Transcript BISD Allergy and Anaphylaxis Training

Why do I need
Food Allergy Training?
Senate Bill 27:
Guidelines require training for all school
personnel
Purpose of training:
To provide to all school staff basic
knowledge and skills to identify students
with a possible allergic reaction to food
and the appropriate emergency actions
for an allergic reaction
Food Allergy Statistics & Facts
• Nearly 6 million or 8% of children have food
allergies
• 16%-18% of children with food allergies have had
allergic reactions to accidental ingestion of food
allergens while in school
• 25% of anaphylactic reactions in schools occur
among students without a previous food allergy
diagnosis
• Approximately 150-200 people die annually from
food allergy reactions or anaphylaxis
• Peanut allergy among children appears to have
tripled between 1997-2008
• There is no cure for food allergies
• Strict avoidance of allergens is critical to the safety
of children with food allergies
Food Intolerance vs Food Allergy
Food Intolerance: an unpleasant reaction to a food, that
unlike a food allergy, DOES NOT involve the immune
system response or the release of histamine.
Food Allergy: a group of disorders characterized
by immunological responses to specific food proteins.
Food allergies can put students at
risk for anaphylaxis.
Food intolerance – does not put a
student at risk for anaphylaxis.
Foods Associated with Allergies
8 common foods account for
90% of food allergic reactions
Peanuts
Tree Nuts
Wheat
Soy
Milk
Eggs
Fish
Shellfish
Other less common foods can also cause
allergic reactions.
Reactions can range from mild to deadly.
Symptoms of Allergic Reactions
ANAPHYLAXIS
A serious allergic reaction
that is rapid in onset and
may cause
DEATH
SEVERE Allergic Reaction
Signs and Symptoms
Body System
Sign or Symptom
Mouth
Tingling, itching, swelling of the tongue, lips or
mouth: blue/grey color of the lips
Throat
Tightening of the throat; tickling feeling in back
of throat; hoarseness or change in voice,
repetitive throat clearing
Nose/Eyes/Ears Runny, itchy nose; redness and/or swelling of
eyes; throbbing in ears, redness of ears
Lung
Stomach
Shortness of breath; repetitive shallow cough;
wheezing
Nausea; vomiting; diarrhea; abdominal cramps
Skin
Itchy rash; hives; swelling of face or extremities;
facial flushing
Heart
Thin weak pulse; rapid pulse; palpitations;
fainting; blueness of lips, face or nail beds;
paleness
Epinephrine
 First-line treatment in the case of
anaphylaxis
 It works by opening the airways, improving
blood pressure, and accelerating heart
rate
 After 20 minutes, may need a repeat
injection
Epinephrine auto-injectors
( Epi-pen)
Two Doses
›Epi=pen
Junior for students (green label)
33-66 lbs
Regular for students
≥ 66 lbs (yellow label)
Administration of Epinephrine
 Medication Authorization – must be on file in the
nurses office for any student prescribed an Epi-pen
 Epi-pen is stored in an unlocked cabinet in the
clinic
 Some students may carry their Epi-pens with them
to class and school activities
Administration of Epinephrine
Administration Do’s:
 Right Student
 Right Medication
 Right Dose
 Right Route
 Right Time
Location of Epinephrine: ( Epi-pen)
o
Kept in clinic in unlocked cabinet
o
Student may carry the auto-injector
911 must be called
when epinephrine is administered!
How to use an Auto-injector
(Epi-pen)
http://www.youtube.com/watch?v
=tjILFYPE3Uw
Post Epinephrine Injection
 911 must be called
(Call 911 before parents, you don’t
want to delay the arrival of EMS)
 Notify the parents
Documentation
 The student’s reaction to the allergen
 Medication administration
 The student’s reaction to the
epinephrine
Self-Administration of Epinephrine
 Per Federal law, students may carry their
epinephrine with them in the classroom and on
school activities
 If a student uses their epinephrine in your
classroom:
o Immediately contact the nurse (if nurse is
not available, notify the front office)
o Monitor the student’s respiratory status
o Note the student’s reaction to the allergen
and the time the epinephrine was administered
Students with Diagnosed
Food Allergies
• Every student with a diagnosed food allergy:
o Should have a Food Allergy Action Plan
o Is eligible for 504 accommodations
• Notification of a student with diagnosed food
allergies:
o Once notification is received by the school
nurse appropriate school personnel will be
notified.
The student’s Food Allergy Action
Plan:
 Provides directions on what to do if a student with
a diagnosed food allergy is having a reaction in
your classroom
 Should be taken on field trips
 A copy should be placed in your sub folder
Food Allergy Action Plan
Food Allergy Action Plan, page 2
Does the student have any symptoms below which may indicate a severe allergic
reaction?
Body
Sign
System
or Symptom
Tingling, itching, swelling of the tongue, lips or mouth: blue/grey
color of the lips
Throat
Tightening of the throat; tickling feeling in back of throat;
hoarseness or change in voice, repetitive throat clearing
Nose/Eyes/Ears Runny, itchy nose; redness and/or swelling of eyes; throbbing in
ears, redness of ears
Lung
Shortness of breath; repetitive shallow cough; wheezing
Stomach
Nausea; vomiting; diarrhea; abdominal cramps
Skin
Itchy rash; hives; swelling of face or extremities; facial flushing
Heart
Thin weak pulse; rapid pulse; palpitations; fainting; blueness of lips,
face or nail beds; paleness
Mouth
Simultaneously with others assisting you:
Call 911
Call Administrator to the scene
If symptoms persist, prepare for CPR
Get AED
Administrator call parents
Stay with student until EMS arrives
Exposure Reduction at School
Campus Wide:
• Allergy aware :
• Allergy Free Area:
Cafeterias do not serve
peanut or nut products on
elementary or middle school
campuses
Students without the
allergen in their lunches
may sit in the allergy free
area in cafeteria (i.e. peanuts)
Classrooms:
• Food:
• Parties:
• Hand washing:
Use non-food items as
rewards or manipulatives
Eliminate foods that contain
allergens from classroom
Avoid foods that contain the
allergen. Allow only prepackaged food items with
readable ingredient list
Wash hands before and after
meals or use hand wipes.
Alcohol based hand gel is
not effective in eliminating
the allergen.
Exposure Reduction at School
Field Trips:
o Notify school nurse at least 2 days prior
to field trip for necessary preparations.
o Invite parent(s) to attend field trip
o Don’t leave for field trip without the
student’s prescribed Epi-pen
o Be aware of foods offered on field trip
(may need to contact facility in
advance).
Transportation:
o Strictly enforce no eating on the bus if
there is a student with food allergies
who is at risk for anaphylaxis riding the
bus
Bullying
 Be aware of how the student with food
allergies is being treated
 Ensure classmates avoid endangering,
isolating, stigmatizing or harassing students
with food allergies
 Enforce school rules on bullying and threats
Responsibilities of the Classroom
Teacher/Specialist
•
Complete Level I and/or Level II Food Allergy
Training annually.
•
View students’ Food Allergy Action Plan
•
Understand and implement the Severe Food Allergy
Plan for your student(s). Ask school nurse for any
clarification needed regarding plan(s).
•
Ensure that all substitute individuals, pull out
teachers (Special Ed, interventions, Dyslexia, etc.) are
informed of the student’s food allergy.
•
Eliminate identified allergens in classroom of student
with food allergies at risk for anaphylaxis.
Responsibilities of the Classroom
Teacher/Specialist (continued)
•
•
•
•
•
•
Send district letter to parents/guardians of
classmates of a food–allergic student who is at risk
for anaphylaxis, explaining any restricted allergen
foods in the classroom.
Inform parents and campus nurse of any events
where food will be served.
Enforce district policy on bullying related to food or
other allergens.
Know the campus communication plan with the front
office and/or campus nurse.
Ensure that student suspected of having an allergic
reaction is accompanied by an adult (preferable) or
student to the clinic.
Do not put a student on the bus if there are any signs
or symptoms of an allergic reaction.
Next Steps: If you…
• have a student with a history of severe food allergy
• are a cafeteria monitor who has a student with a
history of severe food allergy
• are assigned to cover the clinic when a nurse is absent
• are a before or after school program sponsor and have
a student with a history of severe food allergy
 See the school nurse to:
• Review and demonstrate proper epinephrine
administration
• Know where your student’s medication is kept
•In clinic
•With student
•Both
Questions?
Please see the School Nurse!