Managing Life Threatening Allergies In Our Schools

Common food allergies in children Milk Egg Peanut Tree Nuts Shellfish Fish Soy Whey

Allergy Statistics “Researchers believe that the prevalence of food allergies is increasing and the number of deaths from food allergy induced anaphylaxis is growing, and children are the largest group of the population affected by food allergies.” 6%-8% of US children have food allergies 1.2 % of US children have peanut allergies 1.3% of US children have egg allergies 2.5% of US children have milk allergies Peanut allergy is the food allergy most commonly associated with anaphylaxis Peanut anaphylaxis accounts for 30,000 Emergency Room visits per year 150 deaths per year from peanut and tree nut anaphylaxis

What is an allergy? An allergy is an abnormal response to a normal substance. This is the body’s attempt to defend itself against substances that are perceived by the body to be harmful (an Allergen). There are various degrees of reaction. Symptoms can occur up to 72 hours or more after exposure to the allergen and can last up to several days. Symptoms may or may not be life threatening. Allergic reactions could be caused by certain foods, some drugs, bee stings, and products especially latex.

ALLERGIC REACTIONS Skin Contact Poison Plants Animal Scratches Pollen Latex Injection Bee Stings Ingestion Medication Nuts & Shellfish Inhalation Pollen Dust Mold & Mildew Animal Dander

What is Anaphylaxis? Anaphylaxis is the life threatening form of an allergic reaction. According to the American Lung Association, it is a “sudden, severe allergic response that usually produces breathing difficulties, collapse and possible death.” Usually occurs 1-15 minutes after exposure, rarely after 2 hours. Requires immediate action – EpiPen ® Go to for a video demonstration of EpiPens ® Anaphylaxis is the life threatening form of an allergic reaction. According to the American Lung Association, it is a “sudden, severe allergic response that usually produces breathing difficulties, collapse and possible death.” Usually occurs 1-15 minutes after exposure, rarely after 2 hours. Requires immediate action – EpiPen ® Go to for a video demonstration of EpiPens ®

Symptoms that can occur during an Allergic or Anaphylactic Reaction Skin: Hives, swelling, itchy red rash Abdomin:Cramps, nausea, vomiting, diarrhea, gas Neuro: Weakness, impending doom feeling Respiratory: Itchy, watery eyes; runny nose; stuffy nose; sneezing; cough; itching or swelling of lips, tongue or throat; changes in voice; difficulty swallowing; tightness in chest; wheezing; shortness of breath; repetitive throat clearing. Cardiovascular: reduced blood pressure, increased heart rate, shock, pale and sweaty. Common sites for allergic reactions Mouth (swelling of the lips, tongue, itching lips) Airways (wheezing or breathing problems Digestive tract (stomach cramps, vomiting, diarrhea) Skin (hives, rashes, or eczema)

Allergic Reactions vs. Anaphylactic Reactions Anaphylactic Reactions Hives Swelling (face, lips, tongue, throat, upper airway) Difficulty breathing (chest tightness) Vomiting, diarrhea, cramping Difficulty swallowing (voice changes) Weakness, paleness, sweating Feeling of impending doom Allergic Reactions Runny Nose Itchy, Red, watery eyes Local reaction to sting, UNLESS known to be allergic to venom.

Anaphylactic Reactions An Allergic Reaction can advance at any time to an Anaphylactic Reaction. An Anaphylactic Reaction can happen very quickly – usually 1-15 minutes after being exposed to an allergen (nuts, bees, latex, foods) Anaphylactic Reactions can involve many symptoms or just one severe symptom (rapidly progressing hives, difficulty breathing, upper airway swelling.)

Recognize Anaphylactic Reactions Be aware of the students in your classroom that have life threatening allergies Be aware of what the student is allergic to (nuts, latex, bee stings, foods) Recognize the signs and symptoms of an Anaphylactic Reaction. Learn to use an EpiPen ®. Ask your school nurse for training. RESPOND to those symptoms Do Not Ignore

What to do when an Anaphylactic Reaction occurs in your Classroom Call the School Nurse immediately. Identify the student and problem to the School Nurse. Ask the student if they have their EpiPen ® on their person. Administer EpiPen ® Call 911 DO NOT send a student who you suspect of having an anaphylactic reaction to the Health Office. Call the School Nurse to come to your classroom. She will bring an EpiPen ® and emergency equipment to assist the student.

How To Use An Epipen Identify Epipen as student’s Epipen through proper label reading Remove epipen from container Remove grey cap. This activates the Epipen

Directions for Use Of Epipen Hold Epipen in your fist with clenched fingers wrapped around the pen. Hold it about 6 inches from outer thigh Point the Epipen toward outer thigh Swing and jab the black tip against the outer thigh until a loud click is heard. This means the device has been administered. Hold in place seconds, needle will go through clothes because it is spring loaded Pull needle straight out. Massage area for 10 seconds Call 911 if not already done Exam Epipen, if the needle is exposed outside of the black tip you will know the Epipen was administered properly Dispose of Epipen in Sharps container or hand to EMT’s on their arrival

Epipen Demonstration To view a video on Epipen administration you can go to Always stay with student until EMS arrives and takes over. Students may require second dose of epinephrine, only school nurse or EMS may administer second dose.

How does the Medication help? EpiPen ® = Epinephrine Medication Quickly constricts blood vessels Relaxes smooth muscles in the lungs to improve breathing Stimulates heartbeat Works to reverse hives and swelling around the face and lips Wears off in minutes, sometimes requires a second dose, critical that 911 is called and student transported to emergency room!

Emergency Action Plan TAKE ALL REACTIONS SERIOUSLY Administer an Epipen if you recognize a student’s reaction as anaphylactic or call a trained school staff member immediately to assist with the administration of an Epipen Call 911 Monitor student’s breathing and circulation - CPR if needed Notify Parent/Guardian The “Good Samaritan Law” protects all individuals who administer an Epipen from liability. Deciding to become Epipen trained is a personal choice. If you make the decision to become certified, please see your school nurse. Certification involves reviewing the information packet provided, demonstration of Epipen administration, and an understanding of allergic and anaphylactic reactions and how to react to those situations.

3 R’s for handling a Reaction RECOGNIZE the Signs & Symptoms Life threatening or not? REACT quickly – Activate the student’s Emergency Care Plan REVIEW what caused the reaction and did the plan work? Evaluate the Emergency Action Plan implemented. Any lessons learned? Any changes to the plan required?

Food in your classroom and students with life threatening allergies If you have student in your classroom who has a food allergy and snack time takes place, please review that student’s Individualized Health Care Plan. This plan will address snack issues and food allergies. Hands must be washed before and after snack time If a snack is eaten that could be a potential allergen the desk should be cleaned with soap and water Food should not be consumed by students in classrooms at the Middle School and High School unless it is part of a lesson. If you plan on using a food for a health or cultural lesson, administrative and school nurse approval must be received. Teachers should always leave list of students with Life threatening allergies and allergen for substitute (form is available in Health Office)

Foods that may have hidden sources of allergens Egg – pasta, baked goods, candy, mayonnaise, ice cream Milk – hot dogs, deli meats, popsicles, tostito chips, pretzals, cheetos, popcorn, and cake mixes Peanuts – artificial nuts, sunflower seeds, chili, spaghetti sauce, popcorn, granola bars, ice cream, candy, pesto sauce Tree nuts – pecans, walnuts, mortadella, barbecue sauce, cereals, crackers, ice cream, candy, salad dressings, and pesto Fish – Caesar dressing, worcheshire sauce, imitation crabmeat Soy – baked goods, canned tuna, cereal, crackers, and sauces Always read labels!!!!!

Supplies In Your Classroom If you have a student who has an life threatening allergy in your classroom please remember to: 1. Read all labels of supplies being used in your classroom. Identify any potential allergens and do not use them in your classroom. 2. Do not use any supply whose contents is not clearly defined. If you are unsure, please check with the school nurse, manufacturer, or a parent as they may be familiar with the supply or product.

Products that may have hidden sources of Allergens Birdseed Playdough or clay Paints Glue Shaving Cream Toothpaste Animals/animal food Bean bags, hackeysacks, and draft dodgers

Anaphylactic Reaction If a child/staff member in your building does have an anaphylactic reaction and an Epipen is administered, a debriefing will occur with all staff involved immediately after the event. At this debriefing, the event will be discussed “what went right” “what could have been done different” and “why did the anaphylaxis take place (known or unknown allergen). The outcome of the debriefing may assist staff in developing a new plan if necessary for that student or staff member or it may confirm a very appropriate plan.

Final Reminders The School Nurse will provide you with a list of students in your classroom who have allergies The district does have a “Life Threatening Allergy School Policy”. It can viewed through our district website: Parents are a great resource of information if you have any questions regarding a student’s allergies. Always remember to leave the appropriate form for substitutes. This form lists your students who have allergies. You can obtain this form from your school nurse. Bullying can be an issue for those students who suffer from life- threatening allergies. Please address this issue if you observe it or report the bullying to an administrator If you have any questions or concerns regarding a student’s allergies do not hesitate to speak to your school nurse.