ADMINISTRATIVE PROCEDURE FOR POLICY JFD FOOD ALLERGY MANAGEMENT Part I: Education and Training for School Personnel 1. All school personnel will annually view the on-line Allergy Management training on Global Compliance Network (GCN) [See GCN instructions for login, Appendix 1]. This training will be viewed at opening in-service in each school building. 2. The school nurse will supplement the GCN program as follows: a. Demonstrate use of the epinephrine device (e.g., EpiPen, Adrenaclick, or Twinject); b. Emphasize the need to write down the time the epi-pen was administered (as it is effective for 15-20 minutes); c. Review all major allergy symptoms; d. Emphasize that some people will not display all major symptoms; e. Inform the staff of all students in the building who have Individual Health Care Plans (IHCP) and/or 504 plans related to Food allergies, and how to obtain the information in the IHCP or 504 plan; and, f. Encourage all school personnel who have life-threatening allergies to inform the school nurse and have health care plans on file with the nurse. 3. All teachers will be reminded to regularly update Red Substitute Folder with a current roster of all students in the building who have a life-threatening allergy. 4. All custodians will be trained annually regarding cleaning protocols throughout the building and specifically in the lunch rooms. 5. Upon learning of any known food allergen contamination, school personnel will immediately notify custodial staff that such food allergen contamination needs custodial cleaning. 6. Each building will have at least three full time school personnel who are trained in the administration of CPR and use of the AED. Page 1
ADMINISTRATIVE PROCEDURE FOR POLICY JFD Part II: Procedures for Responding to Life Threatening Allergic Reactions to Food ANY SEVERE SYMPTOMS AFTER SUSPECTED INGESTION: LUNG: Short of breath, wheeze, repetitive cough HEART: faint or weak pulse THROAT: Tight, hoarse, trouble breathing/ swallowing MOUTH: Obstructive swelling (tongue or uvula) SKIN: Hives involving more than one body part, itchy rash, swelling, pale, blue GUT: Vomiting, cramping pain BRAIN/RESPONSE: Dizzy, Confused Or combination of symptoms from two or more different body areas INJECT EPINEPHRINE IMMEDIATELY Call 911 Begin monitoring (see below) Notify school office ( who will in turn notify nurse and CPR/AED trained staff) Contact parents Page 2 MILD SYMPTOMS ONLY: MOUTH: Itchy mouth or non-obstructive swelling (lips) SKIN: A few hives around mouth/face, mild itch GUT: Mild nausea/discomfort GIVE PRESCRIBED OR APPROVED OVER THE COUNTER ANTIHISTAMINE (liquid or dissolvable tablet formulation) Stay with child Alert office and nurse Alert parent(s) SEVERITY OF SYMPTOMS CAN CHANGE QUICKLY. IF SYMPTOMS PROGRESS, INJECT EPINEPRHINE (SEE ABOVE) MONITORING: Stay with the child. Tell rescue squad if epinephrine was given. Epinephrin may need to be repeated every 5-15 minutes if symptoms persist or reoccur. For a severe reaction, consider keeping child lying on back with legs raised. Treat child even if parents cannot be reached. This chart is posted in each classroom on the Crisis Folder bin.
ADMINISTRATIVE PROCEDURE FOR POLICY JFD Part III: Process for Implementation of Individual Health Care Plans (IHCP) 1. Each school nurse will review Emergency Health Information (as part of annual registration) required for each student prior to the beginning of the school year. 2. When a life-threatening allergy is noted, the nurse will contact the parent to develop IHCP or, if necessary, 504 plan [see Emergency Health Care Plan form, Appendix 2]. 3. The IHCP must be signed by the parent and physician. 4. The IHCP must include a current photo of the child. 5. Any prescribed medication is stored in the nurse s office and/or carried with the child as provided by the prescription and authorized in the IHCP. 6. All students with life-threatening allergies are coded in the Student Management System. 7. Each student with a life threatening allergy s IHCP or 504 will be accessible to school personnel in that student s classroom and in the nurse s office. 8. All school personnel, including substitute teachers, will be informed of students with whom they will or may come in contact who have a life-threatening allergy (see Part I Education and Training). Page 3 Part IV: Protocols to Prevent Exposure to Food Allergens 1. As noted in Section I and II above, annual staff training on life-threatening food allergies will be conducted. 2. As noted in Section III above, each student with a life-threatening food allergy will have on file in the nurse s office an Individualized Health Care Plan or if necessary, a 504 plan. 3. At the beginning of each school year, an all school letter will be sent to each household explaining Universal Precautions in place by the District [see sample letters, Appendices 3 and 3b]. 4. Each lunchroom or designated eating area will have a nut free zone where students with severe allergies may sit (according to each student s IHCP). 5. For students with other food-related allergies, lunch room provisions will be implemented in accordance with the IHCP. 6. Within classrooms where a healthy snack is allowed, students must provide their own nut-free snack, preferably consisting of fresh fruits and vegetables. 7. Students will be educated regarding the no sharing food practice. 8. Staff members may not provide food items of any type for students. Exceptions may be made for curriculum related projects, student sponsored events, or special celebrations that have been pre-approved by the building administrator. a. At Hickory Point and Shabonee Schools, such projects/events/celebrations will be explained in writing and sent home to the parents of participating students for signature approval for participation [see sample communication, Appendix 4].
ADMINISTRATIVE PROCEDURE FOR POLICY JFD b. At Wood Oaks Junior High, such projects will be explained in writing and sent home for parent notification [see sample notification, Appendix 5]. 9. All PTA-sponsored Hot Lunch meals served in the lunch rooms are purchased by parents via a pre-order system. Parents have the option to participate in this PTA-sponsored service. Students whose lunch is not pre-ordered by parents will not be served this meal without parental permission. 10. District approved disposal wipes will be provided in each Academic Lunch classroom or any other classroom that serves as an alternate lunch room. Students will be instructed to wipe down desks at the end of the period. Additionally, at least one desk in each classroom that serves as an alternate lunchroom will be marked as nut free seating areas. Page 4 Custodial Cleaning Protocol: 11. Food Allergy Policy and Administrative Procedures will be annually reviewed with the daytime custodial staff. 12. All daytime custodians will participate in the annual Education and Training of School Personnel (Section I). 13. All cleaning products and custodial cleaning practices are developed by the Director of Facilities and supervised by both the Director and the Building Chief. 14. After each lunch shift, custodians will wipe down table surfaces and seats. Nut Free tables will be cleaned using designated cleaning materials to prevent cross-contamination from general seating areas. 15. Classroom desks, computer keyboards, doorknobs, and lockers will be cleaned routinely and when specifically alerted.
Appendix 1 of Policy JFD
Northbrook School District 27 Emergency Health Care Plan Appendix 2 of Policy JFD School Year Name: School: DOB: Grade: Allergies: History: Medications: Insert Photo My child will need to sit at peanut-free table at lunch. Yes No MOUTH THROAT SKIN GUT LUNG HEART SIGNS OF AN ALLERGIC REACTION INCLUDE: Itching or swelling of the lips, tongue or mouth Itching and/or a sense of tightness in throat; hoarseness, hacking cough Hives; itchy rash and/or swelling about the face or extremities Nausea, abdominal cramps, vomiting and/or diarrhea Shortness of breath, repetitive coughing and/or wheezing Thready pulse, dizziness, passing out Action: 1. If ingestion is suspected, give over-the-counter or prescription anti-histamine as prescribed. 2. If signs of allergic reaction (as listed above), administer epinephrine (EpiPen, Adrenaclick, or Twinject device). 3. Call 911 immediately! 4. Give copy of Emergency Health Care Plan to the EMT. 5. Notify school nurse/ office. 6. Notify parents. DO NOT HESITATE TO ADMINISTER MEDICATION OR CALL RESCUE SQUAD EVEN IF PARENTS OR DOCTOR CANNOT BE REACHED! Emergency Contacts Parent / Guardian: Cell Phone: Parent / Guardian: Cell Phone: Pediatrician: Home: Work: Home: Work: Phone: Parent Signature Date Physician Signature Date
UNIVERSAL PERCAUTION REGARDING ALLERGIES TO PEANUTS AND/OR TREE NUTS Appedix 3 of Policy JFD Date Dear Parents, This letter is sent to inform you that several students in our building have severe food allergies to peanuts or tree nuts. Exposure to these allergens could cause a life-threatening reaction. Strict avoidance of all nut products, by-products, and residue is the only way to prevent an allergic reaction. We ask your assistance in providing a safe school environment for all students. If your child s classroom in one in which a snack break is allowed, please pack a nut free snack. A safe and healthy snack choice is fresh cut up fruit and vegetables. Peanut butter and nut products are still allowed in the lunchroom/alternate lunch rooms except at the designated nut-free tables/desks. For the safety of all students, we will educate and remind students about our no sharing protocol. That is, students are educated as to the dangers of swapping or sharing snacks, lunch items, or food of any kind. Additionally, some students in the building have life-threatening food allergies beyond nuts. If your child is in a classroom with one of these students, you will receive another letter indicating the specific allergens that need to be avoided for in-class consumption of food. It is our goal to ensure that every student in our school is safe. Our District has adopted a policy for managing students with food allergies. Our policy is in compliance with Public Act 96-0349 and meets the guidelines created by the Illinois State Board of Education and the Illinois Department of Public Health. Please discuss the following with your child: Do not share or exchange any foods with other students at school. Wash hands with soap and water after eating to decrease the chance of crosscontamination on surfaces at school. Food should not be eaten on school buses. If you have any questions or concerns, please feel free to contact me, our school nurse,, or your child s classroom teacher. Thank you for your understanding and cooperation. Sincerely, Building Principal
LETTER TO ADDITIONAL ALLERGY CLASSROOM PARENTS Date Appendix 3b of Policy JFD Dear Parents of student in (insert teacher s name), You have already received a letter indicating that several students in our building have severe food allergies to peanuts or tree nuts. Additionally, your child has one or more classmates with additional life-threatening allergies. These allergies are to the following foods:. Exposure to these allergens could cause a life-threatening reaction. Because these students cannot be in contact with foods containing these allergens, we are requesting that you not send these foods to school for snack. Even trace amounts of these allergens could result in a severe allergic reaction. Sometimes these elements may be hidden in processed foods. It is our goal to ensure that every student in our school is safe. Our District has adopted a policy for managing students with food allergies. Our policy is in compliance with Public Act 96-0349 and meets the guidelines created by the Illinois State Board of Education and the Illinois Department of Public Health. Please discuss the following with your child: Do not share or exchange any foods with other students at school. Wash hands with soap and water after eating to decrease the chance of crosscontamination on surfaces at school. Food should not be eaten on school buses. If you have any questions or concerns, please feel free to contact me, our school nurse,, or your child s classroom teacher. Thank you for your understanding and cooperation. Sincerely, Building Principal
SPECIAL OCCASION FOOD AND BEVERAGE PROCEDURE HICKORY POINT AND SHABONEE SCHOOLS Appendix 4 of Policy JFD Classroom teachers or parent volunteers who are providing food/beverages are required to: 1. Notify the principal and receive permission to serve food/beverage and to contact parents. 2. Once permission is obtained, to notify parents in writing with the following information: a. A complete description of the food time(s) being provided including the brand name. b. When and why the food/beverage is being provided. c. A statement explaining that the parents may provide an alternative snack for their child ONLY in the case of food allergies, not for student s personal preference. d. The option to permit or deny permission for the child s consumption of the treat (or alternative). e. A request for parental signature and return of the form/letter. Sample Letter: Dear Parent, As part of our end-of-unit writing celebration we will be having a Poetry Café. We will be providing XXXX brand hot apple spice cider and XXXX brand ginger snap cookies. You may choose to provide an alternative, similar, snack for your child only if this snack may compromise his/her food allergies. Please indicate your preference for your child: My child,, has permission to consume the cider and cookies. My child,, may NOT have the cider and cookies due to food allergies. Instead, I will send for my child. My child,, may NOT have the cider and cookies. Date Parent Signature
SPECIAL OCCASION FOOD AND BEVERAGE PROCEDURE WOOD OAKS JUNIOR HIGH Appendix 5 of Policy JFD Classroom teachers or parent volunteers who are providing food/beverages are required to: 1. Notify the principal and receive permission to serve food/beverage and to contact parents. 2. Once permission is obtained, to notify parents in writing with the following information: a. A complete description of the food time(s) being provided including the brand name. b. When and why the food/beverage is being provided. c. A statement explaining that the parents may provide an alternative snack for their child ONLY in the case of food allergies, not for student s personal preference. d. The option to permit or deny permission for the child s consumption of the treat (or alternative). Sample Notification to be published in Wildcat Weekly or posted on EdLine Page: Dear Parent, As part of our end-of-unit writing celebration we will be having a Poetry Café on (date) at (time). We will be providing XXXX brand hot apple spice cider and XXXX brand ginger snap cookies. You may choose to provide an alternative, similar, snack for your child only if this snack may compromise his/her food allergies.