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AP 330

Allergic Shock (Anaphylaxis)

Background


The Abbotsford School District recognizes that there are students with diagnosed anaphylaxis and at-risk anaphylaxis. These students require planned care and support on and off school grounds and during school events (e.g., field trips, sporting events).

Procedures


1. Information and Awareness 

1.1 Anaphylaxis is a sudden and severe allergic reaction, which can be fatal, requiring immediate medical emergency measures be taken. Signs and symptoms of a severe allergic reaction can occur within minutes of exposure to an offending substance. Reactions usually occur within two hours of exposure, but in rarer cases can develop hours later. Specific warning signs, as well as the severity and intensity of symptoms, can vary from person to person and sometimes from attach to attack in the same person. (Canadian Society of Allergy and Clinical Immunology, Anaphylaxis in Schools and Other Settings, pp. 6-7)

1.2 At-Risk Anaphylaxis is a condition that is diagnosed and/or stipulated by a Physician and communicated in writing by the Physician to the principal of the school that the student attends. An anaphylactic reaction can involve any of the following symptoms, which may appear alone or in any combination, regardless of the triggering allergen:

  • Skin:  hives, swelling, itching, warmth, redness, rash
  • Respiratory (breathing):  wheezing, shortness of breath, throat tightness, cough, hoarse voice, chest pain/tightness, nasal congestion or hay fever-like symptoms (runny itchy nose and watery eyes, sneezing), trouble swallowing
  • Gastrointestinal (stomach):  nausea, pain/cramps, vomiting, diarrhea
  • Cardiovascular (heart):  pale/blue colour, weak pulse, passing out, dizzy/lightheaded, shock
  • Other:  anxiety, feeling of “impending doom,” headache, uterine cramps in females

The most dangerous symptoms of an allergic reaction involve (both symptoms may lead to death if untreated):

  • Breathing difficulties caused by swelling of the airways; and
  • A drop in blood pressure indicated by dizziness, light headedness or feeling faint/weak.

1.3 All students have the right to access public education.

1.4 Students at risk of anaphylaxis have a right to a safe, healthy, learning environment.

1.5 Some students suffer from life-threatening allergic reactions and the district expects that school administrators, teachers and support staff be informed and aware of the threat of allergic shock. They should know measures to reasonably avoid the allergens for affected students and be able to respond to an allergic reaction emergency.

1.6 Schools can be expected to create an allergy aware environment, but it is unrealistic to expect an allergen free environment, however, schools should be aware of the needs of students with at-risk anaphylaxis and diagnosed anaphylaxis.

1.7 In order for school personnel to effectively respond to life-threatening allergic shock reactions, the following guidelines are recommended. The school administrator shall communicate to all school community members (students, parents, teachers, volunteers, etc.) the district’s protocol regarding anaphylaxis.

1.8 The Board of Education will minimize the risk of anaphylaxis due to allergens, without depriving the at-risk student of normal peer relations or placing unreasonable restrictions on other students.

2. Roles and Responsibilities

The Safety, health and wellbeing of students is a shared responsibility among parents/guardians, students, the health care community, school employees and the Abbotsford School District.

2.1 The parents/guardians shall:

  • Upon registration, and on an annual basis, inform the school about their student’s potential risk for anaphylaxis.
  • Ensure provision of ongoing health support services.
  • Annually complete the AP330-1 Anaphylaxis Emergency Plan, which identifies allergens that trigger reaction and describes treatment protocol signed by the physician.
  • Provide and adequate and current supply of auto-injectors (or other medications) as per the Anaphylaxis Emergency Plan.
  • Update information whenever there is a change related to the student’s condition or medication.
  • Authorize permission for the posting and sharing of the child’s photograph and medical information normally contained in the medical alert form.
  • Provide a medical alert bracelet to be worn by the student at all times.

2.2 The school administrator shall:

  • Ensure that identified anaphylactic students have an Anaphylaxis Emergency Plan.
  • Implement Anaphylaxis Emergency Plans I accordance with the requirements of the Abbotsford School District procedures
  • Ensure that all staff are trained by Fraser Health on how to respond to an anaphylaxis emergency.
  • Ensure that anaphylactic students are identified to staff and that all staff are alerted to the Anaphylaxis Emergency Plans and location(s) of the auto-injectors.
  • Ensure all forms are up to date, placed in an appropriate location for all staff to access, and that medication(s) have not expired.
  • Record information relating to the specific allergy(s) for each identified anaphylactic student to form part of the student’s permanent student record.
  • Report annually all anaphylactic incidents, in aggregate form, to the Board.

2.3 Duty to Assist – Every employee has a duty to render assistance to a student in an emergency situation to the extent that is reasonable for a person(s) without medical training.

2.4 The Abbotsford School District shall report to the Ministry of Education annually, with respect to anaphylaxis protocols and implementation.

3. Sharing Information with Parents and Parent Organizations

3.1 Principals should inform parents of the presence of a student with life threatening allergies in their child's classroom and/or school and the measures being taken to protect the student.

3.2 Parents should be asked to cooperate and avoid including the allergen in school lunches and snacks.

3.3 Parents may be informed of alternative foods to the allergen, food labeling, ingredient lists to be provided when food is being brought from home.

4. Avoidance and Awareness of Allergens in the School Setting  

4.1 The following recommendations should be considered in the context of the anaphylactic student's age and maturity:

  • As a student matures, they should be expected to take increasing personal responsibility for avoidance of their specific allergens.
  • The balance to be achieved in allergen avoidance is to find ways to minimize the risk of exposure without depriving the anaphylactic student of normal peer interactions or placing unreasonable restrictions on the activities of other students in the school.
  • It is understood that schools and classrooms will exercise discretion in adapting to the needs of individual students and the allergens which trigger reactions.

4.2 Ideas for Providing Allergen-Aware Areas 

  • While it is impossible to eliminate all potential allergens from the school environment, it is expected that the principal will develop realistic strategies with parents and staff to create an allergen-aware environment to minimize risk for all members of the school community.
    • Where the classroom is used as a lunchroom, establish it as an allergen aware area, using a cooperative approach with students and parents. Discourage the sharing of food, utensils and containers.
    • Develop strategies for monitoring allergen-aware areas including safe eating areas. Such strategies may include hand and surface washing routines.
    • Identify high-risk areas for anaphylactic students.
    • Sources of contamination may exist outside designated eating areas within the school. The anaphylactic child, the child’s teacher and the child’s parent should also consider possible sources of allergens such as:
      • Curricular materials such as:  play-dough, stuffed toys, science projects, and other manipulatives possibly contaminated in normal use.       
      • Foods or beverages brought to school for seasonal events including traditional Canadian holidays, celebrations and/or multi-cultural events.
      • School equipment, including computer keyboards, musical instruments, locks/lockers, and trash containers, etc.

4.3      Field Trips 

In addition to the usual school safety precautions applying to field trips, the following procedures should be in place to protect the anaphylactic student:

  • Require all supervisors, staff and parents be aware of the identity of the anaphylactic child, the allergens, symptoms and treatment.
  • Ensure that the auto-injector is brought on the field trip by the supervisor.

5. Training       

       5.1 The school administrator shall:

  • Ensure that all school-based staff who are reasonably expected to have supervisory responsibility are provided an orientation/in-service on anaphylaxis, including, but not limited to, administrators, clerks, teachers, teacher assistants, noon hour supervisors, bus drivers and volunteers.
  • Ensure that all school-based staff is trained on how to respond to an anaphylaxis emergency, including, but not limited to, administrators, clerks, teachers, teacher assistants, noon hour supervisors, but drivers and volunteers.
  • Ensure that all school-based staff are trained through Fraser Health on how to respond to an anaphylaxis emergency, including how to deal with an anaphylaxis episode and the use of an epinephrine auto-injector.
  • Ensure appropriate trainings are completed at the beginning of every school year (preferably by September 15), with an additional training session provided later in the year, if needed.

6. Emergency Response Protocol and Planning

6.1 A separate AP 327-1 Medical Alert Planning form should be developed for each anaphylactic student in collaboration with the parent/guardian.

6.2 It is the parent’s responsibility to provide the AP 330-1 Anaphylaxis Emergency Plan form, signed by the physician, to the school administrator on the first day of school or upon the date of registration.

6.3 both the AP 327-1 Medical Alert Planning and the AP 330-1 Anaphylaxis Emergency Plan form shall be updated annually, and when there is a change to the student’s condition or medication.

6.4 When AP 330-1 Anaphylaxis Emergency Plan has been completed and signed by a physician, AP 328-1 Request for Administration of Medication as School is not required.

Appendix


AP 330-1 Anaphylaxis Emergency Plan

References


AP 326 – Student Illness or Injury at School
AP 327 – Medical Alert Conditions
AP 328 – Administration of Medication to Students
www.bced.gov.bc.ca/health/tools.htm
Allergy Safe Communities
Anaphylaxis – A Handbook for School Boards
Anaphylaxis Protection Order – Ministerial Order 232/07
BC Anaphylactic and Child Safety Framework 2007
BC Ministry of Education Core Anaphylaxis Resources
Severe Food Allergies in Children – Ministry of Health

Draft July 2022 | This Administrative Procedure is currently in draft form. If you would like to submit feedback for consideration please email info [at] abbyschools.ca.

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