Online training program
Developed by: Becky Neff, RN & Becky Adams, RN using OSPI's
Guidelines for Care of Students with Anaphylaxis (2009)
Food allergy overview
What is your role?
Signs and symptoms
of children (6-8%)
are diagnosed with
allergies that may
A reaction can occur within
minutes to hours after ingestion.
Symptoms can be mild to life-
An allergic reaction
begins after ingesting a
food causing the body to
produce an antibody
If the reaction becomes severe it
that attaches to the
is then known as anaphylaxis, a
surfaces of cells. A
reaction may not occur
with 1st time exposure
but the next time the
There is no cure for life-
food is ingested, the
threatening food allergies.
proteins in the food
The only way to prevent life-
antibodies and cause the
cells to release histamine
threatening food allergies from
which leads to the
occurring is strict avoidance of
the identified food allergen.
TREE NUTS (Walnuts, cashews, pecans…)
Most stings are caused by yellow jackets, wasps, and hornets.
Some precautions school should follow include:•Insect nests should be removed on or near school property.
•Garbage should be stored in well-covered containers.
•Eating areas should be restricted to inside school buildings for students
and staff at risk.
Students/staff at risk should:•Wear proper shoes that cover the feet. Sandals and flip-flops increase
•Long pants and sleeves rather than shorts•Avoid playing in areas where insects are seen and report to staff.
•Latex products are a
common source of allergic
•Two common types of
Contact dermatitis (skin rash) usually
after 12-36 hours.
Immediate allergic reactions.
Rarely, does exposure lead to
anaphylaxis but depends on
the amount of latex allergen
they are exposed to and their
degree of sensitivity.
•Our district makes an effort
to purchase non-latex
products in the health room
such as, gloves, band aids,
Itching (any part of Throat tightness or
Swelling (any part
Red, watery eyes
Sense of doom
Fainting or loss of
Change of voice
Change of skin color
Symptoms usually appear within minutes or can
occur several hours later.
Symptoms can have a ‘biphasic reaction' meaning
they respond initially to treatment but experience a
resurgence of symptoms hours late.
Studies have shown students with peanut and nut
allergies who also have asthma may experience a
more severe reaction.
Anaphylaxis includes the most dangerous
symptoms including but not limited to breathing
difficulties, a drop in blood pressure or shock, all
of which are potentially fatal.
Anaphylaxis is a potentially life-threatening
condition, requiring immediate medical attention.
Emergency medications should be given
immediately upon concern of exposure to the
allergen and/or any symptoms.
MOST FATALITIES OCCUR DUE TO DELAY IN
THE DELIVERY OF THE EMERGENCY
When in doubt it is better to give epinephrine and
Anyone given epinephrine should be transported
to a hospital even if symptoms appear to have
Epinephrine, also known as adrenaline, is a natural
occurring hormone in the body.
Epinephrine-Brand names include, but are not
limited to EpiPen, EpiPen Jr., and Twinjet auto-
Parents supply the injectors.
School nurses (RN'S) can train unlicensed school
personnel to administer epinephrine to a student
with an order from a physician.
Antihistamines such as, Benadryl and Zyrtec may
be prescribed but ALWAYS GIVE THE EPIPEN
Epinephrine is the life-saving medication
that must be given immediately to avoid
Antihistamines should not be the only medication
given in anaphylaxis since epinephrine is the drug
Notify the office for assistance and request they bring
the Epipen if student/teacher/staff does not have one.
Do not move the student especially if they have any
Keep the student calm.
Have someone CALL 911, parents and school nurse.
Administer the Epipen and note the time given.
If a student is exhibiting signs of a life-threatening
allergic reaction, epinephrine must be given
immediately and 911 called. There should be no
delay in the administration of epinephrine.
Work with school nurse and parent to create a safe
environment for the student.
Participate in training.
Review the Emergency Care Plan (ECP).
Never send a student with a reaction to the health room alone
Alert substitute teachers to their ECP.
Keep the classroom as allergen-safe as possible.
If the student's parent requests, a letter can be sent home
alerting all parents to the fact there is a student with significant
allergies in the class. The student's name should not be shared
in the letter unless their parent provides permission.
Remember to inform volunteers of any life-threatening
Work with the school nurse and administration to
determine if food allergens are on the menu.
Develop protocols for cleaning and sanitation
which avoid cross-contamination.
Order non-latex gloves.
Set up tables in cafeteria that are ‘allergen-free' if
Decisions should be made on a district level as to
whether a not to serve foods with allergens and
what steps can be taken to reduce the chance of a
student experiencing accidental exposure.
Keep a copy of the ECP.
All school sponsored after-school activities
should be consistent with school policies and
procedures regarding life-threatening allergies.
Participate in training.
Ensure that emergency communication
equipment is always available.
Clearly identify who is trained and responsible
for administering the Epipen.
Bus drivers should have the ECP of each
student they transport.
Student may require designated seating.
Transportation supervisor will have list of
students with life-threatening allergies.
Attend training as provided by the district and
become familiar with the district's protocols
Take as much responsibility as possible, based
on developmental level, for avoiding allergens.
Learn to recognize symptoms of an allergic
reaction and alert an adult immediately.
Avoid allergen exposure as much as possible.
Report any teasing or harassment to a school
WA state law allows students to carry and self-
administer Epipen if parent/physician and
school nurse feel they are responsible.
Obtain a detailed health history.
Obtain medication orders signed by the physician and
Write an Emergency Care Plan (ECP) for use by school
Train staff as needed on the ECP and Epipen.
Work with staff to modify the student's environment to
ensure the student's safety in all areas of the school
Develop an Individualized Health Plan (IHP) when
Provide educational overview for the entire school
Continued collaboration with parent/guardian,
teachers, and health care providers to address
continuing student needs.
Avoidance of exposure to allergens is the key
to preventing a reaction.
The risk of adverse events related to allergens
for a student is reduced when school
personnel, medical provider and
parent/guardian work together to develop a
plan for the student.
Allergy information for a student should be
noted by school and health staff on appropriate
records while respecting the student's right to
Before leaving collaborate with the school nurse.
Ensure the epinephrine and Emergency Care Plan
are taken on the trip.
Only trained staff can administer the epinephrine
and should be responsible for the student unless
their parent attends.
A cell phone should be available.
Invite parent/guardians to accompany their child
but make sure they have the students EpiPen.
Notify kitchen staff well in advance especially if
they are responsible for providing a meal so that
appropriate food substitutes can be made if
necessary in the event a parent does not provide
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