Date: March 2018
The key to prevention of anaphylaxis in schools is knowledge, awareness and planning.
Anaphylaxis is severe and sudden allergic reaction when a person is exposed to an allergen. Common allergens for children include: eggs, peanuts, tree nuts such as cashews, cow's milk, fish and shellfish, wheat, soy, insect sting and medications.
Sights and symptoms of a mild to moderate allergic reactions can include:
· swelling of the lips, face and eyes
· hives or welts
· tingling in the mouth
Signs and symptoms of anaphylaxis, a severe allergic reaction, can include:
· difficult/noisy breathing
· swelling of tongue
· difficulty talking and/or hoarse voice
· wheeze or persistent cough
· persistent dizziness or collapse
· student appears pale or floppy
· abdominal pain and/or vomiting
Symptoms usually develop within ten minutes and up to two hours after exposure to an allergen, but can appear within a few minutes.
Adrenaline given as an injection into the muscle of the outer mid-thigh is the first aid treatment for anaphylaxis.
Individuals diagnosed as being at risk of anaphylaxis are prescribed an adrenaline auto-injector for use in an emergency. These adrenaline auto-injectors are designed so that anyone can use them in an emergency.
Merriang Special Developmental School will fully comply with Ministerial Order 706 and the associated guidelines published by the Department of Education and Training.
Our school has a duty of care towards students which includes protecting a student under the school’s charge from risks of injury that the teacher should reasonably have foreseen. They should work in partnership with parents/carers and the student to support students to feel safe at school.
· To provide, as far as practicable, a safe and supportive environment in which students at risk of anaphylaxis can participate equally in all aspects of schooling.
· To actively involve the parents/carers of each student at risk of anaphylaxis in assessing risks, developing risk minimisation strategies and management strategies for the student.
· To ensure that all staff members have adequate knowledge of allergies, anaphylaxis and emergency procedures.
Individual Anaphylaxis Management Plans
All students at Merriang SDS who are diagnosed as being at risk of suffering from an anaphylactic reaction by a medical practitioner must have an Individual Anaphylaxis Management Plan. When notified of an anaphylaxis diagnosis, the principal of Merriang SDS is responsible for developing a plan in consultation with the student’s parents/carers.
Where necessary, an Individual Anaphylaxis Management Plan will be in place as soon as practicable after a student enrols at Merriang SDS and where possible, before the student’s first day.
Parents and carers must:
· obtain an ASCIA Action Plan for Anaphylaxis from the student’s medical practitioner and provide a copy to the school as soon as practicable
· immediately inform the school in writing if there is a relevant change in the student’s medical condition and obtain an updated ASCIA Action Plan for Anaphylaxis
· provide an up to date photo of the student for the ASCIA Action Plan for Anaphylaxis when that Plan is provided to the school and each time it is reviewed
· provide the school with a current adrenaline auto-injector for the student that is not expired
· participate in annual reviews of the student’s Plan.
Each student’s Individual Anaphylaxis Management Plan must include:
· information about the student’s medical condition that relates to allergy and the potential for anaphylactic reaction, including the type of allergies the student has
· information about the signs or symptoms the student might exhibit in the event of an allergic reaction based on a written diagnosis from a medical practitioner
· strategies to minimise the risk of exposure to known allergens while the student is under the care or supervision of school staff, including in the school yard, at camps and excursions, or at special events conducted, organised or attended by the school
· the name of the person(s) responsible for implementing the risk minimisation strategies which have been identified in the Plan
· information about where the student's medication will be stored
· the student's emergency contact details
· an up-to-date ASCIA Action Plan for Anaphylaxis completed by the student’s medical practitioner.
Review and updates to Individual Anaphylaxis Plans
A student’s Individual Anaphylaxis Plan will be reviewed and updated on an annual basis in consultation with the student’s parents/carers. The plan will also be reviewed and, where necessary, updated in the following circumstances:
· as soon as practicable after the student has an anaphylactic reaction at school
· if the student’s medical condition, insofar as it relates to allergy and the potential for anaphylactic reaction, changes
· when the student is participating in an off-site activity, including camps and excursions, or at special events including fetes and concerts.
Our school may also consider updating a student’s Individual Anaphylaxis Management Plan if there is an identified and significant increase in the student’s potential risk of exposure to allergens at school.
· A copy of each student’s Individual Anaphylaxis Management Plan will be stored with their ASCIA Action Plan for Anaphylaxis at the First Aid area, together with the student’s adrenaline auto-injector. Adrenaline auto-injectors must be kept in a Medbag labelled with the student’s name.
Adrenaline auto-injectors for general use
Merriang SDS will maintain a supply of adrenaline auto-injectors for general use, as a back-up to those provided by parents and carers for specific students, and also for students who may suffer from a first time reaction at school.
Adrenaline auto-injectors for general use will be stored in the First Aid area and labelled “general use”.
The principal is responsible for arranging the purchase of adrenaline auto-injectors for general use, and will consider:
· the number of students enrolled at the school at risk of anaphylaxis
· the accessibility of adrenaline auto-injectors supplied by parents
· the availability of a sufficient supply of auto-adrenaline injectors for general use in different locations at the school, as well as at camps, excursions and events
· the limited life span of adrenaline auto-injectors, and the need for general use adrenaline auto-injectors to be replaced when used or prior to expiry.
In the event of an anaphylactic reaction, the emergency response procedures in this policy must be followed, together with the school’s general first aid procedures, emergency response procedures and the student’s Individual Anaphylaxis Management Plan.
A complete and up to date list of students identified as being at risk of anaphylaxis is maintained by the Head of Campus and stored at the First Aid area For camps, excursions and special events, a designated staff member will be responsible for maintaining a list of students at risk of anaphylaxis attending the special event, together with their Individual Anaphylaxis Management Plans and adrenaline auto-injectors, where appropriate.
If a student experiences an anaphylactic reaction at school or during a school activity, school staff must:
· Lay the person flat
· Do not allow them to stand or walk
· If breathing is difficult, allow them to sit
· Be calm and reassuring
· Do not leave them alone
· Seek assistance from another staff member or reliable student to locate the student’s adrenaline auto-injector or the school’s general use auto-injector, and the student’s Individual Anaphylaxis Management Plan, stored at the First Aid area.
· If the student’s plan is not immediately available, or they appear to be experiencing a first time reaction, follow steps 2 to 5
Administer an EpiPen (auto-injector) or EpiPen Jr (auto-injector)(if the student is under 20kg)
· Remove from plastic container
· Form a fist around the EpiPen and pull of the blue safety release (cap)
· Place orange end against the student’s outer mid-thigh (with or without clothing)
· Push down hard until a click is heard or felt and hold in place for 3 seconds
· Remove EpiPen
· Note the time the EpiPen is administered
· Retain the used EpiPen to be handed to ambulance paramedics along with the time of administration
Call an ambulance (000)
If there is no improvement or severe symptoms progress (as described in the ASCIA Action Plan for Anaphylaxis), further adrenaline doses may be administered every five minutes, if other adrenaline auto-injectors are available.
Contact the student’s emergency contacts.
This policy will be available on the Merriang SDS website so that parents and other members of the school community can easily access information about the Merriang SDS anaphylaxis management procedures. The parents and carers of students who are enrolled at Merriang SDS and are identified as being at risk of anaphylaxis will also be provided with a copy of this policy.
The Head of Campus is responsible for ensuring that all relevant staff, including casual relief staff are aware of this policy and Merriang SDS procedures for anaphylaxis management. Casual relief staff who are responsible for the care and/or supervision of students who are identified as being at risk of anaphylaxis will also receive a verbal briefing on this policy.
Staff at Merriang SDS will receive appropriate training in anaphylaxis management, consistent with the Department’s Anaphylaxis Guidelines.
Staff who are responsible for conducting classes that students who are at risk of anaphylaxis attend, and any further staff that the principal identifies, must have completed:
· an approved face-to-face anaphylaxis management training course in the last three years, or
· an approved online anaphylaxis management training course in the last two years.
Merriang SDS uses the following training course: 22300VIC Course in First Aid Management of Anaphylaxis.
Staff are also required to attend a briefing on anaphylaxis management and this policy at least twice per year, facilitated by a staff member who has successfully completed an anaphylaxis management course within the last 12 months, including the Anaphylaxis Supervisor. Each briefing will address:
· this policy
· the causes, symptoms and treatment of anaphylaxis
· the identities of students with a medical condition that relates to allergy and the potential for anaphylactic reaction, and where their medication is located
· how to use an adrenaline autoinjector, including hands on practice with a trainer adrenaline autoinjector
· the school’s general first aid and emergency response procedures
· the location of, and access to, adrenaline autoinjectors that have been provided by parents or purchased by the school for general use.
When a new student enrols at Merriang SDS who is at risk of anaphylaxis, the principal will develop an interim plan in consultation with the student’s parents and ensure that appropriate staff are trained and briefed as soon as possible.
Further information and resources
· School Policy and Advisory Guide:
· Allergy & Anaphylaxis Australia: Risk minimisation strategies
· ASCIA Guidelines: Schooling and childcare
Royal Children’s Hospital: Allergy and immunology
review CYLCE and evaluation
This policy was last updated in March 2018 and is scheduled for review in March 2019.
The principal will complete the Department’s Annual Risk Management Checklist for anaphylaxis management to assist with the evaluation and review of this policy and the support provided to students at risk of anaphylaxis.