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Food allergy: School policies Ruchi S. Gupta, MD, MPH Associate Professor of Pediatrics Ann & Robert H. Lurie Children’s Hospital of Chicago Northwestern.

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Presentation on theme: "Food allergy: School policies Ruchi S. Gupta, MD, MPH Associate Professor of Pediatrics Ann & Robert H. Lurie Children’s Hospital of Chicago Northwestern."— Presentation transcript:

1 Food allergy: School policies Ruchi S. Gupta, MD, MPH Associate Professor of Pediatrics Ann & Robert H. Lurie Children’s Hospital of Chicago Northwestern University Feinberg School of Medicine Facts Policies: CPS Other States Policy Recommendations

2 Basic facts of food allergy Food allergy is an overreaction of the immune system to a food Even a miniscule amount of food may cause a reaction –By rubbing nose, eyes or skin, or putting fingers in mouth –Cross contamination/hidden allergens Fatal reactions can occur –regardless of severity of previous reactions –in spite of perceived allergen avoidance and treatment Current treatment is limited to –avoidance of the food –prompt treatment with epinephrine FACTS Policies: CPS Other States Policy Recommendations

3 Basic facts of food allergy Common allergens PeanutTree nut Shellfish Fish MilkEgg Soy Wheat FACTS Policies: CPS Other States Policy Recommendations

4 8% of children have food allergy –Approximately 2 children per classroom Nearly 40% have had a life-threatening reaction Nearly 1 in 5 have had a reaction in school 1 in 4 first-time allergic reactions occur in school Sources:Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, Holl JL. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics 2011; 128:e9-17. Mcintyre CL, Sheetz AH, Carroll CR, Young MC. Administration of epinephrine for life-threatening allergic reactions in school settings. Pediatrics 2005; 116(5): Basic facts of food allergy Statistics in school FACTS Policies: CPS Other States Policy Recommendations

5 Over 3,500 CPS students Have documented food allergies. Food Allergy Management Policy was approved in January 2011 and went into effect immediately with the following mandates: Annual parent request for diagnosis (Student Medical Information Form) IEPs/504 Plans required for all students with documented food allergies Facts Other States POLICIES: CPS CPS policies Food Allergy Management Policy Policy Recommendations

6 Student Medical Information Form Sent home annually for all students Initiates process of health condition identification and follow up

7 Per the Attorney General’s Office and CPS the purpose and approved use of the District Issued Epi-Pens are: 1. Self-Administration of an epinephrine auto-injector by a student with a known allergy who has forgotten his or her auto- injector or it is otherwise unavailable Section 22-30(f) of the Illinois School Code authorizes school districts and nonpublic schools to provide a student with an epinephrine auto-injector for self-administration, provided the supplied auto-injector meets the student’s personal prescription on file with the school. 105 ILCS 5/22 ‑ 30(f). Facts Other States POLICIES: CPS CPS policies Administration of Medication Policy Policy Recommendations

8 2. Administration of an epinephrine auto-injector to a student with a known allergy Section 22-30(f) of the Illinois School Code permits “…any personnel authorized under a student's Individual Health Care Action Plan, Illinois Food Allergy Emergency Action Plan and Treatment Authorization Form, or plan pursuant to Section 504 of the federal Rehabilitation Act of 1973 to administer an epinephrine auto ‑ injector to the student [having an anaphylactic reaction], that meets the [student’s] prescription on file.” 105 ILCS 5/22 ‑ 30(f). Facts Other States POLICIES: CPS CPS policies Administration of Medication Policy Policy Recommendations

9 3. Administration of an epinephrine auto-injector to a student, with an unknown allergy, having a first-time anaphylactic reaction “When a student does not have an epinephrine auto ‑ injector or a prescription for an epinephrine auto ‑ injector on file, [Section 22-30(f) of the Illinois School Code provides that] the school nurse may utilize the school district or nonpublic school supply of epinephrine auto ‑ injectors to respond to anaphylactic reaction, under a standing protocol from a physician licensed to practice medicine in all its branches and the requirements of this Section.” 105 ILCS 5/22 ‑ 30(f). Facts Other States POLICIES: CPS CPS policies Administration of Medication Policy Policy Recommendations

10 2-4 Epi-Pens® made available to schools on the first week of class. Epi-Pens® bar coded and assigned to schools for tracking purposes. School Nurse will coordinate the storage & access of the Epi-Pens®. Office of Student Health & Wellness launched an educational campaign to educate parents/guardians, schools, and providers on what this initiative will mean to them. Before or shortly after the use of an Epi-Pen® or any epinephrine auto-injector, 911 must be called immediately to address emergency follow up response. A Report on EpiPen Administration and Incident Report must be completed IMMEDIATELY documenting incident, usage of medication, response, and follow up. Facts Other States POLICIES: CPS CPS policies Stock Epinephrine Auto-injectors (Epi-Pens®) Policy Recommendations

11 Report on EpiPen Administration Report is specific to the use of the district issued EpiPens Report must be completed and submitted within 24 hours of administration

12 Facts Policies: CPS OTHER STATES States with food allergy policies & guidelines Policy Recommendations Virtually every state has passed legislation allowing students (with consent) to carry their prescribed epinephrine at school The following 19 states have school-based food allergy guidelines: Arizona California Colorado Connecticut* Illinois Massachusetts* Maryland Missouri Mississippi New Jersey* New York Ohio Pennsylvania Rhode Island* Tennessee Texas Vermont* Washington* West Virginia Sources:Food Allergy & Anaphylaxis Network (2012) available at Asthma and Allergy Foundation State Honor Roll available at * denotes states with Honor Roll standing

13 Facts Policies: CPS OTHER STATES States with food allergy policies & guidelines Policy Recommendations In 2011, President Obama signed the Food Allergy and Anaphylaxis Management Act Emerging trend allows schools to obtain “stock” EpiPen auto- injectors not tied to any one student but to be used in an emergency Kansas passed this law in 2009 EpiPen4Schools ™ Program Sources:Food Allergy & Anaphylaxis Network (2012) available at and Mylan EpiPen4Schools Program information available at

14 Facts POLICY RECOMMENDATIONS Policies: CPS Other States Policy recommendations Establish a multi-disciplinary team to address school-wide approach to identifying, managing, and reducing risk of student exposure to life threatening allergens Expand annual emergency drill program to include food allergy emergencies Require school-wide training on food allergies, the use of EpiPens in emergency situation and identification of location of EpiPens Establish stock EpiPen auto-injectors for schools Require school nurse EpiPen training Develop reporting systems for accountability


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