Anaphylaxis

Edited from shareable source: Draft Anaphylaxis Policy – Government of BC

Preamble

Anaphylaxis is a sudden and severe allergic reaction, which can be fatal, requiring immediate medical emergency measures be taken.

The SelfDesign Learning Community, SelfDesign Learning Foundation and SelfDesign Board recognizes that it has a duty of care to students who are at risk from life-threatening allergic reactions while under school supervision. The Board also recognizes that this responsibility is shared among the student, parents/guardians, the school and health care providers.

The purpose of this policy is to minimize the risk to students with severe allergies to potentially life-threatening allergens without depriving the severely allergic student of normal peer interactions or placing unreasonable restrictions on the activities of other students in the school.

This policy is designed to ensure that students at risk are identified, strategies are in place to minimize the potential for accidental exposure, and contractors are trained to respond in an emergency situation.

Description of Anaphylaxis

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 reaction to reaction in the same persons.

While the exact prevalence is unknown, it has been estimated that more than 600,000 or 1% to 2% of Canadians are at risk of anaphylaxis (from food and insect allergy), and that up to 6% of young children less than three years of age are at risk. In the school age population, it is estimated that between 2-4% of children are at risk of anaphylactic reactions to foods.

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, diarrhoea
Cardiovascular (heart): pale/blue colour, weak pulse, passing out, dizzy/light-headed, shock
Other: anxiety, feeling of “impending doom”, headache, uterine cramps in females

Because of the unpredictability of reactions, early symptoms should never be ignored, especially if the person has suffered an anaphylactic reaction in the past.

It is important to note that anaphylaxis can occur without hives.

If an allergic student expresses any concern that a reaction might be starting, the student should always be taken seriously. When a reaction begins, it is important to respond immediately, following instructions in the student’s Student Emergency Procedure Plan. The cause of the reaction can be investigated later.

The following symptoms may lead to death if untreated:

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

Anaphylaxis Policy

While the SelfDesign Learning Community, Foundation and Board cannot guarantee an allergen-free environment when learners are engaged in person in SelfDesign learning at camps, in-person gatherings, reasonable steps will be taken to provide an allergy-safe and allergy-aware environment for students with life-threatening allergies.

The SelfDesign Learning Community will implement the steps outlined in this policy, which include:

Identifying Individuals at Risk
Record Keeping – Monitoring and Reporting
Emergency Procedure Plans
Provision and Storage of Medication
Process for monitoring and reporting Anaphylaxis incidents to Board
Allergy Awareness, Prevention and Avoidance Strategies

1. Identifying Individuals at Risk

On the registration form for Camps and Field Trips parents/guardians are asked to report on their child’s medical conditions, including whether their child has a medical diagnosis of anaphylaxis. Information on a student’s life threatening conditions, will be recorded and updated on the student’s Permanent Student Record annually.

It is the responsibility of the parent/guardian to:

Inform the school principal, through the enrolment and registration processes, if or when their child is diagnosed as being at risk for anaphylaxis.
Complete medical administration authorization form for each in-person event, and the Student Emergency Procedure Plan at time of enrolment (or in a timely manner following a new diagnosis) which includes a photograph, description of the child’s allergy, emergency procedures, contact information, and consent to administer medication. The Student Emergency Procedure Plan should be posted and shared in key areas such as the school’s learner records, and with key individuals such as the learner’s educators, camp facilitators, the First Aid designate at camp . If consent is given, when in person, the plan will be posted in the First Aid designates supply kit, and food consumption areas (e.g. cafeterias). Parental permission is required to post or distribute the plan.
Provide the school with updated medical information at the beginning of each school year, and whenever there is a significant change related to their child.

2. Record Keeping – Monitoring and Reporting

For each identified student, the camps administrator and lead camp facilitator will keep an up to date Student Emergency Procedure Plan on file, accessible to principal and vice principals. All school administration and camps personnel will review these files prior to each camp.

These plans will contain the following information:

Student-Level Information
- Name
- Contact information
- Diagnosis
- Symptoms
- Emergency Response Plan
School-Level Information
- Emergency procedures/treatment
Physician section including the student’s diagnosis, medication and physician’s signature.

It is the school principal’s responsibility for collecting and managing the information on students’ life threatening health conditions and reviewing that information annually to form part of the students’ Permanent Student Records.

The school principal will also monitor information about anaphylactic incidents in aggregate form (to include number of at-risk anaphylactic students and number of anaphylactic incidents) annually.

3. Emergency Procedure Plans

a. Student Level Emergency Procedure Plan

The school principal ensures that the parents/guardians and student (where appropriate), are provided with an opportunity to meet with designated staff (camps administrator and lead facilitator), prior to the beginning of each camp/field trip or as soon as possible to develop/update an individual Student Emergency Procedure Plan. The Student Emergency Procedure Plan must be signed by the student’s parents/guardians and the student’s physician. A copy of the plan will be placed in readily accessible, designated areas such as the camp facilitator’s handbook and the camp office / facilitator room/ first aid room / kitchen, with consent from the parent.

The Student Emergency Procedures Plan is contained with the SDLC Medication Administration Policy.

b. School Level Emergency Procedure Plan

Administer the student’s auto-injector (single dose) at the first sign of a reaction. Note time of administration.
Call emergency medical care (911 – where available)
Consult the Student’s Emergency Plan
Contact the child’s parent/guardian
A second auto-injector may be administered within 5 to 15 minutes after the first dose is given IF symptoms have not improved (i.e. the reaction is continuing, getting worse, or has recurred).
If an auto-injector has been administered, the student must be transported to a hospital (the effects of the auto-injector may not last, and the student may have another anaphylactic reaction).
One person stays with the child at all times.
One person goes for help or calls for help.

This plan is outlined in the Handbook of Camps Procedures and Protocols.

4. Provision and Storage of Medication

Children at risk of anaphylaxis who have demonstrated ability to self-administer will carry one auto-injector with them at all times and have a back-up auto-injector stored with the camp first aid supplies, which are identified by a red bag or box, and always located in a central, easily accessible, unlocked location. For children who have not demonstrated maturity, their auto-injector(s) will be stored with camp first aid supplies as outlined above.

All Camp facilitators, camp participants and other camp personnel are oriented to the location of the student auto-injectors at the beginning of each camp.

Parents/guardians will be informed that it is the parents/guardians’ responsibility:

to provide the appropriate medication (e.g. single dose epinephrine auto-injectors) for their anaphylactic child;
to inform the school where the anaphylactic child’s medication will be kept (i.e. with the student in their backpack lid, in the student’s handbag or toiletries bag, and/or other locations);
to inform the school when they deem the child competent to carry their own medication/s (children who have demonstrated ability to self-administer, should carry their own auto-injector), and it is their duty to ensure their child understands they must carry their medication on their person at all times;
to provide a second auto-injector to be stored in a central, accessible, safe but unlocked location;
to ensure anaphylaxis medications have not expired; and
to ensure that they replace expired medications.

5. Process for monitoring and reporting Anaphylaxis incidents

Medical & incident reports following each camp are submitted to the principal
Principal monitors and keeps record of reports regarding anaphylaxis

6. Allergy Awareness, Prevention and Avoidance Strategies

a. Awareness

With the consent of the parent, the principal and the camp / field trip facilitators will ensure that the student’s peers are provided with information on severe allergies in a manner that is appropriate for the age and maturity level of the students, and that strategies to reduce teasing and bullying are incorporated into this information, and that acknowledges confidentiality.

Additional best practice, where possible:

Posters which describe signs and symptoms of anaphylaxis and how to administer a single dose auto-injector will be placed in relevant areas and / or used as a resource for orientation and education of peers and camp staff.

b. Avoidance/Prevention

Individuals at risk of anaphylaxis will be constantly learning effective strategies for how to avoid specific triggers in a variety of settings. While the key responsibility lies with the students at risk and their families, the school community must participate in creating an “allergy-aware” environment. Special care is taken to avoid exposure to allergy-causing substances. Camp/ field trip participants (and their parents/guardians) are oriented to and asked to abide by the guidelines set out in the Handbook of Camps Procedures and Protocols on Food Safety and safe handling.

Non-food allergens (e.g. medications, latex) where possible will be identified and restricted from camps where a child with a related allergy may encounter that substance.

7. Training Strategy (Pre-camp or field trip for all Camp personnel)

Prior to the beginning of each camp or field trip, all facilitators will review the policy and plans for identifying and treating anaphylaxis. Efforts shall be made to include the parents/guardians, and students (where appropriate), in the training. Camp or field trip participants will learn about anaphylaxis in camp / field trip orientation.

Change Log

Policy page updated August 18, 2022
Last reviewed/updated August 18, 2022