first aid assistance (in the Junior School, and potentially in other circumstances, this involves providing the student with the appropriate medication according to the student s action plan. This may include providing assistance with oral medication or the injection of the student in the thigh with an Anapen/EpiPen in the prescribed way); place the student in the recovery position and monitor vital signs; call the relevant school office and/or Matron/Head of School or staff room for assistance; contact or request the relevant Head of School to phone the student s parents; and as soon as practicable, contact the Safety, Health and Risk Manager and complete an Injury and Incident Report Form. Note: within Children s Services, the Nominated Supervisor must be notified as soon as practicable. Issuing and Maintenance of EpiPens/Anapens Parents are responsible for the purchase, supply and maintenance of EpiPens/Anapens for their children. Parents are also responsible for replacing EpiPens/Anapens prior to their expiry date. To ensure the safety and health of students with anaphylaxis, The Hutchins School requires that where prescribed by a doctor and /or noted on an anaphylaxis action plan, parents/carers of the student at risk must supply an EpiPen/Anapen for their child whist at School. A student will not be permitted to attend school when an EpiPen/Anapen has not been supplied in accordance with the above. As part of The Hutchins School s allergy risk management strategies, a number of back up EpiPens have been purchased. Matron will conduct routine inspection of first aid kits and will review the expiry date and condition of back up EpiPens purchased by the school. All student EpiPens/Anapens are to be sent home at the end of the school year. Parents are responsible for providing an updated (where necessary) EpiPen/Anapen prior to school commencing each year (i.e. PD week). ~ Page 6 of 12 ~

7 Storage of EpiPens/Anapens EpiPens/Anapens should be stored in accordance with the manufacturer s instructions. EpiPens/Anapens should be stored in an unlocked, easily accessible place away from direct heat. They should not be stored in the refrigerator or freezer. EpiPens/Anapens issued by parents/carers are to be labelled with the student s name. Back up EpiPens purchased by the school are to be labelled Back up EpiPen1, Back up EpiPen2 etc and recorded in the first aid register. Where a student is not able to carry their pen with them, student EpiPens/Anapens are to be stored at the following locations. School Area ELC Junior School Middle School Location ELC First Aid Room Junior School Reception Students are expected to carry their own EpiPen/Anapen. Where special cases arise, a central storage area will be determined. Senior School Students are expected to carry their own EpiPen/Anapen. Where special cases arise, a central storage area will be determined. Boarding House Director of Boarding Office Back up EpiPens (purchased by the school) are to be stored in the following locations School Area ELC Junior School First Aid Room Senior School Outdoor Education The Lodge Location Duty bum bag ELC Staffroom Duty bum bag Junior School Reception First Aid Room Senior School Senior School Staff Lunch Room Director of Outdoor Education Office Art Teacher s Office ~ Page 7 of 12 ~

8 Disposal of used EpiPens/Anapens After use, store the pen in a container with hard plastic sides and a sealable lid for example an ice cream container. The EpiPen/Anapen should be taken to hospital with the child and be disposed of in a hospital sharps bin. Post Incident Support It is acknowledged that anaphylactic reactions can be very traumatic experience for the student, others witnessing the reaction and parents/carers. Post incident support in the form of counselling will be provided by the School Counsellor to affected students and staff, if required. A post incident review shall be undertaken by the Safety, Health and Risk Manager to ensure the effectiveness of the procedures and response. The post incident review should include: a) EpiPen/Anapen to be replaced prior to student returning to School. b) Student Anaphylaxis Action Plan reviewed with student, parents and medical practitioner. c) Review of emergency response; amendments to procedures, training etc where necessary. Education, Training & Awareness All members of staff, must receive training in the recognition of and first aid for anaphylaxis, including the injection of adrenalin with an EpiPen or AnaPen. Generally, at the commencement of each school year (or at any other time where it is considered necessary such as the arrival of a new anaphylactic student or newly employed teacher) teaching staff (other than relief staff) will be briefed on the action plans for each anaphylactic student in the section of the School in which they teach. Relief teachers will be provided with a relief teacher s folder in the ELC and Junior School. A print out of anaphylactic students will be attached to the supervision form in the Middle and Senior Schools. The awareness of anaphylaxis is to be discussed at staff meetings and during Professional Development sessions. ~ Page 8 of 12 ~

9 Refresher Training As a general rule, refresher training should be conducted every two years. Staff are encouraged to complete the ASCIA Anaphylaxis e training course, refer to 6. Supporting Procedures and/or Guidelines Nil 7. Related External Documents Nil 8. Record Keeping This policy is to be kept for two (2) years until review unless there is a significant legislative, organisational change or an anaphylaxis incident requiring earlier review. Parents/carer are encouraged to review Anaphylaxis Management Plans on a regular basis, as a suggestion annually. The Hutchins School will send a letter to parents requesting review and provision of any updated information on an annual basis. The master copy is kept on SharePoint (Policies) and is read only in PDF form. All printed copies are uncontrolled. ~ Page 9 of 12 ~

10 Record Keeping Schedule Record/document Location Person Responsible Student Action Plans including supporting documents from medical practitioner Student information & health summary (sent annually) First Aid Kit & Back up Epi Pen register Back up EpiPen renewal compliance First Aid and Anaphylaxis Training Records Completed Injury & Incident Report Forms Relief teacher information Synergetic Doc Man Section Synergetic SharePoint OH&S Enterprise Risk Manager Synergetic staff profiles Enterprise Risk Manager Hard Copy OH&S Office Information obtained from Synergetic Debtors Administrator Debtors Administrator Matron / Safety, Health and Risk Manager Safety, Health and Risk Manager Academic Assistant (MS & SS) Junior School Academic Secretary (ELC & JS) Safety, Health and Risk Manager Junior School Academic Secretary (ELC & JS) Assistant to the Deputy Headmaster (MS & SS) 9. Policy Owner Headmaster 10. Attachments Sample Action Plan for Anaphylaxis developed by ASCIA ~ Page 10 of 12 ~

11 References Australasian Society of Clinical Immunology and Allergy 2010 Anaphylaxis allergy/anaphylaxis Australasian Society of Clinical Immunology and Allergy (ASCIA), 2010, ASCIA Guidelines for Prevention of Food Anaphylactic Reactions in Schools, Presschools and Childcare, viewed February AnaAlert People at Risk, Viewed 7 March 2012, at risk_aboutanapen_education.php Department of Education Requirements for schools having an enrolled student with anaphylaxis nts for schools having an enrolled student with anaphylaxis Education and Care Services National Regulations Part 4.2, Children s Health and Safety, Division 4, Administration of Medication, parts ons.pdf Council of Australian Governments. National Quality Standard for Early Childhood Education and Care and School Aged Care, Quality Area 2 (2.1.1: Each Child s Health Needs are Supported). State Government of Victoria Department of Education and Training Anaphylaxis Guidelines A resource for managing severe allergies in Victorian government schools. Viewed 9 February v1.01b.pdf The Asthma Foundation of Victoria, 2007, Anaphylaxis Awareness Booklet. Further resources Anaphylaxis Australia Australasian Society of Clinical Immunology and Allergy (ASCIA) ~ Page 11 of 12 ~

12 Royal Children s Hospital About Anapen (training video) at risk_about anapen_education.php For further advice or guidance on conducting risk assessments staff may contact: Darryl White (Safety, Health and Risk Manager) on Ext 314 Todd Blackhall (Director Outdoor Education) on Ext 279 ~ Page 12 of 12 ~

13 Action plan for Anaphylaxis Name: Date of birth: Photo for use with EpiPen or Epipen Jr adrenaline autoinjectors (with blue safety release and orange needle end) mild to moderate Allergic reaction swelling of lips, face, eyes hives or welts tingling mouth abdominal pain, vomiting (these are signs of a severe allergic reaction to insects) ACTION Confirmed allergens: Family/emergency contact name(s): Work Ph: Home Ph: Mobile Ph: Plan prepared by: Dr Signed Date: How to give EpiPen or EpiPen Jr 1 Form fist around EpiPen and pull off BLUE SAFETY RELEASE. Push down hard until a click is heard or felt and hold in place for 10 seconds Place ORANGE end against outer mid-thigh (with or without clothing). Remove EpiPen. Massage injection site for 10 seconds. ASCIA This plan was developed by ASCIA For insect allergy, flick out sting if visible. Do not remove ticks Stay with person and call for help Give medications (if prescribed)... Dose:... Locate EpiPen or EpiPen Jr Contact family/emergency contact a n a p h y l a x i s ( s e v e r e A l l e r g i c r e a c t i o n ) difficult/noisy breathing swelling of tongue swelling/tightness in throat difficulty talking and/or hoarse voice wheeze or persistent cough persistent dizziness or collapse pale and floppy (young children) ACTION Watch for any one of the following signs of Anaphylaxis 1 Lay person flat, do not stand or walk. If breathing is difficult allow to sit 2 Give EpiPen or EpiPen Jr 3 Phone ambulance*- 000 (AU), 111 (NZ), 112 (mobile) 4 Contact family/emergency contact 5 Further adrenaline doses may be given if no response after 5 minutes (if another adrenaline autoinjector is available) If in doubt, give EpiPen or EpiPen Jr EpiPen Jr is generally prescribed for children aged 1-5 years. *Medical observation in hospital for at least 4 hours is recommended after anaphylaxis. Additional information