ANAPHYLAXIS MANAGEMENT AND FOOD SHARING POLICY

Transcription

1 ANAPHYLAXIS MANAGEMENT AND FOOD SHARING POLICY *This policy was developed and is adopted by consensus of Preshil Leadership - The Margaret Lyttle Memorial School, vember 2017 Preshil is rigorous in its protection of students with life-threatening food allergies. School policy is based on the Victorian Education and Training Reform Act 2006 and the Ministerial Order #706 - Anaphylaxis Management in Schools, Anaphylaxis Management The Principal is responsible for ensuring that the school s Health Communication Plan, Anaphylaxis Management and Food Sharing Policy provides up-to-date information for all staff, students and parents about anaphylaxis and the school s anaphylaxis management procedures. The Anaphylaxis Management and Food Sharing Policy is designed to raise staff, student and school community awareness about severe allergies and the school's policies. It specifies the steps to be taken if a student has an anaphylactic reaction in a classroom, schoolyard, on a school excursion or school camp, and at special events conducted or organised by the school. This Anaphylaxis Management Plan is communicated to parents via the Preshil School website: The Plan also includes information for volunteers and Casual Relief Teachers (CRT) about any student in their care at risk of an anaphylactic reaction and how to respond to a reaction. The office staff, Heads of Campus and HR Department advise teaching and non-teaching staff, elective staff, volunteers and CRTs as to the location of the adrenaline auto-injectors and the ASCIA and Anaphylaxis Management Plans for students at both Senior and Junior campuses. The CRTs are given a list of anaphylactic students including the location of the ASCIA Action Plans for Anaphylaxis for Anaphylaxis and location of the adrenaline autoinjector devices and school-purchased adrenaline auto-injector devices. At the Senior campus, Blackhall Kalimna, the ASCIA Action Plans for Anaphylaxis for Anaphylaxis and adrenaline auto-injectors are located in the main office area, as well as a copy of the ASCIA Action Plans for Anaphylaxis for Anaphylaxis in the staffroom. At the Junior campus, Arlington, the adrenaline auto-injectors and ASCIA Action Plans for Anaphylaxis for Anaphylaxis are located in the staff room, as well as a copy of the same ASCIA Action Plans for Anaphylaxis for Anaphylaxis in the photocopy area. The Principal authorises the yearly purchase of additional adrenaline auto-injector devices for general use and as a back-up to those supplied by parents.

2 The number of adrenaline auto-injectors needed is determined on: 1. The number of students enrolled and at risk of anaphylaxis at the school; the age/weight of the students at each campus is taken into consideration, when purchasing these adrenaline auto-injectors 2. The type of adrenaline auto-injector needed by the students 3. The accessibility of adrenaline auto-injectors supplied by parents 4. The availability of a sufficient supply of adrenaline auto-injectors for general use in First Aid/Office areas on both campuses, including the schoolyard, at excursions, camps and special events conducted, organised or attended by the school. The Principal authorises the school to replace the school-purchased adrenaline autoinjectors each year. Individual Anaphylaxis Management Plans All parents applying to enrol a child are asked to identify the child s additional needs, such as anaphylaxis management. If a child has been diagnosed by a medical practitioner as being at risk of anaphylaxis, the parents are asked to supply the ASCIA Anaphylaxis Management Plan, prior to commencement. The Principal or Wellbeing Coordinator consults with the parents in developing an individual Anaphylaxis Management Plan. The ASCIA Action plan is given to the Principal immediately after the child enrols and before the student s first day. If this is not possible, an individual interim Anaphylaxis Management Plan will be in place as soon as practicable after enrolment. The interim Anaphylaxis Management Plan will be in place until a verified ASCIA Action plan is in place. The staff are advised as soon as possible at briefings/staff meetings of the ASCIA Action Plans for Anaphylaxis for Anaphylaxis and/or interim plans of new and existing students, or of any changes to any ASCIA or interim Action plans. The individual Anaphylaxis Management Plan includes: a) An ASCIA Action plan with information about the medical diagnosis, including the type of allergy or allergies the child has, and the symptoms associated with this reaction. b) Strategies for minimising the risk of exposure to allergens while the student is under the care or supervision of school staff on campus, and at offcampus settings such as school camps, excursions, etc. c) The name of the person/s responsible for implementing these strategies d) Information on where the student s adrenaline auto-injector and other allergy medication will be located e) Emergency contact details The ASCIA Action Plan Parents are required to provide each year an Anaphylaxis Management Plan, hereafter known as the ASCIA Action Plan for their child, signed by the medical practitioner treating the child at the time of enrolment. If the child has an anaphylactic reaction, either away from or at school, the parents are required to have their child s ASCIA Action Plan updated and then, to provide the school with the new updated ASCIA Action Plan.

3 The ASCIA Action Plan will include: An up-to-date photograph of the child The emergency procedures to be taken in the event of an allergic reaction while at school The emergency procedures to be taken in the event of an allergic reaction while on a school excursion, a school camp, or an off-campus event. Parents are also required to provide an Epinephrine Auto-Injector (Adrenaline auto-injector device), to be kept in the office on the campus the child is attending. Some students may also have antihistamine medication to be administered if an allergic reaction presents. This antihistamine medication is supplied by the parents, with the name of the student and dosage required, clearly labelled. This medication is also listed on the ASCIA Action plan Review of Individual Anaphylaxis Plans Each year the School reviews the student s ASCIA Action Plan in consultation with the parents/carers, including: a) Immediately if the student has an anaphylactic reaction at school b) Immediately if the student s medical condition has changed c) Before the student is participating in an off-site excursion or special event organised or attended by the school. Parents are responsible for: 1. Informing the school if their child s medical condition changes 2. Providing an updated ASCIA Action Plan, or interim plan if relevant 3. Providing a more up-to-date photo for the ASCIA Action Plan when it is being annually reviewed 4. Purchasing at least one adrenaline auto-injector pen for their child and updating this annually, or before expiry date. Staff Anaphylaxis Supervisors are required to: Update all staff via if a child s ASCIA Action Plan has been changed, or an interim plan is in place Keep records of the expiry dates of adrenaline auto-injector pens Send reminders to parents when adrenaline auto-injector pens are due to be replaced. Update spreadsheets with updated adrenaline auto-injector pen expiry dates. School Management of Anaphylaxis Preshil s Anaphylaxis Policy is integrated with the Preshil First Aid Policy, the Preshil Emergency Procedures Policy and the Preshil Excursion Policy. These are also on our school intranet: Compass/School Documentation/Staff Handbook. At Preshil, two staff members have completed the Anaphylaxis Supervisor 22303VIC in July The Secondary Campus Anaphylaxis Training was held on 18 April 2017 and at the Primary Campus on 27 April As of August 2017, all staff are required to complete the Australasian Society of Clinical Immunology and Allergy (ASCIA) online e-training course and have their competency in using an adrenaline auto injector tested in person by an Anaphylaxis Supervisor staff member who has completed 22303VIC, within 30 days of completing the course. This is

4 valid for two years and staff will be required to complete a refresher course every six months, implemented by the staff anaphylaxis supervisor. The two Anaphylaxis Supervisor staff members are retrained every three years within the expiry date of the initial training. Staff will be retrained fully with the Australasian Society of Clinical Immunology and Allergy (ASCIA) e-training course every two years. New staff are also required to complete the Australasian Society of Clinical Immunology and Allergy (ASCIA) online e-training course within four weeks of commencement date at Preshil, course and have their competency in using an adrenaline auto injector tested in person by an Anaphylaxis Supervisor staff member who has completed 22303VIC, within 30 days of completing the course. At Preshil, all staff require First Aid training, and each excursion, school event or school camp has trained First Aid staff in attendance. The teaching and non-teaching staff, including office and administration are all currently trained in First Aid HLTAID003, CPR (as of ) and Anaphylaxis as of (Term 2 and Term 3, 2017). Preshil keeps an updated spreadsheet of students and staff with anaphylaxis, number of Adrenaline auto-injector devices provided by the family and the dates of renewal for these adrenaline auto-injector devices. Parents/Carers are sent reminders when the adrenaline auto-injector devices are due for renewal. During off-site activities, staff will take the adrenaline auto-injector devices, including a spare auto-injector device and a copy of the student/s ASCIA Anaphylaxis Plan, as well as emergency contact details for the student/s. Communication Plan In the case of a student needing the use of an adrenaline auto-injector due to an anaphylactic reaction, the Principal will ensure that the School Management and Emergency Response procedures are followed. See Appendices One and Two. Staff Training Ministerial Order #706 identifies the Principal as being responsible for selecting two staff to attend training courses on anaphylaxis such as: the Australasian Society of Clinical Immunology and Allergy (ASCIA) e-training course. The Principal will ensure that these Anaphylaxis Supervisor staff members oversee the training of all other staff, including nonteaching staff on both campuses and have their competency in using an adrenaline auto injector tested in person by an Anaphylaxis Supervisor staff member within 30 days of completing the course. Staff records are kept to track trained staff and expiry of training dates. Therefore, all students who have been diagnosed as at risk of anaphylaxis will be taught and/or supervised by Anaphylaxis-trained staff. The recognised anaphylactic training courses are: 22099VIC, 22300VIC OR 10313NAT. The principal will ensure that sufficient trained staff are present while students are under the school s care or supervision, at either campuses, or on excursions, camps, or off-site events. The Principal also ensures that at least twice a year all staff attend updates of in-service training by staff members, or First Aid trainers trained in anaphylaxis management. Whole school staff training occurs in a briefing twice per calendar year, with the first to occur at

5 the beginning of the year, delivered by a staff member who has successfully completed an anaphylaxis management training course in the last 2 years. This briefing includes communicating to staff: the location of ASCIA Action Plans for Anaphylaxis for Anaphylaxis; At the Senior campus, Blackhall Kalimna, the ASCIA Action Plans for Anaphylaxis for Anaphylaxis are located in the main office area, as well as a copy of the ASCIA Action Plans for Anaphylaxis for Anaphylaxis in the staffroom. At the Junior campus, Arlington, ASCIA Action Plans for Anaphylaxis for Anaphylaxis are located in the staff room, as well as a copy of the ASCIA Action Plans for Anaphylaxis for Anaphylaxis in the photocopy area. access to adrenaline auto-injectors that have been provided by parents (At the Senior campus, Blackhall Kalimna, adrenaline auto-injectors are located in the main office area. At the Junior campus, Arlington, the adrenaline auto-injectors are located in the staff room). access to adrenaline auto-injectors that have been purchased by the school for general use (At the Senior campus, Blackhall Kalimna, adrenaline auto-injectors are located in the main office area. At the Junior campus, Arlington, the adrenaline auto-injectors are located in the staff room). The student-named boxes containing student s named adrenaline auto-injectors The generic-named boxes containing general use adrenaline auto-injectors. Training is given wherever possible before the student s first day at school, and as required for any new staff employed during the year. New staff need to complete the online course within four weeks of employment, which includes the auto-injector practice device assessment by the Staff Anaphylaxis Supervisors. Training includes attendance and participation in a briefing twice a year (one at the beginning of the year) by a person who has successfully completed an anaphylaxis management training course. These briefings will include: The Preshil Anaphylaxis Management Policy Preshil s First Aid and Emergency Response Procedures (See Appendices One and Two) Online training course accessed at Causes, symptoms and treatment of anaphylaxis Identities of students diagnosed at risk and the location of their individual management plans, medication and adrenaline auto-injector device Recognition and appropriate response to an anaphylactic reaction, including online and hands-on assessment with a Supervisor auto-injector device. HR will keep records of the trained teaching and non-teaching staff and the dates for renewal. If training before the school year starts is not possible, an Interim Plan is developed in consultation with the parents based on the school s first aid and emergency procedures to be followed if a child has an anaphylactic reaction. Preventative Measures - Food Safety All staff on duty are made aware of every child with food allergies. This includes on campus events, excursions, yard duty, camps and special event days. A photograph of each child is displayed in a place where staff have access, such as the staff rooms at both

6 campuses and in the front office areas. The adrenaline auto-injector pens are labelled and kept in the office areas at the Senior campus and in the staff room at the Junior campus. The school-purchased adrenaline auto-injector pens are also kept in the office areas at the Senior campus and in the staff room at the Junior campus. An updated list informs the Anaphylaxis Supervisor of the need to inform parents when the adrenaline auto-injector pens are nearing their expiry date. A reminder for the purchase of a new adrenaline auto-injector is also sent to the parents via direct . Preshil students are discouraged, in general, from sharing food. There is a no food sharing policy for the Sixes and Sevens onwards. Any child with a food allergy is banned from sharing their food or taking food from other children. Other children in the class are told that they cannot share food with the child who has an allergy. The Nursery School and the Fives are nut aware zones. Letters are sent to parents advising that nuts are not to be included in the food children bring to school. Children are supervised in washing their hands before and after eating. Parents of a child with a food allergy are informed in advance when food-sharing activity is included in the curriculum, such as Trying Foods from Other Nations or Cooking in the Classroom or Elective programs. They are given the opportunity to provide alternative foods for their child. This policy also applies to birthday cakes brought in for a class celebration. Communication Plan for Anaphylaxis and First Aid Training The Principal ensures that all staff have access to the Staff Handbook, which includes the Anaphylaxis Policy. This Staff Handbook also outlines procedures for First Aid, Excursions and Camps. This handbook is available to all staff via Compass, the school s intranet. Annual Risk Assessment Preshil s Risk Assessment is monitored annually and includes sections on allergies and preventative measures for students and staff. See Appendix 3: Annual Risk Management Checklist This is amended according to Department Guidelines when required.

7 Appendix One: Procedures To Respond To An Anaphylaxis Emergency When students have an anaphylactic reaction schools must: o Check the student s most recent ASCIA Action plan and Anaphylaxis Management Plan o Ask students whether they have self-administered an adrenaline auto-injector (such as EpiPen) o If the student has not already done so, administer an adrenaline auto-injector (such as EpiPen) o Students own auto-injectors are stored at the front office at the Senior School and in the Staffroom at Junior School. The school-purchased adrenaline auto-injectors are also stored in the same locations, as previously listed. If the student is at an offsite event, such as camp, excursion or other event, the EpiPen is stored in the First Aid bag and is with the teacher in charge of the students during the camp, excursion, event or off-site activity. o Call an ambulance 000 and follow instructions o Contact the student s emergency contact person and then the Department's Security Services Unit on o If off-site, call the school to inform the Principal that the auto-injector has been administered, an ambulance has been called and the emergency contacts have been informed. Administering an EpiPen o te: Where possible these devices should only be used by staff trained to use it. However, in an emergency they may be administered by any person following instruction from the student s ASCIA Action Plan for Anaphylaxis. Prior to use: o Confirm the expiry date to ensure it is in-date (not expired). If the device has expired, use an alternative device if easily accessible. If no other option is available or easily accessible, then USE the expired device. o Check the viewing window to ensure the adrenaline is not cloudy or discoloured. If the device is cloudy or discoloured, use an alternative device if easily accessible. If no other option is available or easily accessible, then USE the cloudy or discoloured device. o Ensure the device is the correct medication for the individual being treated, or the device is the school adrenaline auto-injector for general use.

8 Appendix Two: Using the EpiPen Stage Description 1. Remove the EpiPen from the plastic container. te: Children under 20kg are prescribed an EpiPen Junior which has a smaller dose of adrenaline. 2. Form a fist around the EpiPen and pull off the blue safety cap. 3. Place the orange end against the outer mid-thigh and (with or without clothing). 4. Push down hard until a click is heard or felt and hold for 3 seconds. 5. Remove the EpiPen, being careful not to touch the needle, and return it to its plastic container. 6. te the time you gave the EpiPen 7. Call an ambulance on 000 as soon as possible. 8. The used auto-injector must be handed to the ambulance paramedics along with the time of administration. 9. Reassure the student experiencing the reaction, as they are likely to be feeling anxious and frightened. Do not move the student. 10. Ask another staff member to move other students away and reassure them separately. 11. Watch the student closely in case of repeat reaction. Important: Where there is no marked improvement and severe symptoms, as described in the student s ASCIA Action Plan for Anaphylaxis, are present, a second injection of the same dose may be administered after 5 to 10 minutes. Self-administering of an adrenalin auto-injector This table describes items in relation to students self-administering an adrenaline autoinjector, such as EpiPen. Item Determining capability Duty of care Responsibility to inform Rights Description The decision about whether a student is able to carry and potentially self-administer the adrenaline auto-injector is made while developing the student s ASCIA Action Plan for Anaphylaxis Staff duty of care extends to administering an adrenaline autoinjector for the student even if their ASCIA Action Plan for Anaphylaxis states the student can self-administer When students carry their own adrenaline auto-injector they must inform staff if they use it, so an ambulance can be called immediately Students have a right to self-administer the adrenaline auto-injector, but may not be physically able

9 Appendix Three: Annual risk management checklist School name: Date of review: Who completed this checklist? Review given to: Comments: (to be completed at the start of each year) Preshil The Margaret Lyttle Memorial School Name: Position: Name Position General information 1. How many current students have been diagnosed as being at risk of anaphylaxis, and have been prescribed an adrenaline auto injector? 2. How many of these students carry their adrenaline auto injector on their person? 3. Have any students ever had an allergic reaction requiring medical intervention at school? 4. If, how many times? 5. Have any students ever had an anaphylactic reaction at school? 6. If, how many students? 7. If, how many times? 8. Has a staff member been required to administer an adrenaline auto injector to a student? 9. If, how many times? 10. If your school is a government school, was every incident in which a student suffered an anaphylactic reaction reported via the Incident Reporting and Information System (IRIS)? SECTION 1: Training 11. Have all school staff who conduct classes with students who are at risk of anaphylaxis successfully completed an approved anaphylaxis management training course, either: o Online training (ASCIA anaphylaxis e-training) within the last 2 years, or o Accredited face-to-face training (22300VIC or 10313NAT) within the last 3 years? 12. Does your school conduct twice yearly briefings annually? 13. If no, please explain why not, as this is a requirement for school registration. 14. Do all school staff participate in a twice-yearly anaphylaxis briefing? 15. If no, please explain why not, as this is a requirement for school registration.

10 16. If you are intending to use the ASCIA Anaphylaxis e-training for Victorian Schools: o Has your school trained a minimum of 2 school staff (School Anaphylaxis Supervisors) to conduct competency checks of adrenaline auto injectors (EpiPen )? 17. Are your school staff being assessed for their competency in using adrenaline auto injectors (EpiPen ) within 30 days of completing the ASCIA Anaphylaxis e-training for Victorian Schools? SECTION 2: Individual Anaphylaxis Management Plans 18. Does every student who has been diagnosed as being at risk of anaphylaxis and prescribed an adrenaline autoinjector have an Individual Anaphylaxis Management Plan which includes an ASCIA Action Plan for Anaphylaxis completed and signed by a prescribed medical practitioner? 19. Are all Individual Anaphylaxis Management Plans reviewed regularly with parents (at least annually)? 20. Do the Individual Anaphylaxis Management Plans set out strategies to minimise the risk of exposure to allergens for the following inschool and out of class settings? 21. During classroom activities, including elective classes 22. In canteens or during lunch or snack times 23. Before and after school, in the school yard and during breaks 24. For special events, such as sports days, class parties and extracurricular activities 25. For excursions and camps 26. Other 27. Do all students who carry an adrenaline auto injector on their person have a copy of their ASCIA Action Plan for Anaphylaxis kept at the school (provided by the parent)? 28. Where are the Action Plans kept? 29. Does the ASCIA Action Plan for Anaphylaxis include a recent photo of the student? 30. Are Individual Management Plans (for students at risk of anaphylaxis) reviewed prior to any off site activities (such as sport, camps or special events), and in consultation with the student s parent/s? SECTION 3: Storage and accessibility of adrenaline autoinjectors 31. Where are the student(s) adrenaline auto injectors stored? 32. Do all school staff know where the school s adrenaline auto injectors for general use are stored? 33. Are the adrenaline auto injectors stored at room temperature (not refrigerated) and out of direct sunlight? 34. Is the storage safe?

11 35. Is the storage unlocked and accessible to school staff at all times? Comments: 36. Are the adrenaline auto injectors easy to find? Comments: 37. Is a copy of student s individual ASCIA Action Plan for Anaphylaxis kept together with the student s adrenaline auto injector? 38. Are the adrenaline auto injectors and Individual Anaphylaxis Management Plans (including the ASCIA Action Plan for Anaphylaxis) clearly labelled with the student s names? 39. Has someone been designated to check the adrenaline auto injector expiry dates on a regular basis? 40. Who? 41. Are there adrenaline auto injectors, which are currently in the possession of the school, which have expired? 42. Has the school signed up to EpiClub (optional free reminder services)? 43. Do all school staff know where the adrenaline auto injectors, the ASCIA Action Plans for Anaphylaxis for Anaphylaxis for Anaphylaxis and the Individual Anaphylaxis Management Plans are stored? 44. Has the school purchased adrenaline auto injector(s) for general use, and have they been placed in the school s first aid kit(s)? 45. Where are these first aid kits located? 46. Do staff know where they are located? 47. Is the adrenaline auto injector for general use clearly labelled as the General Use adrenaline auto injector? 48. Is there a register for signing adrenaline auto injectors in and out when taken for excursions, camps etc.? SECTION 4: Risk Minimisation strategies 49. Have you done a risk assessment to identify potential accidental exposure to allergens for all students who have been diagnosed as being at risk of anaphylaxis? 50. Have you implemented any of the risk minimisation strategies in the Anaphylaxis Guidelines? If yes, list these in the space provided below. If no please explain why not as this is a requirement for school registration. 51. Are there always sufficient school staff members on yard duty who have current Anaphylaxis Management Training?

12 SECTION 5: School management and emergency response 52. Does the school have procedures for emergency responses to anaphylactic reactions? Are they clearly documented and communicated to all staff? 53. Do school staff know when their training needs to be renewed? 54. Have you developed emergency response procedures for when an allergic reaction occurs? 55. In the classroom? 56. In the schoolyard? 57. In all school buildings and sites, including gymnasiums and halls? 58. At school camps and excursions? 59. On special event days (such as sports days) conducted, organised or attended by the school? 60. Does your plan include who will call the ambulance? 61. Is there a designated person who will be sent to collect the student s adrenaline auto injector and individual ASCIA Action Plan for Anaphylaxis? 62. Have you checked how long it takes to get an individual s adrenaline auto injector and corresponding individual ASCIA Action Plan for Anaphylaxis to a student experiencing an anaphylactic reaction from various areas of the school including: 63. The classroom? 64. The schoolyard? 65. The sports field? 66. The school canteen? 67. On excursions or other out of school events is there a plan for who is responsible for ensuring the adrenaline auto injector(s) and Individual Anaphylaxis Management Plans (including the ASCIA Action Plan) and the adrenaline auto injector for general use are correctly stored and available for use? 68. Who will make these arrangements during excursions? Who will make these arrangements during camps? Who will make these arrangements during sporting activities? Is there a process for post-incident support in place? 75. Have all school staff who conduct classes attended by students at risk of anaphylaxis, and any other staff identified by the principal, been briefed by someone familiar with the school and who has completed an approved anaphylaxis management course in the last 2 years on: 76. The school s Anaphylaxis Management Policy? 77. The causes, symptoms and treatment of anaphylaxis?

13 78. The identities of students at risk of anaphylaxis, and who are prescribed an adrenaline auto injector, including where their medication is located? 79. How to use an adrenaline auto injector, including hands on practice with a Supervisor adrenaline auto injector? 80. The school s general first aid and emergency response procedures for all in-school and out-of-school environments? 81. Where the adrenaline auto injector(s) for general use is kept? 82. Where the adrenaline auto injectors for individual students are located including if they carry it on their person? 83. SECTION 6: Communication Plan 84. Is there a Communication Plan in place to provide information about anaphylaxis and the school s policies? 85. To school staff? 86. To students? 87. To parents? 88. To volunteers? 89. To casual relief staff? 90. Is there a process for distributing this information to the relevant school staff? 91. What is it? 92. How will this information kept up to date? 93. Are there strategies in place to increase awareness about severe allergies among students for all in-school and out-of-school environments? 94. What are they?