Anaphylaxis Management Policy

Transcription

1 Anaphylaxis Management Policy Rationale Thomas Carr College is committed to providing, as far as practicable, a safe and supportive environment for students who are at risk of anaphylaxis. The College is also committed to the provision of competent and prompt emergency care to ensure the health and optimum outcome of all staff, students or visitors who may experience an anaphylactic reaction, whether on or off school premises. The keys to prevention of anaphylaxis in schools are planning, risk minimisation, education and awareness of those students who are at risk. The College will fully comply with Ministerial Order 706 and the associated Guidelines published and amended by the Department from time to time. Anaphylaxis is a severe, rapidly progressive allergic reaction that is potentially life threatening. Common allergens in school aged children are peanuts, eggs, tree nuts (eg hazelnuts, cashews and almonds), cow's milk, wheat, soy, fish and shellfish, sesame seeds, latex, certain insect stings (eg bee and wasp stings) and medications. Anaphylaxis is treated with adrenaline, which is given as an injection (EpiPen) into the muscle of the outer mid thigh. Policy Guidelines To provide prompt and competent emergency care to staff, students or visitors who may be experiencing an anaphylactic reaction To proactively seek information about severe allergies from parents/guardians/staff To ensure staff know the identity of students who are at risk of anaphylaxis and are aware of the EpiPen locations To encourage students, where possible, to take responsibility for their own health issues, when information is provided and supported by parents/guardians To provide staff with training in how to recognise and respond to an anaphylactic reaction, including administration of an EpiPen To provide information to staff, students and parents/guardians to raise awareness about severe allergies and the College s management Policy To provide individual management plans, in consultation with parents/guardians, for students when on and off campus Responsibility for implementation: Policy status Reviewed Key Stakeholders: College staff and students Endorsement Body: College Executive Ratification Body: College Board Policy Author: College Nurse, Director of Student Services Date of Approval: 2015 Date of Scheduled Review: 2018 The content of this policy can be changed at the College Board s discretion at any time without notification.

2 Anaphylaxis Management Procedures 2015 Implementation All students have their own Anaphylaxis Kit which is kept in a clearly marked unlocked cupboard in the main Administration Office. Each kit is individually labelled with the students name and photo. The kit contains the students EpiPen, ASCIA (Australasian Society of Clinical Immunology and Allergy Inc.) Action Plan for Anaphylaxis, any other medication prescribed on the Action Plan and a ballpoint pen. The students Anaphylaxis Kit will only be removed when signed out for off campus activities and if required for emergency use. The College has purchased 7 EpiPens for General Use, and as a back up to those supplied by Parents. The General Use Anaphylaxis Kit contains an EpiPen, ASCIA Action Plan for Anaphylaxis (general), ballpoint pen, Salbutamol inhaler and spacer for administration as well as Asthma First Aid instructions. These are located in the main Administration Office, Health Centre, Student Reception, Food Technology, Canteen, Gymnasium, Trade Training Centre. The Good Samarian Campus (GSC) in Coragulac also stocks 2 General Use Anaphylaxis Kits. Refer to Appendix 2 Location of First Aid Equipment. First Aid backpacks all contain a General Use Anaphylaxis Kit. These are located in the Health Centre (4) for off campus activities; Gymnasium (22) for ACS Sport, carried by each ACS Coach; and Good Samaritan Campus (GSC) for transporting students to and from the campus by train. A recent colour photo of all students who have been diagnosed as at risk of Anaphylaxis will be displayed in the Staff Lunchroom, Health Centre, main Administration Office, Student Reception, Food Technology area, Science Laboratories, the Gymnasium, Learning Centre, Canteen and in yard duty folders. They will also be displayed at GSC in the Administration office, Staff room and Kitchen. Photos will be discretely displayed for staff to see only. Each student s allergen will also be identified. Every student enrolled to Thomas Carr College who has been identified as at risk of anaphylaxis will have a Medical Alert attached to their student profile on SIMON, so every teacher who has a student in their class at risk of anaphylaxis can be easily identified The College will request that parents/guardians provide a current ASCIA Action Plan that has been signed by the student s medical practitioner and has an up-to-date colour photo of the student, an EpiPen that has not expired, and any other medication prescribed on the Action Plan. The College also requests that parents/guardians inform the College in writing if their child s medical condition changes, and if relevant, provides an updated ASCIA Action Plan. The College will request that parents/guardians of students who are also diagnosed with Asthma, provide a current Asthma Action Plan that has been signed by the student s medical practitioner; a reliever medication as prescribed (eg Ventolin) that has not expired and a spacer for administration of the reliever. The College Nurse will ensure that an Individual Anaphylaxis Management Plan is developed, in consultation with the student s parents/guardians, for any student who has been diagnosed by a Medical Practitioner as being at risk of anaphylaxis. The Individual Anaphylaxis Management Plan will contain information about the student s medical condition that relates to allergy, including the type of allergy/allergies; strategies to minimise the risk of exposure to known allergens while the student is under the care or supervision of School Staff; information on where the student s medication will be stored; the student s emergency contact details; and an ASCIA Action Plan. The Individual Anaphylaxis Management Plan will be reviewed, in consultation with the student s parents/guardians in the following circumstances: annually; if the student s medical condition, insofar as it relates to allergy and the potential for anaphylactic reaction changes; as soon as practical after the student has an anaphylactic reaction at school; and when the student is to participate in an off-site activity. The College Nurse will complete an annual Risk Management Checklist as published by the Department of Education and Early Childhood Development to monitor compliance with their obligations. The College Nurse will keep an up-to-date register of students/staff at risk of anaphylaxis and emergency contact details. This is based on the provision that parents/guardians and staff provide this information. The College Nurse will check that the EpiPen is correctly stored, not cloudy or expired, at the beginning of each term. The parent/guardian will be informed in writing, and by phone if necessary, a month prior to the expiration of the students EpiPen. The College will encourage ongoing communication between parents/guardians and staff about the current status of the student s allergies, the school s policies and their implementation. All casual relief teaching staff will be given a Casual Relief folder containing a brief on where to access the Anaphylaxis Management Policy; identifying students at risk of anaphylaxis; the location of student and General Use Anaphylaxis Kits; and the emergency response procedure in the event of an anaphylactic reaction.

3 The College Nurse will work with staff to develop strategies to raise school staff, student and community awareness about severe allergies and prevention strategies. See Appendix 1 Risk minimisation and prevention strategies When a student is off campus, it is the student/parent responsibility to ensure they bring their own EpiPen from home, to be carried on them at all times. This includes travel to and from school by bus, excursions, camps and sporting events eg ACS and carnivals. In addition to the students own EpiPen, the Students Anaphylaxis kit, along with a General Use kit, will be signed out, and back in, to the Administration Office by the Supervising Teacher. The College will offer training to School Staff, who will undertake an Anaphylaxis Management Training Course every three years (valid for three years). School Staff will be offered the opportunity to participate in a briefing, to occur twice per calendar year. This briefing will cover the College s Anaphylaxis Management Policy; the causes, symptoms and treatment of anaphylaxis; how to use an EpiPen, including hands on practise; the College s general first aid and emergency response procedures; identification of the students diagnosed at risk of Anaphylaxis; and the location of EpiPens provided by Parents and those purchased by the College for general use. Emergency Response In the event of an anaphylactic reaction, the school s first aid and emergency response procedures must be followed. If a person is suspected to be experiencing an allergic reaction (mild or severe), ensure someone stays with them 2 students to be designated by the supervising teacher to be runners, to collect the students Anaphylaxis kit and a General Use Anaphylaxis kit from the front Administration Office. If there is a General Use Anaphylaxis kit in closer proximity, this is to be sent for also. Note: If the person has not been diagnosed as at risk of anaphylaxis, the runners are to collect the General Use kit only. Upon delivery of the Anaphylaxis kit, the Staff member is to check: ASCIA Action Plan for Anaphylaxis name and photo matches that of the student in question (omit this step if student has not been diagnosed as at risk of anaphylaxis & a General Use kit is being utilised ) Assess for signs and symptoms of allergy as per ASCIA Action Plan for Anaphylaxis Follow the treatment plan for mild to moderate or severe (anaphylaxis) reaction If the EpiPen is administered, record the time of administration on the Action Plan and immediately phone an ambulance Further adrenaline doses may be given if there is no response after 5 minutes, on the advice of Ambulance Victoria If uncertain whether it is anaphylaxis or asthma administer the EpiPen first, then asthma reliever If in doubt, administer the EpiPen Commence CPR at any time if person is unresponsive and not breathing normally Staff member to remain with student until Ambulance arrives ensure a staff member is allocated to meet and direct the ambulance When able, contact the students family or emergency contact Complete an incident form as soon as possible Appendix 1 - Risk minimisation and prevention strategies Food banning is not generally recommended. Instead, a no-sharing with the students with food allergy approach is recommended for food, utensils and food containers, across all settings. All casual relief teaching staff will be given a Casual Relief folder containing a brief on where to access the Anaphylaxis Management Policy; identifying students at risk of anaphylaxis; the location of student and General Use Anaphylaxis Kits; and the emergency response procedure in the event of an anaphylactic reaction. In-school settings Classrooms 1. Liaise with Parents about food-related activities ahead of time 2. Use non-food treats where possible, but if food treats are used in class it is recommended that Parents of students with food allergy provide a treat box with alternative treats. Treat boxes should be clearly labelled and only handled by the student. 3. Never give food from outside sources to a student who is at risk of anaphylaxis 4. Treats for the other students in the class should not contain the substance to which the student is allergic. It is recommended to use non-food treats where possible. 5. Products labelled 'may contain traces of nuts' should not be served to students allergic to nuts. Products labelled may contain milk or egg should not be served to students with milk or egg allergy and so forth. 6. Be aware of the possibility of hidden allergens in food and other substances used in cooking, food technology, science and art classes (e.g. egg or milk cartons, empty peanut butter jars) 7. All students at risk of anaphylaxis have a medical alert on their student profile in SIMON, accessible to all classroom teachers

4 Food Technology 1. Food Technology staff completed a course in First Aid Management of Anaphylaxis, along with twice yearly briefings 2. A colour photo of all students at risk of anaphylaxis are displayed along with their particular allergen/s 3. All students at risk of anaphylaxis have a medical alert on their student profile in SIMON, accessible to all classroom teachers 4. A General Use Anaphylaxis Kit located in Food Technology - containing EpiPen, ASCIA Action Plan for Anaphylaxis (general), ballpoint pen, Salbutamol inhaler and spacer for administration as well as Asthma First Aid instructions. 5. Products labelled 'may contain traces of nuts' should not be served to students allergic to nuts. Products labelled may contain milk or egg should not be served to students with milk or egg allergy and so forth. 6. Be aware of the possibility of hidden allergens in food and other substances used in cooking, food technology, science and art classes (e.g. egg or milk cartons, empty peanut butter jars) 7. Recipes provided which are free from potential allergens 8. Students at risk of anaphylaxis also take responsibility in checking the ingredients they are to use 9. Students at risk of anaphylaxis to collect their ingredients first 10. Ensure all cooking utensils, preparation dishes, plates, and knives and forks etc are washed and cleaned thoroughly after preparation of food and cooking 11. Students at risk of anaphylaxis to be provided with a cooking area and utensils specifically designated for their use, to ensure they have never come into contact with allergens ie dairy, egg etc 12. Students at risk of anaphylaxis to wash all of their own cooking utensils, preparation dishes, plates, and knives and forks etc 13. Have regular discussions with students about the importance of washing hands, eating their own food and not sharing food 14. Cooking area and utensils specifically designated for a student if required Canteen 1. Canteen staff should be able to demonstrate satisfactory training in food allergen management and its implications on food-handling practices, including knowledge of the major food allergens triggering anaphylaxis, cross-contamination issues specific to food allergy, label reading, etc. 2. Canteen staff, including volunteers, should be briefed about students at risk of anaphylaxis and, where the Principal determines in accordance with clause of the Order, have up to date training in an Anaphylaxis Management Training Course. 3. A colour photo of all students at risk of anaphylaxis are displayed along with their particular allergen/s 4. A General Use Anaphylaxis Kit located in the Canteen - containing EpiPen, ASCIA Action Plan for Anaphylaxis (general), ballpoint pen, Salbutamol inhaler and spacer for administration, as well as Asthma First Aid instructions 5. Ensure all cooking utensils, preparation dishes, plates, and knives and forks etc are washed and cleaned thoroughly after preparation of food and cooking, and all surfaces are wiped down with warm soap water regularly 6. Be wary of contamination of other foods when preparing, handling or displaying food. For example, a tiny amount of butter or peanut butter left on a knife and used elsewhere may be enough to cause a severe reaction in someone who is at risk of anaphylaxis from cow s milk products or peanuts 7. Products labelled 'may contain traces of nuts' should not be served to students allergic to nuts. Products labelled may contain milk or egg should not be served to students with milk or egg allergy and so forth 8. Canteen provides a range of healthy meals/products that exclude peanut or other nut products in the ingredient list or a may contain... statement 9. Students are encouraged to check ingredients prior to the purchase of items Yard 1. Sufficient School Staff on yard duty are trained in the administration of the Adrenaline Autoinjector (i.e. EpiPen ) to be able to respond quickly to an anaphylactic reaction if needed 2. The Students Anaphylaxis Kit containing the students EpiPen, ASCIA Action Plan for Anaphylaxis, any other medication prescribed on the Action Plan and a ballpoint pen is easily accessible from the yard, and staff are aware of its exact location 3. Yard duty staff can identify, by face, those students at risk of anaphylaxis. A colour photo of all students at risk of anaphylaxis are displayed along with their particular allergen/s in Yard duty folders 4. All staff on yard duty are aware of the School s Emergency Response Procedures and how to notify the administration office of an anaphylactic reaction in the yard 5. Students with anaphylactic responses to insects are encouraged to stay away from water or flowering plants 6. Lawns and clover are regularly mowed and outdoor bins covered Special events (sporting carnivals, incursions, class parties, etc) 1. Sufficient School Staff supervising the event are trained in the administration of an Adrenaline Autoinjector to be able to respond quickly to an anaphylactic reaction if required 2. School Staff avoid using food in activities or games, including as rewards

5 3. For special occasions, School Staff consult Parents in advance to either develop an alternative food menu or request the Parents to send a meal for the student 4. Parents of other students should be informed in advance about foods that may cause allergic reactions in students at risk of anaphylaxis and request that they avoid providing students with treats whilst they are at School or at a special School event 5. Party balloons should not be used if any student is allergic to latex 6. Students with anaphylactic responses to insects are encouraged to stay away from water or flowering plants. School Staff liaise with Parents to encourage students to wear light or dark rather than bright colours, as well as closed shoes and long-sleeved garments when outdoors. Out of School Settings Student/parent responsibility For all out of school settings, the student is to bring their own EpiPen along with their ASCIA Action Plan for Anaphylaxis from home. This includes travel to and from school by bus, excursions and sporting events including ACS, and camps. School staff responsibility For all out of school excursions, each students Anaphylaxis kit as well as a General Use Anaphylaxis Kit is signed out from the Administration Office by the Supervising Staff member Travel to and from School by bus 1. The Adrenaline Autoinjector (EpiPen) and ASCIA Action Plan for Anaphylaxis must be with the student even if the student is deemed too young to carry an Adrenaline Autoinjector (EpiPen) on their person at School. School Staff consult with Parents of students at risk of anaphylaxis and the bus service provider Excursions and/or whole school sporting carnivals 1. Sufficient School Staff supervising the event are trained in the administration of an Adrenaline Autoinjector (EpiPen) and are be able to respond quickly to an anaphylactic reaction if required 2. A School Staff member trained in the recognition of anaphylaxis and the administration of the Adrenaline Autoinjector (EpiPen) accompanies any student at risk of anaphylaxis on excursions 3. School Staff avoid using food in activities or games, including as rewards 4. In addition to the students own EpiPen, the Students Anaphylaxis Kit containing the students EpiPen, ASCIA Action Plan for Anaphylaxis, any other medication prescribed on the Action Plan and a ballpoint pen is signed out by the supervising staff member to be taken on the excursion 5. In addition to the students own EpiPen and Students Anaphylaxis Kit, a General Use Anaphylaxis kit containing EpiPen, ASCIA Action Plan for Anaphylaxis (general), ballpoint pen, Salbutamol inhaler and spacer for administration, as well as Asthma First Aid instructions is signed out by the supervising staff member to be taken on the excursion 6. For each excursion, a risk assessment is undertaken for each individual student attending who is at risk of anaphylaxis. The risks may vary according to the number of anaphylactic students attending, the nature of the excursion/sporting event, size of venue, distance from medical assistance, the structure of excursion and corresponding staff-student ratio. All School Staff members present during the excursion need to be aware of the identity of any students attending who are at risk of anaphylaxis and be able to identify them by face. 7. The School may consult Parents of anaphylactic students in advance to discuss issues that may arise; to develop an alternative food menu; or request the Parents provide a meal (if required) ACS 1. Sufficient School Staff supervising the event are trained in the recognition of anaphylaxis, administration of an EpiPen and are able to respond quickly to an anaphylactic reaction if required 2. Students are to bring their own EpiPen from home. The EpiPen, along with their ASCIA Action Plan for Anaphylaxis is to be handed to their coach. The ACS Coach will place it in their First Aid back pack to be taken to the event. Upon completion of ACS, it will be returned to the student. 3. If a student forgets their home EpiPen, they will sign their student Anaphylaxis Kit out at the front office, and return it back to the front office as soon as possible 4. In addition to the students own EpiPen, a General Use Anaphylaxis kit containing EpiPen, ASCIA Action Plan for Anaphylaxis (general), ballpoint pen, Salbutamol inhaler and spacer for administration, as well as Asthma First Aid instructions is provided in the ACS Coach s First Aid back pack to be taken to the event 5. School Staff avoid using food in activities or games, including as rewards Good Samaritan Campus and Camps 1. The Good Samaritan Campus (GSC) in Coragulac can provide food that is safe for students at risk of anaphylaxis 2. The GSC cook is able to demonstrate satisfactory training in food allergen management and its implications on food-handling practices, including knowledge of the major food allergens triggering anaphylaxis, crosscontamination issues specific to food allergy, label reading, etc

6 3. GSC avoids stocking peanut or tree nut products, including nut spreads. Products that may contain traces of nuts may be served, but not to students who are known to be allergic to nuts. 4. A risk assessment conducted at GSC with risk minimisation and preventions strategies implemented 5. Use of substances containing allergens should be avoided where possible 6. Cooking and art and craft games do not involve the use of known allergens 7. Consider the potential exposure to allergens when consuming food on buses and trains to and from camp, and in rooms 8. Students with anaphylactic responses to insects should always wear closed shoes and long-sleeved garments when outdoors and are encouraged to stay away from water or flowering plants 9. Staff participating in the camp are clear about their roles and responsibilities in the event of an anaphylactic reaction, as per the GSC emergency response procedures 10. The Students Anaphylaxis Kit containing the students EpiPen, ASCIA Action Plan for Anaphylaxis, any other medication prescribed on the Action Plan and a ballpoint pen; will remain close to the student, and staff will be aware of its location at all times. If mobile phone access is not available, an alternative method of communication in an emergency must be considered, e.g. a satellite phone. 11. The GSC campus has 2 Anaphylaxis Kits for General Use, or as a back- up device in the event of an emergency. General Use kits contain an EpiPen, ASCIA Action Plan for Anaphylaxis (general), ballpoint pen, Salbutamol inhaler and spacer for administration as well as Asthma First Aid instructions 12. Prior to the camp taking place the College Nurse may consult with the student's Parents to review the students Individual Anaphylaxis Management Plan to ensure that it is up to date and relevant to the circumstances of the particular camp Overseas Travel 1. Investigate the potential risks at all stages of the overseas travel such as: travel to and from the airport/port; travel to and from Australia (via aeroplane, ship etc); various accommodation venues; all towns and other locations to be visited; sourcing safe foods at all of these locations; and risks of cross contamination including o exposure to the foods of the other students; o hidden allergens in foods o whether the table and surfaces that the student may use will be adequate cleaned to prevent a reaction o whether the other students will wash their hands when handling food 2. Assess where each of these risks can be managed using minimisation strategies such as the following: translation of the student s Individual Anaphylaxis Management Plan and ASCIA Action Plan sourcing of safe foods at all stages obtaining the names, address and contact details of the nearest hospital and Medical Practitioners at each location that may be visited obtaining emergency contact details sourcing the ability to purchase additional auto injectors 3. Record details of travel insurance, including contact details for the insurer. Determine how any costs associated with medication, treatment and/or alteration to the travel plans as a result of an anaphylactic reaction can be paid 4. Plan for appropriate supervision of students at risk of anaphylaxis at all times, including that: there are sufficient School Staff attending the excursion who have been trained there is an appropriate level of supervision of anaphylactic students throughout the trip, particularly at times when they are taking mediation and eating food there will be capacity for adequate supervision of any affected student(s) requiring medical treatment, and that adequate supervision of other students will be available staff/student ratios should be maintained during the trip, including in the event of an emergency where the students may need to be separated 5. The School should re-assess its Emergency Response Procedures, and if necessary adapt it to the particular circumstances of the overseas trip. Keep a record of relevant information such as the following: dates of travel name of airline, and relevant contact details itinerary detailing the proposed destinations, flight information and the duration of the stay in each location; hotel addresses and telephone numbers proposed means of travel within the overseas country list of students and each of their medical conditions, medication and other treatment (if any) emergency contact details of hospitals, ambulances, and Medical Practitioners in each location; details of travel insurance plans to respond to any foreseeable emergency including who will be responsible for the implementation of each part of the plans

7 possession of a mobile phone or other communication device that would enable the School Staff to contact emergency services in the overseas country if assistance is required Work Experience 1. Schools should involve Parents, the student and the employer in discussions regarding risk management prior to a student at risk of anaphylaxis attending work experience. Staff must be shown the ASCIA Action Plan for Anaphylaxis and how to use the Adrenaline Autoinjector in case the work experience student shows signs of an allergic reaction whilst at work experience. It is important to note that it is not recommended that banning of food or other products is used as a risk minimisation and prevention strategy. The reasons for this are as follows: it can create complacency among staff and students it does not eliminate the presence of hidden allergens it is difficult to "ban" all triggers (allergens) because these are not necessarily limited to peanuts and nuts. Triggers and common allergens can also include eggs, dairy, soy, wheat, sesame, seeds, fish and shellfish

8 Appendix 2 -