Procedure

Procedure 9610.2 - Treatment Of Students With A Known Risk Of Anaphylaxis / Life-Threatening Allergies

The Surrey Board of Education is committed to providing a level of care that will ensure the safety and well-being of students with a known risk of anaphylaxis/life- threatening allergies. Given the severe consequences of anaphylaxis, effective training, management and response is very important. It is necessary for parents/guardians, school administrators, staff, students and others to share in these responsibilities, to provide a safe environment in schools along with prompt appropriate response to any crisis that may develop.

While it is impossible to completely eliminate all potential allergens from the school environment, strategies to minimize risk, including identification of individuals at- risk, recognition of symptoms, potential triggers and regulations around emergency response (Anaphylaxis Emergency Plan) are essential to set standards and provide for consistency among all schools and for all students. It should be noted that any food, non-food item (i.e. plant, latex, etc.) or scent could trigger an anaphylactic reaction.

If formal training is deemed necessary, this can be requested of the School Nurses and/or upon referral to Nursing Support Services (NSS). The teaching of the administration of emergency medications is available upon request from the Public Health Nurse/school nurse. Complex training for delegated care is provided by Nursing Support Services. Both services may be contact through the local Public Health Unit.

The board expects staff will be provided training, as appropriate, to recognize symptoms and respond effectively.

1. OBJECTIVE

To provide anaphylaxis policies, procedures and clarity around roles and responsibilities in order to reduce preventable, serious reactions and deaths due to anaphylaxis / life-threatening allergies in schools.

2. ANAPHYLAXIS / LIFE THREATENING ALLERGIES

Specific information regarding policies, procedures and guidelines may be found in the publication entitled Anaphylaxis / Life-threatening Allergies HANDBOOK herein after called the Handbook. It can be accessed electronically on the Hub. School and district personnel are advised to become thoroughly familiar with its contents.

It is the responsibility of the principal to ensure that the school has in place:

An anaphylaxis / life threatening allergic reaction prevention and management plan.
Emergency procedures for responding to anaphylaxis or other life- threatening allergic reactions.

3. DEFINITIONS

3.1.

Anaphylaxis (an-‘uh-fuh’-lak-sis) is a sudden and potentially fatal allergic reaction, requiring immediate medical emergency measures be taken.
Symptoms may include anyof the following, which may appear alone or in any combination, regardless of the triggering allergen:

Itchy eyes, nose, face, body
Flushing/redness/warmth of face and body
Swelling of eyes, face, lips, tongue and throat (throat tightness), trouble Swallowing
Nasal congestion or hay fever-like symptoms (runny itchy nose and watery eyes, sneezing)
Cough, hoarse voice, inability to breathe
Hives/rash
Headache, nausea, pain/cramps, vomiting, diarrhea, uterine cramps in females
Wheezing, shortness of breath, chest pain/tightness
Anxiety, a feeling of foreboding, fear, and apprehension
Weakness and dizziness/light-headedness, pale blue colour, weak pulse, shock
Loss of consciousness, coma

The most dangerous symptoms of an allergic reaction involve:

Breathing difficulties caused by swelling of the airways
A drop in blood pressure indicated by dizziness

3.2.

Epinephrine (EpiPen® auto-injector)
The recommended emergency treatment for a student suffering an anaphylactic reaction is the administration of epinephrine (adrenaline) by an auto-injector (i.e., EpiPen®). The person affected must then be rushed to hospital to receive further medical attention, even if the symptoms decrease with the administration of the epinephrine.
There is a need to ensure the safety of students who suffer from extreme allergies and empower school administrators to respond to their needs consistently but at the same time recognize individual differences from case to case. The following procedure is intended to achieve this end.

4. IDENTIFICATION OF INDIVIDUALS AT-RISK

Early symptoms should never be ignored, because of the unpredictability of reactions, especially if the person has suffered an anaphylactic reaction in the past. Since it is not always possible to identify a child at-risk of anaphylaxis in advance, and because there is recognition that anaphylaxis, asthma and severe allergies are closely connected, it is prudent for school communities to recognize and be prepared to respond to an anaphylactic event, should it occur. (Refer to Appendix A in the Handbook)

5. MANAGEMENT OF THIS MEDICAL CONDITION SHOULD FOLLOW THE THREE “A’S” OF ANAPHYLAXIS:

1. AWARENESS
2. AVOIDANCE
3. ACTION

AWARENESS

The anaphylactic child must be identified to those who have day- to day contact.
Information must be provided on which allergens can cause the reaction.
A treatment protocol must be in place and understood by those interacting with the child.
Students should be taught about the challenges others face, which provides an opportunity to learn understanding, and acceptance.

AVOIDANCE

Avoidance is the key to preventing anaphylaxis.

It is impossible to completely eliminate all potential allergens from the school environment therefore children with allergies need to be vigilant. Strategies to minimize risk include the following:

a)	In cooperation with the other students and their parents designate the child’s classroom/lunchroom/school “allergen aware”.
b)	Encourage good habits of hand washing before and after eating, and clean up after eating.
c)	Where possible, and in coordination with the parent of the anaphylactic child, arrange for the provision of allergen-free food for hot lunches, sports days and other food-related occasions.

As the student matures and enters the secondary school level, the student should be able to assume more responsibility for his or her allergy management.

ACTION

Know how to recognize the symptoms of an anaphylactic reaction and the protocol to follow. This knowledge is critically important as it can be lifesaving.
Know where the child’s EpiPens (adrenalin auto-injector) are located.
Know how to administer the EpiPen at first sign of a reaction (even if the child is capable of self-administering, the severity of symptoms and the stress of the situation require an adult’s help). Ask the school nurse to provide training.
Arrange immediate transport to the hospital and possible re- administration of another EpiPen after 15 minutes.

THERE IS NO DANGER IN REACTING TOO QUICKLY!

The above outline of the Three “A’s” and the need for shared responsibility is a brief introduction to the issues surrounding anaphylaxis. Additional information is available and should be referred to when there is an anaphylactic student at your school. Please refer to the Anaphylaxis/Life Threatening Allergies Handbook.

Revised:	2018-06-20
Approved:	2009-06-25 (formally Policy 9601)
X-Ref:	Form #25900.10