Anaphylaxis Policy Anaphylaxis is a serious allergic reaction and can be life threatening. The allergic reaction may be related to food, insect stings, medicine, latex, exercise, etc., with the most common food allergens being peanuts, tree nuts, seafood, egg and milk products. Our anaphylaxis policy is intended to help support the needs of a child with a severe allergy and provide information on anaphylaxis and increase awareness of parents, staff, students and visitors to our centre. General information on life-threatening allergies including anaphylactic allergies will be provided to staff, parents, students, and volunteers. What causes Anaphylaxis? Anaphylactic shock is an overreaction of the body s immune system to a causative allergen. The course of the life threatening allergy can vary from person to person. The shock can be characterized by swelling, difficulty breathing, abdominal cramps, vomiting, diarrhea, circulatory collapse, and in severe cases, coma and death. What are the signs and symptoms of Anaphylaxis? The symptoms of anaphylaxis can develop quickly although the initial presentation can be delayed and/or mild. Symptoms that can indicate the onset of any extreme allergic reaction include: Swelling (lips, throat, tongue, hands and feet) Difficulty breathing, wheezing, coughing Abdominal cramping, vomiting, diarrhea Itching of the skin and hives (raised rash) A feeling of uneasiness, upset or red in the face Rapid heart rate Shock may soon follow, in which the blood vessels become leaky, blood pressure falls and the person becomes cold, clammy and faint. Circulatory collapse is also possible.
Identification of Children at Risk Parents are responsible to inform the Director/Supervisor of their child s allergy. Parents will be responsible to complete the Individual Anaphylaxis Emergency Plan form for the centre. A copy of this form will be kept in the child s file and in the program room emergency binder. Each program room and the food preparation area, will post in a visible area, a list of known allergies of all children enrolled in the centre, along with a photo of that child. Parents are responsible to ensure that their child has an up-to-date auto injector, labeled with the child s name, at the centre when the child is in attendance. The child will not be permitted to attend without the proper medication on site. An auto-injector that has a past expiry date will be returned to the parents and the child will not be permitted to attend until a valid auto injector is brought to the centre. When new medication is brought into the centre, it must be given to management for record keeping purposes. If an autoinjector must be used, it will be taken to the hospital with the child(ren) and given to medical personnel. Parents must sign our Consent to Administer Medication form that authorizes staff to administer the adrenaline auto-injector. Parents are responsible to inform staff of any changes to their child s treatment procedures. An EpiPen poster will be posted in each program room throughout the centre. Strategies to reduce the risk of exposure to Anaphylactic causative agents When a child enrolls at the center, the parents will be required to provide information in the intake package on any medical condition regarding their child, as well as whether their child is at risk of anaphylaxis. Upon enrollment, parents are informed that bringing food from home is not permitted unless approved by the Supervisor or Director. Information on life threatening allergies will be discussed with staff, parents, students and volunteers upon enrollment of the child, and/or prior to commencing employment or interaction with children. All families, staff, students and volunteers at CCCCG will be notified of children attending the center who are at risk for potentially life threatening allergies and the foods and causative agents relating to the allergy.
All staff, students and volunteers are required to review the Anaphylaxis Emergency Plan for a child with anaphylaxis and the emergency procedures to follow when they begin their employment and annually thereafter. Our cook is trained in food handling and holds a current Food Handling Certificate. A comprehensive list of allergens will be maintained in the food preparation area. All meals will be prepared on site using nut-free ingredients purchased by the centre cook. All nut-free ready to eat items (like granola bars, bread, crackers) will be purchased by the centre cook with the exception of ready to eat items for children with allergies/food restrictions (please note that the food must be peanut free) such as, soy/rice milk, dairy or egg-free breads and cheeses. Parents must provide these items for their child/children and must provide the centre cook or program staff with an ingredient list of the foods that they bring into the centre. Please note that our centre is peanut free, therefore we must be aware of treats that parents or other staff bring in. Any items with the statement may contain peanuts or tree nuts can be eaten during lunches and breaks outside of the program rooms. Staff are to wash their hands before returning to the program. Our menu will avoid foods that are highly allergenic to the children in our care, as well as in materials/foods that may be used for craft and sensory programming. When a child has an allergy or food restriction, the parents will receive a copy of the menu plan to review. Any food substitutions will be the responsibility of the parent. All food substitutions must be labeled with the child s name, the food name, and the date received. Our allergy list will be revised as necessary based on the children in our care and the information provided to us in writing by the parents/guardian. Each program room and food preparation area will post in a visible area a list of known life threatening allergies of all children enrolled in the centre along with a photo of that child. An Administration of the Epi-Pen Procedures and Medical Emergency Procedures, will be posted in each program room. All program staff, students and volunteers will be provided with training from management (who have been previously trained by a physician or parent) on the procedures to be followed in the event of a child having an anaphylactic reaction, including how to recognize the signs and symptoms of anaphylaxis and administering medication (i.e. Epi-pen). In the event of anaphalytic shock, anyone trained on the signs/symptoms and administration of an auto injector can administer the EpiPen. Hand washing is mandatory before and after eating. Surfaces (i.e. tables, toys, etc.) are disinfected before and after any food is served.
Ensure that all medications are in fanny packs in the designated area, away from the reach of children. All chemicals used by CCCCG are locked in cupboards away from the children or in a separate room or out of reach. Avoid of the use of latex (i.e. gloves are latex free, no balloons). Treatment Procedures A procedure for each child with an allergy must be established by the child s physician. This procedure will be reviewed with the family annually. If such a procedure is not established by a physician, the centre cannot be held responsible in the event of an adverse reaction or outcome. The procedures will be outlined in the Anaphylaxis Emergency Plan that the parents are required to fill out when a child s allergy is confirmed. A copy of this plan will be kept in the child s file, in the program room emergency binder, and posted in all program rooms/kitchen/playground sheds. Treatment for the children can be immediate or delayed depending on the reaction (see Individual Anaphylaxis Emergency Plan). EpiPens In order to facilitate a rapid response to an anaphylactic reaction, it is the responsibility of the centre staff to store and administer EpiPens. EpiPens will be stored in a fanny pack that is kept on a designated hook in the program room. In the case where the child is on a walk / fieldtrip, the staff carrying the medication in a fanny pack must be aware of the location of the child at all times. In the playground, the fanny pack will be located on the hook in the gazebo area. Staff will check all medications upon return to the centre. Children s EpiPens must always be brought on fieldtrips or outings. All children must wear a fieldtrip tag when going on a fieldtrip or outing (walk). A child with an allergic reaction will have a brightly colored tag to wear. Parents and centre staff are responsible to ensure that all medications are up to date and present on site at the centre. If an EpiPen is not up to date (past expiry date), staff and/or management will inform parents that their child will not be permitted to attend the centre until an up to date EpiPen is brought to the centre. In the event that a child s medication that is kept on site at the centre needs to travel with an authorized pick up person, parents will have signed a consent form allowing this to occur, recognizing that if the medication is not on site on the following day of the child s attendance, the child will not be permitted to attend.
Individual Anaphylaxis Emergency Plan Each child enrolled at the centre will be required to have an individual plan and emergency procedures in the event of a life-threatening emergency. The parent/guardian and physician will be required to provide relevant information to the child s individual plan including emergency procedures that include: A description of the child s allergy. Monitoring and avoidance strategies. Signs and symptoms of an anaphylactic allergy. Action to be taken by the childcare staff in the event the child has an anaphylactic reaction, whether immediate or delayed. If a child is not given an EpiPen as a first step as outlined in their Individual Anaphylaxis Emergency Plan, parents are required to indicate which symptoms would require administering alternative medication as the first step (i.e. Benadryl) All medications required to follow the Anaphalaxis Emergency Plan as set by the parents/guardians must be on site at the centre Parent/guardian consent that allows the childcare staff to administer the allergy medication in the event of an anaphylactic reaction. Emergency contact information. All staff, students, and volunteers will be trained by management on the emergency procedures to follow in the event that a child has an anaphylactic reaction. The training will include the signs and symptoms and how to administer an epinephrine auto-injector Epi-Pen. All staff will be trained annually. The individual plan for a child with anaphylaxis and the emergency procedure shall be reviewed by all employees prior to commencing employment and at least annually thereafter and by all volunteers and students prior to providing care and guidance. Emergency Procedures 1. Administer the EpiPen. Note the time of administration. 2. Call 911. This should be done at the same time the EpiPen is administered by delegating the task to another staff member. 3. Contact the child s parent/guardian. 4. The staff member who administered the EpiPen should stay with the child until medical personnel arrive. Staff will provide all relevant information including the signs/symptoms, times, location EpiPen was given, and any side effects. 5. A Serious Occurrence Report must be completed and filed with the Ministry of Education, and the County of Wellington Child Care Services