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Anaphylaxis Guidelines

Updated april 2010

Rationale

The College has a Duty of Care to implement practical strategies to minimise the risk of exposure to known allergens within the College environment. The College cannot guarantee a totally allergen free environment. John XXIII College is an "allergy aware" school. The key to prevention of anaphylaxis in schools is knowledge of the student who has been diagnosed as at risk, awareness of allergens, and prevention of exposure to those allergens.

What is anaphylaxis?

Anaphylaxis is a severe and sudden allergic reaction and is potentially life-threatening.

It must be treated as a medical emergency, requiring immediate treatment and urgent medical attention.

Treatment for anaphylaxis

Adrenaline given through an adrenaline autoinjector (such as an Epipen or Anapen) into the muscle of the outer mid thigh is the most effective first aid treatment for anaphylaxis.

It is available in 2 “strengths”: Epipen junior or Anapen junior(suitable for children weighing 10 – 20kg) and Epipen or Anapen(suitable for children weighing more than 20kg).

Role of College

John XXIII College follows recommendations suggested in the Australasian Society of Clinical Immunology and Allergy (ASCIA) Anaphylaxis Training Resources for Educators and Allied Health Professionals and Anaphlyaxis Management Guidelines for Western Australian Schools (from Government of Western Australia)
Staff follow the emergency management for Anaphylaxis as outlined in the ASCIA Anaphylaxis Action Plans.
John XXIII College acknowledges a duty of care to provide a safe and supportive environment which addresses, to the extent possible, reduction of the risks of exposure to known allergens. This includes ensuring that the health care needs of the student are identified and managed at school and during off–site activities eg. Excursions and camps.
Parent/Guardian complete and sign Medical Information on their child/ren at enrolment or as part of regular health updates. It is stated on student information form that if a child requires an adrenaline autoinjector, parent must contact College nurse to complete an Action Plan.
College nurse meets with Parent/guardian to:

Discuss the child’s allergy, reaction, treatment and management.
Parent/Guardian to provide a completed ASCIA Anaphylaxis Action Plan for their child, signed by General Practioner or Immunologist. Signed Action Plans are kept in Health Centre.
Obtain prescribed adrenaline autoinjector for child from parent/guardian. Parent/guardian advised when adrenaline autoinjector is discoloured or expired.
Give parent/guardian Anaphylaxis information package consisting of:

* Permission form for parent to sign allowing pictured action plans be placed in learning area offices(secondary) and primary staff board.
* Medication request form to sign.
* Action plan for doctor to sign
* Allergy awareness information for Parent and child

College nurse meets with student to discuss allergy management at school. Student is given information on allergy management.
Annual professional development provided to staff in anaphylaxis management and administration of adrenaline autoinjector.

Staff first aid courses are conducted each term by Australian Red Cross in order to have an adequate number of staff with current First Aid qualification. In the event of an Anaphylaxis, staff must follow emergency first aid procedures for anaphylaxis management and phone for an ambulance immediately, contact nurse and Contact parents/carers immediately.

Staff informed to check medical information on students available on Maze and on hard copy in Staff room.

pictured Action Plans of students placed in Secondary Learning Area Offices, staff room (primary students only) and primary school duty folders. Review Action Plans annually. The signs of anaphylaxis and steps on how to give an Epipen are detailed on the standard Action Plan from the Australasian Society of Clinical Immunology and Allergy (ASCIA).

Teachers and students are requested to avoid bringing in nuts/nut products to school.

Advise that students with Allergies wear a Medic-Alert bracelet/necklet

Request parents avoid sending in food containing nuts/nut products, seafood to school.

List of anaphylaxis students and ASCIA Action plans placed in all yard duty first aid kits.

Teachers to inform casual/relief teachers of students with anaphylaxis and where adrenaline autoinjectors and action plans situated.

Educate children not to share food, food utensils, drink containers, pens, pencils or any mouth pieces. Encourage hand washing before and after eating.

staff should avoid using food in activities or games, including rewards.

OFF SITE SCHOOL EVENTS(excursions, sport events)

Teachers must collect a first aid kit and generic adrenaline autoinjector for all off site activities
Students must carry their adrenaline autoinjector on them for all off site activities.
Staff contact campsite accomodation providers in advance of any student with food allergies.
Games and activities should not involve use of known allergens.
One or more staff members who have been trained in the recognition of anaphylaxis and the administration of the adrenaline autoinjector should accompany student on camps and excursions. All staff present during camps and excursions need to be aware if there is a student at risk of anaphylaxis.
Mobile phones must be taken on all off site school events.
When planning camps teachers should consult with parent/guardian in advance to discuss issues that may arise, to develop an alternative food menu or request parent/guardian to send a meal (if required)
Staff should develop an emergency procedure that sets out clear roles and responsibilities in the event of an anaphylactic reaction.

OFF SITE SCHOOL EVENTS ( camps )

Adequate staff trained in the recognition of anaphylaxis and the administration of adrenaline autoinjector should be present at camps.
Adequate staff attending camps must have current first aid certificate.
All staff/helpers present at camps need to be aware if there is a student at risk of anaphylaxis.
Staff must have mobile phones. Staff should be aware of what local emergency services are in the area and how to access them.
Class Camp co-ordinator must inform campsite accomodation in advance of what food allergies students have.
Class Camp co-ordinator should develop risk management plan for student at risk of anaphylaxis in consultation with parent/guardian. Discuss need to develop alternative menu or allow student to bring their own meals.
Parent/Guardian must provide adrenaline autoinjector for their child. Student must carry adrenaline autoinjector with them at all times.
Staff still have a duty of care towards the student even if they carry their own adrenaline autoinjector.
Staff must take first aid kit on camps, generic autoinjector placed in each kit with ASCIA Action Plans.
First aid kit must be nearby at all times.
Game and activities on camps should not involve use of known allergens.
As students with nut allergies are attending camp, all students/staff are requested that no snacks/food containing nuts be taken on camp.
Use of other substances containing allergens (eg. soaps, lotions or sunscreens containing nut oils) should be avoided.
Students with allergies to insect venoms should always wear closed shoes when outdoors.
Staff to encourage student with insect venom allergy to apply insect repellent when outdoors.
Bee/wasp nests to be reported immediately to camp manager.

INSECT STINGS

Students to be sent to the nurse immediately in the case of bee, wasp, bull-ant and spider stings/bite.
Staff or student to scrape a bee sting out immediately, do not pull out.
Advise students with insect allergies to wear shoes at all times.

FOOD ALLERGY/CLASSROOM FOOD

Students must be sent to nurse immediately if they may have ingested a known allergen. Rinse mouth out with water immediately.

Staff to be aware that the use of food items in crafts, cooking classes, art and science experiments (eg. milk containers, egg cartons, nutshells, eggshells, peanut paste jars) can be risk items to the allergy child.

Education children not to share food or drink and to be careful when ordering food from canteen.

Request parents to avoid sending in food containing nuts, eggs, seafood with their child/ren.

Liase with parent/guardian about food related activities ahead of time.

Children with severe food allergies should only eat food that has been prepared at home.

Use non-food treats where possible.

Staff must consider the needs of anaphylaxis students before planning class parties, class activities, excursions and camps. Staff to be aware of prevention strategies and ensure that they are implemented.

CANTEEN AND FOOD PRODUCTION DEPARTMENT

Canteen staff and food production department staff are given a list of students with allergies and the foods to which they are allergic.
Canteen staff remove items with known allergen as a listed ingredient. This does not apply to those foods labeled ‘may contain traces of nuts’.
"Allergy Aware" posters are placed in canteen area and food production dept, advising students to be cautious before purchasing food and before handling foods in cooking class.
Inform food preparation personnel about measures necessary to prevent cross contamination during the handling, preparation, storing and serving of food.
Remind food allergie students to be careful when preparing food, if a student is unsure what ingredient is in a food,they should not handle it or taste it.
Ensure tables and surfaces are wiped clean regularly.

ADRENALINE AUTOINJECTOR

Students old enough to understand the administration of adrenaline autoinjector, are requested to carry their epipen on them at all times. It should be carried on the person, not left in school bag, pencil case, locker or similiar.
Staff are still responsible for administration of adrenaline autoinjector as the child may not be able to self administer.
If a student self-administers adrenaline autoinjector, they must immediately alert a staff member who will remain with student and an ambulance must be called.

Inform staff that Generic adrenaline autoinjectors and anaphylaxis action plans are located in unlocked first aid kits in: health centre, student reception, cooking dept, canteen, sport dept, secondary sport first aid kits, secondary mary ward centre, drama department, year 7 department, library, secondary duty first aid kit, primary sport first aid kit, years 1-3 duty first aid kit, years 4-6 duty first aid kit, preprimary, kindergarten, day excursion kits, camp kits.
Adrenaline autoinjectors are checked each term on campus for expiry and discolouration.
Staff informed that there are Epipen trainer pens x 2 permanently placed in the staff room for practice by staff. Anaphylaxis action plans and epipen instructions are attached.
Inform staff each term to check Epipen instruction guide on 'clickview player' on computer.

RESPONSIBILITIES OF PARENT/GUARDIAN

Parent/Guardian complete and sign Medical Information on their child/ren on enrolment and as part of annual Medical Information updates.
Parent/Guardian advised on Medical Information form that if their child has anaphylaxis and has been prescribed with an adrenaline autoinjector, the parent must contact College nurse to discuss management and complete an Action Plan. Parent/Guardian must supply signed Action plan completed by General Practioner or Immunologist.
Parent/Guardian must supply Health Centre with Child's adrenaline autoinjector.
When a child no longer requires an adrenaline autoinjector, Parent must supply written confirmation of this from General Practioner or Immunologist.
Food for the allergic child should be prepared from home. Lunch Boxes and drink bottles should be clearly labelled with child's name.
Teach child not to accept food or drink from others and not to take any risks with their allergy.
Educate child not to share food utensils, pens, pencils or any mouth pieces.
Educate child to wash hands before and after eating.
Parent/Guardian should educate their child to manage his/her allergy and teach them to self-administer their adrenaline autoinjector. This is age appropriate.
Advise parent/guardian that when age appropriate, adrenaline autoinjector should be carried on child, not left in school bag, pencil case, locker or similiar.
Child must have adrenaline autoinjector for all out of school activities eg, sport, excursions, camps etc.
Parent/Guardian must contact staff prior to their child attending College camps to assist in planning and preparation for the student.
When a child with a food allergy in Primary School has a lunch order, parent/guardian are requested to write their food allergy in Red on lunch bag.
Parent/Guardian to replace Adrenaline autoinjector when expired, discoloured or has been used.
It is recommended that your child wear a Medic Alert Bracelet.
Inform College staff of any changes to their child's emergency contact details.
Inform College nurse of any changes to their child's medical condition.
For allergy information and management visit: www.allergy.org.au or www.allergyfacts.org.au

RESPONSIBILITIES OF STUDENT

Students should know the signs and symptoms of an allergic reaction and be familiar with the use of the Adrenaline Autoinjector.
Students should carry their adrenaline autoinjector and ASCIA action plan on them, when age appropriate. It should be carried on the person, not left in school bag, pencil case, locker or similiar.
Adrenaline autoinjector and ASCIA action plan should be with child on all out of school activities, eg. sport
If a student self administers adrenaline autoinjector, they must immediately alert a staff member.
Students must go to nurse immediately in the case of bee/wasp/ant/spider stings. In the case of a bee sting, scrape sting out, do not pull out.
If you have allergies to Bees/Wasps, you must wear closed in shoes at all times. Observe for Bee/Wasp activity around College.
Students to go to nurse immediately if they ingest a known allergen, mouth must be rinsed out with water immediately.
Students must not share food or drink. Students should wash hands before and after eating.
Students advised to be careful when buying food from canteen or participating in class/College food activities. Always check food labels, if unsure what ingredient is in a food, avoid eating it.
Students are advised to inform a teacher, College Counsellor or College nurse should other children communicate any negative comments or behaviour about their allergy.
Students should communicate their allergies to friends.
For allergy information and management visit: www.allergy.org.au or www.allergyfacts.org.au

GENERAL ISSUES

Maintenance staff to do regular inspections for bee/wasp nests around the College.
Students with severe allergies are encouraged to wear a medic alert bracelet.
Teachers should regularly clean bench tops and be aware of the possibility of contaminated surfaces, books equipment or toys that may have been used by other students.
Students who communicate any negative comments or behaviour to a child with allergies or attempt to harm an anaphylactic student with an allergen will be addressed by College Bullying policy.
Students are educated and given information on the "be a Mate" program annually. This is a teaching guide that provides basic information and awareness about food allergies.
"Allergy aware" Posters placed in: canteen, food production dept, primary school classes.
Staff will be debriefed after an Anaphylaxis incident.
ASCIA (Australian Society of Clinical Immunology and Allergy) has on line Anaphylaxis e-training and education for school and childcare staff, the course can also be taken by parents, friends, carers or patients themselves. Go to www.allergy.org.au to complete training.

REFERENCES

Anaphylaxis Management Guidelines for Western Australian Schools - Government of Western Australia 2009

Resources from ASCIA (Australian Society of Clinical Immunology and Allergy) - 2010

Resources from Anaphylaxis Australia Inc - 2008

Student Health Care Advice Paper - from Western Australian Department of Education and Training 2006

Anaphylaxis Guidelines for Schools - from New South Wales Department of Education and Training 2006