Anaphylaxis Management Guidelines
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- Maude Greene
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1 Anaphylaxis Management Guidelines This statement should be read in conjunction with the Anaphylaxis Guidelines for Victorian Government Schools. BACKGROUND 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 (eg cashews) cow s milk fish and shellfish wheat soy sesame latex certain insect stings certain medication The key to prevention of anaphylaxis in schools is: knowledge of those students who have been diagnosed at risk awareness of triggers (allergens) prevention of exposure to these triggers Partnerships between schools and parents are important in ensuring that certain foods or items are kept away from the student while at school. Adrenaline given through an EpiPen auto injector to the muscle of the outer mid-thigh is the most effective first aid treatment for anaphylaxis. PURPOSE To provide, as far as practicable, a safe and supportive environment in which students at risk of anaphylaxis can participate equally in all aspects of the student s schooling. To raise awareness about anaphylaxis and the school s anaphylaxis management policy in the 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 responding to an anaphylactic reaction. ANAPHYLAXIS MANGEMENT PLANS The principal will ensure that an individual anaphylaxis 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. 1
2 The individual anaphylaxis management plan will be in place as soon as practicable after the student enrols and where possible before their first day of school. Individual Anaphylaxis Management Plans 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 The name 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 Anaphylaxis Management Plans must 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 Ensure that the emergency procedures plan (ASCIA Action Plan) is signed by the medical practitioner responsible for developing the Action Plan. Individual Anaphylaxis Action Plan must be located in the container with Epipen and other medication. See Appendix 1 for St Patrick s School Individual Anaphylaxis Management Plan Template. See Appendix 2 for St Patrick s School Anaphylaxis Action Plan Template. Communication Plan The principal or nominee 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. 2
3 Communication Plan Reaction Classroom Response Severe Reaction 1. Anaphylaxis trained teacher to administer student s Epipen (located on the door in the LC5 classroom). 2. Call ambulance using the classroom telephone. 3. Phone school office to request parents/emergency contact be notified and to ask for help to remove other students from the classroom. 4. Administration Officer to also bring student s spare Epipen from the Sickbay to the classroom if needed. 5. Administration Officer to direct ambulance to appropriate classroom on arrival. Reaction School Yard Response Severe Reaction 1. Yard duty teacher to remain with the student at all times. 2. Yard duty teacher or LSO to administer Epipen from the Red tapped bumbag. 3. Yard duty teacher to send two responsible students to the school office with the Red Severe Anaphylaxis Card. 4. Administration Officer to call the Ambulance immediately. 5. Administration Officer to take second Epipen to the yard duty teacher. 6. Administration Officer to contact parents/emergency contact. 7. Administration Officer to direct ambulance officers to student s location in the yard. Reaction Excursion Response Prior to leaving for an excursion parents will be asked to provide a 2 nd Epipen for the child to take on the excursion. 1. Supervising teacher is to ensure that the student s Epipen is taken on the excursion. 2. Supervising teacher is to carry the student s Epipen with them at all times. 3
4 3. If students are to be separated into small groups on the excursion, the child with anaphylaxis must stay with the supervising teacher or anaphylaxis trained staff member. Severe Reaction 1. Supervising teacher to administer student s Epipen. 2. Call the ambulance. 3. Contact parents/emergency contact by mobile phone. Reaction School Camp Response Prior to leaving for an camp, parents will be asked to provide a 2 nd Epipen for the child to take on the camp. 1. Supervising teacher is to ensure that the student s Epipen is taken on the camp. 2. Supervising teacher is to carry the student s Epipen with them at all times. 3. If students are to be separated into small groups on the camp, the child with anaphylaxis must stay with the supervising teacher or anaphylaxis trained staff member. 4. Student is to be located in a room or cabin closest to the anaphylaxis trained supervising staff member. Severe Reaction 1. Supervising teacher to administer student s Epipen. 2. Call the ambulance. 3. Contact parents/emergency contact by mobile phone. Casual Relief Staff During induction all casual relief staff will be made aware of anaphylaxis students Management and Action Plans located on the staffroom wall. Casual relief staff are expected to check the Emergency Teacher folder located on the wall inside the door of each classroom prior to beginning teaching. The folder contains general information, including information about students with medical needs specific to that classroom. Medical action plans are also displayed clearly on the cupboard door in the classroom. Casual relief staff are expected to familiarise themselves with these. In the case of a casual relief teacher taking children offsite for any reason, an anaphylaxis trained Learning Support Officer will accompany the class. 4
5 Volunteers It is the responsibility of the classroom teacher to inform any volunteers of students with anaphylaxis in their classroom. Staff Training The Principal will ensure that all staff will be briefed twice yearly in anaphylaxis management. Once every three years staff will complete a course in First Aid Management of Anaphylaxis 22099VIC conducted by a qualified instructor. A Refresher course in Anaphylaxis Management will be required of all staff annually. These are also conducted by a qualified instructor. The Principal or nominee who has up to date anaphylaxis management training will brief all staff annually 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. An anaphylaxis presentation and video presentation is available on: FUSE@ Communication to Parents Our Anaphylaxis Guidelines and procedures will be made available to parents via our website. Prevention Strategies The classroom teacher and/or other supervising teachers are responsible for the following: Keep a copy of the student s ASCIA Action Plan in the classroom displayed near the bumbag. Liaise with parents/carers about food related activities ahead of time Use non-food treats where possible, but if food treats are used in class, it is recommended that parents/carers provide a treat box with alternative treats. Treat boxes should be clearly labelled and only handled by the student Never give food from outside sources to a student who is at risk of anaphylaxis Be aware of the possibility of hidden allergens in cooking, food technology, science and art classes (e.g. egg or milk cartons) Have regular discussions with students about the importance of washing hands, eating their own food and not sharing food Storage and Accessibility of Epipens 5
6 Children diagnosed as being at risk of anaphylaxis are prescribed adrenaline in an auto-injector commonly known as the EpiPen. The EpiPen and EpiPen Junior are designed so that anyone can use them in an emergency. If a student has been prescribed an EpiPen, the EpiPen must be provided by the student s parent/carers to the school. EpiPens are stored correctly and accessed quickly. Remember that in some cases, exposure to an allergen can lead to an anaphylactic reaction in as little as five minutes. Epipens are stored in an unlocked, easily accessible place away from direct heat. EpiPens are clearly labelled with the student s name. A copy of the student s ASCIA Action Plan is kept with the EpiPen. Each student s EpiPen should be distinguishable from other students EpiPens and medications. All staff know where the EpiPen is located. Make sure the EpiPen is not cloudy or out of date (EpiPens should last for at least 12 months and will have an expiry date printed on them. It is the parents responsibility to supply their child s EpiPen to the school and to replace it before it expires.) The Principal or nominee should regularly check the EpiPens, At least a month before its expiry date, the designated school staff member should contact the student s parents to replace the EpiPen. 6
7 Appendix 1 Individual Anaphylaxis Management Plan This plan is to be completed by the principal or nominee on the basis of information from the student s medical practitioner (ASCIA Action Plan for Anaphylaxis) provided by the parent/carer. It is the parents /carers responsibility to provide the school with a copy of the student s ASCIA Action Plan for Anaphylaxis containing the emergency procedures plan (signed by the student s medical practitioner) and an up-to-date photo of the student to be appended to this plan; and to inform the school if their child s medical condition changes. School Student s name Date of birth Severely allergic to Other health conditions Medication at school Emergency contacts parent/carer Parent/Carer (1) Name Relationship Home Phone Work Phone Mobile Address Phone Year level Parent/Carer (2) (if available) Name Relationship Home Phone Work Phone Mobile Address Other emergency contacts if parent/carer not available Other contact (1) Name Relationship Home Phone Work Phone Mobile Address Other contact (2) (if available) Name Relationship Home Phone Work Phone Mobile Address Medical practitioner contact Name Phone Emergency care to be provided Storage for adrenaline autoinjector (device specific) (ie EpiPen/Anapen) 7
8 Environment To be completed by principal or nominee. Please consider each environment/area (on and off school site) the student will be in for the term, eg classroom, canteen, food tech room, sports oval, excursions and camps etc. Risk identified Actions required to minimise risk Who is responsible? Completion date? Risk identified Actions required to minimise risk Who is responsible? Completion date? Risk identified Actions required to minimise risk Who is responsible? Completion date? Risk identified Actions required to minimise risk Who is esponsible? Completion date? Risk identified Actions required to minimise risk Who is esponsible? Completion date? 8
9 Appendix 2 9
10 Strategies to Avoid Allergies St Patrick s Primary School has developed a Strategies to Avoid Allergens that is reviewed annually. This should be kept in classroom & distributed to the broader school community. Risk Strategy Who? Minimising risk Food allergies: Sharing lunches Regular discussions with relevant classes about the importance of eating your own food and not sharing Class has lunch in specified area which is a focus of supervision Encourage parent of child to be involved on special days that involve food Principal / teacher Class parties Advise parent of the student at risk of food allergies ahead of time so that they can provide suitable food Food for allergic student should only be approved and provided by the student s parent Consider non-food rewards Cupcakes, as replacement for a piece of birthday cake, can be stored in identifiable container (labelled with child s details) in a freezer Class activities Insect bite allergies Grassed and garden areas Be aware that craft items can be risk items e.g. egg cartons, milk containers, peanut butter jars Specify play areas that are lowest risk to the student and encourage the student and his or her peers to play in this area Decrease number of plants in school grounds that attract bees Ensure allergic students wear shoes at all times When using isolation as part of discipline ensure not to stand student next to flowering plants Principal Medication allergies Students taking other students medication brought from home without staff knowledge Latex allergies Inform school community of policy about administration of medications Monitor implementation of policy to minimise students bringing unauthorised medications Educate student and peers about medication allergies and the importance of taking medication prescribed only for them Encourage affected students to wear medic alert bracelet or necklace Implement effective procedures for administering prescribed medications at school Avoid use of party balloons Avoid contact with swimming caps and latex gloves Principal Principal Staff member Principal / staff Sport teacher 10
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