New Providence School District

Trish Kalinger, R.N. Carol McCabe, R.N. Jan Miller, R.N.

SEVERE ALLERGY GUIDELINES

FOR SCHOOL STAFF

Guidelines were developed for management of life-threatening food allergies in schools to educate school staff.

N.J.S.A. 18A:40-12.3-6 Revised by legislature in 2006

A rapid, severe, possibly life-threatening, allergic response that occurs when a person is exposed to an allergy-causing substance

A rapid, severe, possibly life-threatening, allergic response that occurs when a person is exposed to an allergy-causing substance

Allergens enters body by:

IngestionInhalationSkin contactInjection

Allergens enters body by:

IngestionInhalationSkin contactInjection

Tree Nuts

Eggs

Soy

Seafood

Peanuts

Milk

Wheat

Fish

About Food Allergies

Occurs in 2-2.5% of population CDC: 12 deaths in 2004

Reasons for increase? Environment Hygiene hypothesis Genetics Increased awareness Better diagnosis Fear of legal consequences

Yellow jackets*

Wasps

Hornets

Bees

Fire ants

Rubber gloves

Balloons

Goggles

Science/P.E. equipment

Clothing

Medical equipment

Exercise

Pesticides

Herbicides

Cedar chips

Idiopathic (no apparent cause)

Tingling, itching &/or swelling

MouthTongue

LipsThroat

Tingling, itching &/or swelling

MouthTongue

LipsThroat

HivesItchy rash

Swelling of face & extremities

Swollen, red, watery eyes

HivesItchy rash

Swelling of face & extremities

Swollen, red, watery eyes

NauseaVomitingDiarrhea

Abdominal cramps

NauseaVomitingDiarrhea

Abdominal cramps

Violent sneezingSevere, sudden runny noseTightness in throat/chest

WheezingFrequent, tight coughShortness of breath

Violent sneezingSevere, sudden runny noseTightness in throat/chest

WheezingFrequent, tight coughShortness of breath

DizzinessWeaknessPalenessFainting

Weak or rapid pulseLow blood pressure

Blueness

DizzinessWeaknessPalenessFainting

Weak or rapid pulseLow blood pressure

Blueness

RestlessnessPanicChills

Sudden fatigueSense of impending doom

RestlessnessPanicChills

Sudden fatigueSense of impending doom

• Assess symptoms.

• Do not leave student alone.

• Alert Emergency Response Team and Building Principal.

•Direct someone to call 911.

DIAL 9-911 - any building phone

• Assess symptoms.

• Do not leave student alone.

• Alert Emergency Response Team and Building Principal.

•Direct someone to call 911.

DIAL 9-911 - any building phone

Procedure

The Student

Reassure.

Allow to sit upright. *

If faint, lie flat and elevate legs.

If faint or unconscious & vomiting, position on side.

Goal: Recognize and promptly treat a reaction

REMEMBER:• No way to predict if the allergic reaction will

progress to anaphylaxis.• Symptoms may:

Occur slowly and worsen gradually

Occur quickly and severely

Improve with medication but return

in minutes or hours (“bi-phasic”)

Epinephrine•Drug of choice – only by injection

•Works rapidly

EpiPen

Any student who

receives an EpiPen must be transported by the EMS for medical care.

Risk Reduction

Student Considerations Encourage students to eat only food

that their parents have provided. No food sharing or trading Wash hands after eating. Consider planning an allergy

awareness lesson for classmates.

Risk ReductionClassroom Considerations Do not open lunches in the classroom. Do not use allergens in classroom. Avoid use of food as a reward. Plan parties with allergy parent input. Be alert for the unexpected! Special visitors who bring food/prizes Unplanned snacks/treats Large group refreshments

Risk ReductionCafeteria Considerations Plan seating with parent input. Consider assigned seating. Designate an allergen-free table. Clean tables with disposable towels

and detergent between each lunch. Place garbage cans away from

allergen-free tables.

The 3 R’s: Recognize symptoms. React quickly. Review cause & plan.