SEVERE ALLERGY GUIDELINES FOR SCHOOL STAFF

1. SEVERE ALLERGY GUIDELINES FOR SCHOOL STAFF New Providence School District Trish Kalinger, R.N. Carol McCabe, R.N. Jan Miller, R.N.

2. N.J.S.A. 18A:40-12.3-6 Revised by legislature in 2006 Guidelines were developed for management of life-threatening food allergies in schools to educate school staff.

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

4. Anaphylaxis Allergens enters body by: • Ingestion • Inhalation • Skin contact • Injection

5. Food Peanuts Milk Wheat Fish Tree Nuts Eggs Soy Seafood

6. 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

7. Insects Yellow jackets* Wasps Hornets Bees Fire ants

8. Latex Rubber gloves Balloons Goggles Science/P.E. equipment Clothing Medical equipment

9. Other Exercise Pesticides Herbicides Cedar chips Idiopathic (no apparent cause)

10. ANAPHYLAXIS Signs & Symptoms

11. Mouth Tingling, itching &/or swelling Mouth Tongue Lips Throat

12. Skin Hives Itchy rash Swelling of face & extremities Swollen, red, watery eyes

13. Stomach Nausea Vomiting Diarrhea Abdominal cramps

14. Respiratory Violent sneezing Severe, sudden runny nose Tightness in throat/chest Wheezing Frequent, tight cough Shortness of breath

15. Heart Dizziness Weakness Paleness Fainting Weak or rapid pulse Low blood pressure Blueness

16. General Restlessness Panic Chills Sudden fatigue Sense of impending doom

17. Procedure • 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

18. The Student • Reassure. • Allow to sit upright. * • If faint, lie flat and elevate legs. • If faint or unconscious & vomiting, position on side.

19. 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”) • Goal: Recognize and promptly treat a reaction

20. Epinephrine • Drug of choice – only by injection • Works rapidly EpiPen

21. Any student who receives an EpiPen must be transported by the EMS for medical care.

22. 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.

23. Risk Reduction Classroom 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

24. Risk Reduction Cafeteria 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.

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

26. THE END