TUNSTALL SQUARE KINDERGARTEN Anaphylaxis Management Purpse This plicy will prvide guidelines t: Minimise the risk f an anaphylactic reactin ccurring while children are in the care f Tunstall Square Kindergarten. Ensure that staff members respnd apprpriately t an anaphylactic reactin by initiating apprpriate treatment, including cmpetently administering an aut adrenaline injectin device. Raise the centre cmmunity s awareness f anaphylaxis and its management thrugh educatin and plicy implementatin. Cmply with sectin 26A f the Children s Services Act 1996 and the Children s Services Regulatins 2009, Schedule 3. Plicy statement Values Tunstall Square Kindergarten believes that the safety and wellbeing f children wh are at risk f anaphylaxis is a whle-f-cmmunity respnsibility. Tunstall Square Kindergarten is cmmitted t: Prviding, as far as practicable, a safe and healthy envirnment in which children at risk f anaphylaxis can participate equally in all aspects f the children s prgram and experiences. Raising awareness abut allergies and anaphylaxis amngst the centre cmmunity and children in attendance. Actively invlving the parents/guardians f each child at risk f anaphylaxis in assessing risks, develping risk minimisatin strategies and management strategies fr their child. Ensuring each staff member and ther relevant adults have adequate knwledge f allergies, anaphylaxis and emergency prcedures. Facilitating cmmunicatin t ensure the safety and wellbeing f children at risk f anaphylaxis. Scpe This plicy will apply whether r nt there is a child diagnsed by a registered medical practitiner as being at risk f anaphylaxis enrlled at the centre. It applies t children enrlled at the centre, their parents/guardians, staff and cmmittee. It als applies t ther relevant members f the centre cmmunity, such as vlunteers and visiting specialists. Reviewed: August 2011 Page 1 f 17
Backgrund and legislatin Anaphylaxis is a severe, life-threatening allergic reactin. Up t tw per cent f the general ppulatin and up t five per cent f children are at risk. The mst cmmn causes in yung children are eggs, peanuts, tree nuts, cw s milk, bee r ther insect stings, and sme medicatins. A reactin can develp within minutes f expsure t the allergen and yung children may nt be able t express the symptms f anaphylaxis. Hwever with planning and training, a reactin can be treated effectively by using an adrenaline aut-injectr ften referred t as an EpiPen. In any centre that is pen t the general cmmunity it is nt pssible t achieve a cmpletely allergen-free envirnment. Instead the licensee, staff, parents/guardians need t adpt a range f prcedures and risk minimisatin strategies t reduce the risk f a child having an anaphylactic reactin, including strategies t minimise the presence f the allergen in the centre. The Children s Services Act 1996 sectin 26A, requires prprietr s f licensed children s services t have an anaphylaxis management plicy in place whether r nt there is a child enrlled wh has been diagnsed at risk f anaphylaxis. The Children s Services Regulatins 1998 were amended in 2008 t prescribe plicies, plans, prcedures and training related t anaphylaxis. The matters t be included in the anaphylaxis management plicy are in the new Schedule 3 f the CSR. The Children s Services Regulatins 2009 require: All staff members n duty whenever a child, wh has been diagnsed at risk f anaphylaxis, is being cared fr r educated by the service, has undertaken training in anaphylaxis training which has been apprved by the Secretary. CSR r67 All staff members n duty whenever children are being cared fr r educated by the service t undertake annual training in Cardi Pulmnary Resuscitatin (CPR) and administratin f the adrenaline aut-injectin device CSR r65 All staff emplyed, engaged, appinted r apprved by the service t have cmpleted a first aid and anaphylaxis training, which has been apprved by the Secretary, by 1 January 2012 and then at least every 3 years. Relevant legislatin includes but is nt limited t: Children s Services and Educatin Legislatin Amendment (Anaphylaxis Management) Act 2008 (Act) cmmenced n 14 July 2008 amending the Children s Services Act 1996 and the Educatin and Training Act 2005. The Children s Services Act 1996 (CSA) Children s Services Regulatins 2009 (CSR) Health Act 1958 Health Recrds Act 2001 Occupatinal Health and Safety Act 2004 Anaphylaxis Act Amendments 2008 Privacy Act Reviewed: August 2011 Page 2 f 17
Definitins Actin plan: refer t Anaphylaxis medical management actin plan Adrenaline aut-injectin device: An intramuscular injectin device fr the autmatic administratin f adrenaline device and is cmmnly referred t as an EpiPen Adrenaline aut-injectin device training: Training in the use f the EpiPen prvided by allergy nurse educatrs r ther qualified prfessinals such as dctrs, first aid trainers, thrugh accredited training r thrugh the use f the self paced trainer CD ROM and trainer EpiPen. Allergen: A substance that can cause an allergic reactin. Allergy: An immune system respnse t smething that the bdy has identified as an allergen. Peple genetically prgrammed t make an allergic respnse will make antibdies t particular allergens. Allergic reactin: A reactin t an allergen. Cmmn signs and symptms include ne r mre f the fllwing: hives, tingling feeling arund the muth, abdminal pain, vmiting and/r diarrhea, facial swelling, cugh r wheeze, difficulty swallwing r breathing, lss f cnsciusness r cllapse (child pale r flppy), r cessatin f breathing. Ambulance cntact card: A card that the centre has cmpleted, which cntains all the infrmatin that the Ambulance Service will request when phned n 000, (further infrmatin abut what yu will need t knw when yu call this number is available n the Ambulance Victria website) and nce cmpleted by the centre it shuld be kept by the telephne frm which the 000 phne call will be made. Anaphylaxis: A severe, rapid and ptentially fatal allergic reactin that invlves the majr bdy systems, particularly breathing r circulatin systems. Anaphylaxis medical management actin plan (smetimes referred t as an Actin plan): An individual medical management plan prepared and signed by the child s treating medical practitiner at the date it was signed, prviding the child s name and allergies, a phtgraph f the child, descriptin f the prescribed anaphylaxis medicatin fr that child and clear instructins n treating an anaphylactic episde. An example f this is the Australian Sciety f Clinical Immunlgy and Allergy (ASCIA) Actin Plan. Anaphylaxis management training: Accredited anaphylaxis management training that includes strategies fr anaphylaxis management, recgnitin f allergic reactins, risk minimisatin strategies, emergency treatment and practise with an EpiPen trainer. Children at risk f anaphylaxis: Thse children whse allergies have been medically diagnsed and wh are at risk f anaphylaxis. Cmmunicatin plan: A plan that frms part f the plicy utlining hw the centre will cmmunicate with parents/guardians and staff in relatin t the plicy and hw parents/guardians and staff will be infrmed abut risk minimisatin plans and emergency prcedures when a child diagnsed at risk f anaphylaxis is enrlled at a centre. Department f Educatin and Early Childhd Develpment (DEECD): State gvernment department respnsible fr the licensing, funding and regulatin f children s services in Victria. EpiPen : A frm f an aut-injectin device cntaining a single dse f adrenaline, delivered via a spring-activated needle, which is cncealed until administered. Tw strengths are Reviewed: August 2011 Page 3 f 17
available, an EpiPen and an EpiPen Jr, and are prescribed accrding t the child s weight. The EpiPen Jr is recmmended fr a child weighing 10-20kg. An EpiPen is recmmended fr use when a child is in excess f 20kg. EpiPen kit: An insulated cntainer, fr example an insulated lunch pack cntaining a current adrenaline aut-injectin device, a cpy f the child s anaphylaxis actin plan, and telephne cntact details fr the child s parents/guardians, the dctr/medical service and the persn t be ntified in the event f a reactin if the parents/guardians cannt be cntacted. If prescribed an antihistamine may be included in the kit. Intlerance: Often cnfused with allergy, intlerance is a reprducible reactin t a substance that is nt due t the immune system. Licensee: Persn r bdy crprate wh hlds a licence t perate a children s service under the Act N fd sharing: The practice where the child at risk f anaphylaxis eats nly that fd that is supplied r permitted by the parents/guardians, and des nt share fd with, r accept ther fd frm any ther persn. Nminated staff member: A staff member nminated t be the liaisn between parents/guardians f a child at risk f anaphylaxis and the cmmittee. This persn als checks the adrenaline aut-injectin device is current, the EpiPen kit is cmplete and leads staff practice sessins after all staff have undertaken anaphylaxis management training. Prprietr: Includes the wner f the service, primary nminee and any persn wh manages r cntrls the service. Risk minimisatin: A practice f reducing risks t a child at risk f anaphylaxis by remving, as far as is practicable, majr surces f the allergen frm the centre and develping strategies t help reduce risk f an anaphylactic reactin. Risk minimisatin plan: A plan specific t the centre that specifies each child s allergies, the ways that each child at risk f anaphylaxis culd be accidentally expsed t the allergen while in the care f the centre, practical strategies t minimise thse risks, and wh is respnsible fr implementing the strategies. The risk minimisatin plan shuld be develped by the licensee in cnsultatin with the families f children at risk f anaphylaxis and staff at the centre and shuld be reviewed at least annually, but always upn the enrlment r diagnsis f each child wh is at risk f anaphylaxis. A sample risk minimisatin plan is utlined in Schedule 3. Service cmmunity: All adults wh are cnnected t the children s centre. Treat bx: A cntainer prvided by the parents/guardians that cntains treats, fr example, fds which are safe fr the child at risk f anaphylaxis and used at parties when ther children are having their treats. Nn-fd rewards, fr example stickers, stamps and s n are t be encuraged fr all children as ne strategy t help reduce the risk f an allergic reactin. Surces and related centre plicies Brchure titled Allergies and anaphylaxis (July 2007) available thrugh the Ryal Children s Hspital, Department f Allergy and Immunlgy. Australasian Sciety f Clinical Immunlgy and Allergy (ASCIA), at www.allergy.rg.au prvides infrmatin n allergies. The Actin Plan fr Anaphylaxis can be dwnladed Reviewed: August 2011 Page 4 f 17
frm this site. Cntact details f clinical immunlgists and allergy specialists are als available n this site. Anaphylaxis Australia Inc, at www.allergyfacts.rg.au is a nn-fr-prfit supprt rganisatin fr families f children with fd related anaphylaxis. Items such as strybks, tapes, EpiPen trainers and ther items are available fr sale frm the prduct catalgue n this site. Anaphylaxis Australia Inc. prvides a telephne supprt line fr infrmatin and supprt t help manage anaphylaxis. Ryal Children s Hspital, Department f Allergy and Immunlgy, at www.rch.rg.au prvides infrmatin abut allergies and the services prvided by the hspital. Cntact may be made with the Department f Allergy and Immunlgy t evaluate a child s allergies and if necessary, prvide an adrenaline aut-injectr prescriptin, as well as t purchase an EpiPen trainer kit. Department f Educatin and Early Childhd Develpment website at www.educatin.vic.gv.au prvides infrmatin related t anaphylaxis, including frequently asked questins related t anaphylaxis training. (An anaphylaxis resurce kit has been prvided t all centres. This kit cntains an EpiPen trainer and trainer CD ROM t enable staff t practice the administratin f the EpiPen regularly. This trainer shuld be labelled as a trainer and be stred separately frm all ther EpiPen s, fr example in a file with anaphylaxis resurces, s that the EpiPen trainer is nt cnfused with an actual EpiPen.) Centre plicies Incident and medical emergency management Asthma Cmmunicatin Enrlment Fd safety Hygiene Illness Inclusin and equity Prgram participatin Supervisin Healthy eating and active play Excursins and centre events Privacy Reviewed: August 2011 Page 5 f 17
The cmmittee is respnsible fr: Ensuring: An anaphylaxis management plicy which meets legislative requirements and includes a risk minimisatin plan and cmmunicatin plan, is develped and in place, displayed at the centre and reviewed regularly All parents/guardians aware f this plicy and are prvided access t the plicy upn request. All staff have undertaken apprved anaphylaxis management training upn emplyment r engagement and thereafter every 3 years (CSR r63) and training in CPR and the administratin f the aut-injectin device (CSR r65) annually. All staff practise using an adrenaline aut-injectin device at least nce a year, whether r nt a child at risk f anaphylaxis is enrlled and attending the service. Staff recrds include the dates when the staff member cmpleted first aid and anaphylaxis training and CPR and the administratin f the aut-injectin device training CSR r38(2d&e) A risk management plan is develped fr each child at Tunstall Square Kindergarten diagnsed at risk, in cnsultatin with that child s parents/guardians. (Attachment 3) In centres where there is a child diagnsed at risk f anaphylaxis is enrlled the cmmittee is als respnsible fr: Displaying a sign, prminently, at the main entrance f the centre stating that a child diagnsed at risk f anaphylaxis is being cared fr r educated at the centre. Including a cpy f the cmpleted accredited anaphylaxis management training certificate in the staff member s file Ensuring All staff members n duty have cmpleted accredited anaphylaxis management training (recgnised by the Secretary CSR r.67 and that practice in the administratin f an aut-adrenaline injectr device is undertaken at least annually althugh quarterly is recmmended. Where pssible, (prir t 2012), that all relievers have undertaken relevant anaphylaxis training and when a relieving staff member is nt trained in anaphylaxis management, prcedures are implemented fr infrming the staff member wh will be respnsible fr the administratin f an adrenaline autinjectin device in an emergency and that all ther staff members n duty at the centre are trained in anaphylaxis management, That all relieving staff are aware f the symptms f an anaphylactic reactin, the child at risk f anaphylaxis, the child s allergies, the individual anaphylaxis medical management actin plan and the lcatin f the EpiPen kit. Parents/guardians are infrmed if the reliever in the centre is nt trained in anaphylaxis management befre a child at risk f anaphylaxis is left at the centre. (Relevant nly prir t 2012). That all staff (including relievers and vlunteers) are able t identify all children diagnsed at risk f anaphylaxis; where the adrenaline aut-injectin device is Reviewed: August 2011 Page 6 f 17
lcated fr each f thse children; where the anaphylaxis medical management plan fr thse children is lcated Staff members accmpanying any at risk children utside the centre carry the fully equipped EpiPen kit and a cpy f the anaphylaxis medical management plan fr thse children. N child wh has been prescribed an adrenaline aut-injectin device is permitted t attend the centre r its prgrams withut that device. Making parents/guardians aware f this plicy, and prviding access t it n request. Implementing a cmmunicatin strategy and encuraging nging cmmunicatin between parents/guardians and staff regarding the current status f the child s allergies, this plicy and its implementatin. CSR Schedule 3 (4) Displaying an Australasian Sciety f Clinical Immunlgy and Allergy (ASCIA) generic pster called Actin plan fr Anaphylaxis in a key lcatin at the centre, fr example, in the children s rm, the staff rm r near the medicatin cabinet. Displaying an ambulance cntact card by telephnes. Cmplying with the prcedures utlined in Attachment 1 (Risk minimisatin prcedures). Displaying a ntice stating that a child wh has been diagnsed at risk f anaphylaxis is attending the service. CSR r40(1k) Staff are respnsible fr: Asking all parents/guardians as part f the enrlment prcedure, prir t their child s attendance at the centre, whether the child has allergies and dcumenting this infrmatin n the child s enrlment recrd. CSR r34b Ensuring that parent/guardians f children wh have allergies have prvided an anaphylaxis medical management actin plan signed by a dctr prir t the child s cmmencement at the centre r upn diagnsis. CSR r34c Ensuring that a cpy f the child s individual anaphylaxis medical management actin plan signed by the child s treating medical practitiner is inserted in t the enrlment recrds fr each child. Ensuring that parents/guardians prvide a cmplete EpiPen kit while the child is present at the centre. Prviding a cpy f the plicy t the parents/guardians f the child at risk CSR r43 Ensuring a cpy f the at risk child s anaphylaxis medical management actin plan is visible t all staff. Ensuring ther persns invlved in the prgram (fr example parents n duty, students n placement) are aware f children at risk f anaphylaxis. Fllwing the child s anaphylaxis medical management actin plan in the event f an allergic reactin, which may prgress t anaphylaxis. Practising the administratin f an aut adrenaline injectin device using an EpiPen trainer and anaphylaxis scenaris n a regular basis, preferably quarterly. Reviewed: August 2011 Page 7 f 17
Ensuring that the EpiPen kit is stred in a lcatin that is knwn t all staff, including relief staff; easily accessible bth indrs and utdrs, t adults (nt lcked away); inaccessible t children; and away frm direct surces f heat. Cntacting the parents/guardians immediately if the child s adrenaline aut injectin device has nt been left at the centre. Ensuring that the EpiPen kit (cntaining the child s medicatin and anaphylaxis medical management actin plan) fr each child at risk f anaphylaxis is carried by the qualified staff member accmpanying the child n excursins that this child attends. CSR r74 (4d) Prviding infrmatin t the centre cmmunity abut resurces and supprt fr managing allergies and anaphylaxis. Cmplying with the prcedures utlined in Attachment 1. Administering any medicatin in accrdance with the prcedures utlined in the Administratin f medicatin plicy. CSRr83(3) Nminating a staff member t: Cnduct anaphylaxis scenaris and supervise practise sessins in administratin f adrenaline aut injectr prcedures t determine the levels f staff cmpetence and cnfidence in lcating and using the adrenaline aut-injectin device at least quarterly. Rutinely (e.g. mnthly) check the EpiPen kit t ensure that it is cmplete and that the adrenaline aut-injectin device has nt expired. (The manufacturer will nly guarantee the effectiveness f the adrenaline aut-injectin device t the end f the nminated expiry mnth). Liaise with the cmmittee and parents/guardians f children at risk f anaphylaxis. Fllwing the apprpriate prcedures where a child wh has nt been diagnsed as allergic, but wh appears t be having an anaphylactic reactin, ie: Calling an ambulance immediately by dialling 000. Cmmencing first aid measures. Cntacting the parents/guardians. Cntacting the persn t be ntified in the event f illness if the parents/guardians cannt be cntacted. Cntacting a cmmittee licensee representative as sn as practicable. Parents/guardians are respnsible fr: Reading and being familiar with the plicy Cmplying with the prcedures utlined in Attachment 1. Bringing relevant issues t the attentin f bth staff and cmmittee Parents/guardians f a child at risk f anaphylaxis are respnsible fr: Infrming staff, either n enrlment r n diagnsis, f their child s allergies. Develping an anaphylaxis risk minimisatin plan with centre staff. Reviewed: August 2011 Page 8 f 17
Prviding staff with an anaphylaxis medical management actin plan signed by a registered medical practitiner and written cnsent t use any prescribed medicatin in line with this actin plan. Prviding staff with a cmplete EpiPen kit. Regularly checking the adrenaline aut-injectin device expiry date. Assisting staff by ffering infrmatin and answering any questins regarding their child s allergies. Ntifying the staff f any changes t their child s allergy status and prviding a new anaphylaxis medical management actin plan in accrdance with these changes. Cmmunicating all relevant infrmatin and cncerns t staff, fr example, any matter relating t the health f the child. Cmplying with the centre s plicy that n child wh has been prescribed an adrenaline aut injectin-device is permitted t attend the centre r its prgrams withut that device. Cmplying with the prcedures utlined in attachment 1. Evaluatin In rder t assess whether the plicy has achieved the values and purpses the prprietr (cmmittee) will: Selectively audit enrlment checklists (fr example, annually) t ensure that dcumentatin is current and cmplete. Seek feedback regarding this plicy and its implementatin with parents/guardians f children at risk f anaphylaxis t gauge their satisfactin with bth the plicy and its implementatin in relatin t their child. This can be facilitated thrugh discussins and the annual centre survey. Review the centre s respnse if a child has an anaphylactic reactin t identify if there is a need fr additinal training and any ther crrective actin such as a change t current plicies r plans. Ask staff t share their learning fllwing participatin in anaphylaxis management training with the licensee t identify any issues, which may need t be addressed. Regularly review the plicy and centre practices t ensure they are cmpliant with any new legislatin, research r best practice prcedures. Attachments Attachment 1: Risk minimisatin prcedures Attachment 2: Enrlment checklist fr children at risk f anaphylaxis Attachment 3: Sample risk minimisatin plan Authrisatin This plicy was adpted by the Tunstall Square Kinder cmmittee f management at a cmmittee meeting n 12 th September 2011. Review date: 15/8/2013 Reviewed: August 2011 Page 9 f 17
Attachment 1 The fllwing prcedures shuld be develped in cnsultatin with the parents/guardians f at risk children and implemented t help prtect thse children frm accidental expsure t fd allergens. These prcedures shuld be regularly reviewed t identify any new ptential accidental expsures t allergens. In relatin t the child at risk: This child shuld nly eat fd that has been specifically prepared fr him/her. Sme parents/guardians may chse t prvide all fd fr their child. Where the centre is preparing fd fr the child: ensure that it has been prepared accrding t the parents/guardians instructins. checked and apprved by the parent/guardian in accrdance with the risk minimisatin plan Bttles, ther drinks and lunch bxes, including any treats, prvided by the parents/guardians fr this child shuld be clearly labelled with the child s name. There shuld be n trading r sharing f fd, fd utensils and cntainers with this child. In sme circumstances it may be apprpriate that a highly allergic child des nt sit at the same table when thers cnsume fd r drink cntaining r ptentially cntaining the allergen. Hwever, children with allergies shuld nt be separated frm all children and shuld be scially included in all activities. Parents/guardians shuld prvide a safe treat bx fr this child. Where this child is very yung, prvide his/her wn high chair t minimise the risk f crss-cntaminatin. When the child diagnsed at risk f anaphylaxis is allergic t milk, ensure nn-allergic babies are held when they drink frmula/milk. Ensure apprpriate supervisin f the child at risk, n special ccasins such as excursins, centre events r family days. Children diagnsed at risk f anaphylaxis because f insect/sting bites shuld wear shes and lng-sleeved, light-clured clthing. In relatin t ther practices at the centre: Ensure tables, high chairs and bench tps are washed dwn after eating. Ensure hand washing fr all children and adults upn arrival at the centre, befre and after eating. All children need t be clsely supervised at meal and snack times and cnsume fd in specified areas. T minimise risk, children shuld nt wander arund the centre with fd. Staff shuld use nn-fd rewards, fr example stickers, fr all children. The risk minimisatin plan will infrm the centre s fd purchases and menu planning (where prvided). Reviewed: August 2011 Page 10 f 17
Fd preparatin persnnel (staff and vlunteers) shuld be instructed abut measures necessary t prevent crss cntaminatin between fds during the strage, handling, preparatin and serving f fd such as careful cleaning f fd preparatin areas and utensils. Where fd is brught frm hme t the centre all parents/guardians will be asked nt t send fd cntaining specified allergens r ingredients as determined in the risk minimisatin plan. Restrict use f fd and fd cntainers, bxes and packaging in crafts, cking and science experiments, depending n the allergies f particular children. Staff shuld discuss the use f fds in children s activities with parents/guardians f the at risk child and any fd used shuld be cnsistent with the risk management plan. Keep garden areas free frm stagnant water and plants which attract biting insects. Reviewed: August 2011 Page 11 f 17
Attachment 2 Enrlment checklist fr children at risk f anaphylaxis Risk minimisatin plan is cmpleted in cnsultatin with parent/guardian, prir t the attendance f the child at the centre, which includes strategies t address the particular needs f each child at risk f anaphylaxis and this plan is implemented. Parents/guardians f a child at risk f anaphylaxis have been prvided a cpy f the centre s Anaphylaxis management plicy. All parents/guardians are made aware f the Anaphylaxis management plicy. Anaphylaxis medical management actin plan fr the child is signed by the child s dctr and is visible t all staff. A cpy f the child s anaphylaxis medical management actin plan is included in the child s EpiPen kit Adrenaline aut-injectin device (within expiry date) is available fr use at any time the child is in the care f the service Adrenaline aut-injectin device is stred in an insulated cntainer in a lcatin easily accessible t adults (nt lcked away), inaccessible t children and away frm direct surces f heat. All staff, including relief staff, are aware f each EpiPen kit lcatin and the lcatin f the child s anaphylaxis medical management actin plan. All staff have undertaken accredited anaphylaxis management training which includes strategies fr anaphylaxis management, risk minimisatin, recgnitin f allergic reactins, emergency treatment; and practise with an EpiPen trainer quarterly which is recrded annually in the staff recrds. The centre s emergency actin plan fr the management f anaphylaxis is in place and all staff understand the plan. A treat bx is available fr special ccasins (if relevant) and is clearly marked as belnging t the child at risk f anaphylaxis. Parents/guardians current cntact details are available. Infrmatin regarding any ther medicatins r medical cnditins (fr example asthma) is available t staff. If fd is prepared at the centre, measures are in place t prevent cntaminatin f the fd given t the child at risk f anaphylaxis. Reviewed: August 2011 Page 12 f 17
Attachment 3 Sample risk minimisatin plan The fllwing infrmatin is nt a cmprehensive list but cntains sme suggestins t cnsider when develping/reviewing yur centre s risk minimisatin plan Hw well has the centre planned fr meeting the needs f children with allergies wh are at risk f anaphylaxis? Wh are the children? What are they allergic t? List names and rm lcatins f each f the at risk children. List all f the knwn allergens fr each f the at risk children. List ptential surces f expsure t each knwn allergen and strategies t minimise the risk f expsure. This will include requesting that certain fds/items nt be brught t the centre. D staff and ther persns participating in the prgram recgnise the at risk child/ren? List the strategies fr ensuring that all staff, including relief staff, recgnise each f the at risk children, the children s specific allergies that they are aware f the child s anaphylaxis medical management actin plan. Cnfirm where each child s Anaphylaxis medical management actin plan (including the child s phtgraph) will be displayed. D families and staff knw hw the centre manages the risk f anaphylaxis? Recrd when each family f a child at risk child f anaphylaxis is prvided a cpy f the centre s Anaphylaxis management plicy. Recrd when each family prvides a cmplete EpiPen kit Test that all staff, including relief staff, knw where the anaphylaxis medicatin and anaphylaxis medical management plan is kept fr each at risk child. Regular checks f the expiry date f each EpiPen are undertaken by a nminated staff member and the families f each at risk child. The licensee writes t all families requesting that specific prcedures be fllwed t minimise the risk f expsure t a knwn allergen. This may include cnsidering strategies such as requesting the fllwing items are nt sent t the centre: Fd cntaining the majr surces f allergens r fds where transfer frm ne child t Reviewed: August 2011 Page 13 f 17
anther is likely e.g. peanut/nut prducts, whle egg r chclate. Fd packaging f at-risk fds (see knwn allergens at pint 2), fr example cereal bxes, egg cartns. A new written request is sent t families if the fd allergens change. Ensure all families are aware f the plicy that n child wh has been prescribed an adrenaline autinjectin device is permitted t attend the centre withut that device. The centre displays the ASCIA generic pster, Actin Plan fr Anaphylaxis, in a key lcatin and lcates a cmpleted ambulance card by the telephne/s. The EpiPen kit is taken n all excursins attended by the at risk child. Has a cmmunicatin plan been develped which includes prcedures t ensure: All staff, vlunteers, parents/guardians are infrmed abut the anaphylaxis management plicy and prcedures fr the management f anaphylaxis at Tunstall Square Kindergarten. Parents/guardians f a child diagnsed at risk f anaphylaxis are able t cmmunicate with staff members abut any changes t the child s diagnsis r anaphylaxis management plan. All staff including relief and visiting staff, vlunteers are infrmed abut and familiar with all anaphylaxis medical management plans and the Tunstall Square Kindergarten risk management plan. All parents are prvided with a cpy f the anaphylaxis management plicy prir t cmmencing Tunstall Square Kindergarten. A cpy f this plicy is displayed n the ntice bard at the entrance t Tunstall Square Kindergarten. Staff will meet with parents/guardians f a child diagnsed at risk f anaphylaxis prir t the child s cmmencement at Tunstall Square Kindergarten and will develp an individual cmmunicatin plan fr that family. An inductin prcess fr all staff and vlunteers includes infrmatin regarding the management f anaphylaxis at Tunstall Square Kindergarten including lcatin f EpiPen kits, anaphylaxis medical management plans, risk minimisatin prcedures and identificatin f children at risk. Reviewed: August 2011 Page 14 f 17
D all staff knw hw the centre aims t minimise the risk f a child being expsed t an allergen? Think abut times when the child culd ptentially be expsed t allergens and develp apprpriate strategies including wh is respnsible fr implementing them (see fllwing sectin fr pssible scenaris and strategies). Menus are planned in cnjunctin with parents/guardians f at risk children Fd fr the child at risk child is prepared accrding t their parents/guardians instructins t avid the inclusin f fd allergens. As far as practical, the fd n the menu fr all children shuld nt cntain ingredients such as milk, egg and peanut/nut prducts t which the child is at risk. The at risk child shuld nt be given fd if the label fr the fd states that the fd may cntain traces f a knwn allergen. Hygiene prcedures and practices are used t minimise the risk f cntaminatin f surfaces, fd utensils and cntainers by fd allergens (refer t Hygiene plicy and Fd safety plicy). Cnsider the safest place fr the at risk child t be served and cnsume fd, while ensuring they are scially included in all activities, and ensure this lcatin is used by the child. Staff and cmmittee develp prcedures fr ensuring that each at risk child nly cnsumes fd prepared specifically fr him/her. NO FOOD is intrduced t a baby if the parents/guardians have nt previusly given this fd t the baby. Ensure each child enrlled at the centre washes his/her hands upn arrival at the centre, befre and after eating. Teaching strategies are used t raise awareness f all children f anaphylaxis and n fd sharing with the at risk child/ren, and the reasns fr this. Bttles, ther drinks and lunch bxes prvided by the family f the child at risk child shuld be clearly labelled with the child s name. A safe treat bx is prvided by the family f each at risk child and used by the centre t prvide treats t the at risk child as apprpriate D relevant peple knw what actin t take if a child has an anaphylactic reactin? Knw what each child s anaphylaxis medical management actin plan says and implement it. Knw wh will administer the EpiPen and stay with the child; wh will telephne the ambulance and the parents/guardians; wh will ensure the supervisin f the ther children; wh will let the ambulance fficers int the centre and take them t the child. All staff have undertaken accredited anaphylaxis management training and regular practise sessins. A cmpleted ambulance card is lcated next t the telephne/s. Reviewed: August 2011 Page 15 f 17
Ptential expsure scenaris and strategies Hw effective is the centre s risk minimisatin plan? Review the risk minimisatin plan with parents/guardians f at risk children at least annually, but always upn enrlment f each at risk child and after any incident r accidental expsure. Scenari Strategy Wh Fd is prvided by the centre and a fd allergen is unable t be remved frm the centre s menu (e.g. milk). Menus are planned in cnjunctin with parents/guardians f at risk child/ren and fd is prepared accrding t parents/guardians instructins. Alternatively the parents/guardians prvide all f the fd fr the at risk child. Ck, primary nminee, parents/guardians Ensure separate strage f fds cntaining allergen. Ck and staff bserve fd handling, preparatin and serving practices t minimise the risk f crss cntaminatin. This includes hygiene f surfaces in kitchen and children s eating area, fd utensils and cntainers. Licensee and ck Ck, staff & vlunteers There is a system in place t ensure the at risk child is served nly the fd prepared fr him/her. Ck & staff An at risk child is served and cnsumes their fd at a place cnsidered t pse a lw risk f cntaminatin frm allergens frm anther child s fd. This place is nt separate frm all children and allws scial inclusin at mealtimes. Staff Children are regularly reminded f the imprtance f n fd sharing with the at risk child. Staff Children are clsely supervised during eating Staff Reviewed: August 2011 Page 16 f 17
Party r celebratin Give plenty f ntice t parents/guardians abut the event. Ensure a safe treat bx is prvided fr the at risk child. Ensure the at risk child nly has the fd apprved by his/her parents/guardians. Specify a range f fds that parents/guardians may send fr the party and nte particular fds and ingredients that shuld nt be sent. Licensee/ primary nminee/qualified staff Parents/guardians/ staff Staff Licensee/ primary nminee Prtectin frm insect bite allergies Specify play areas that are lwest risk t the at risk child and encurage him/her and peers t play in the area. Decrease the number f plants that attract bees. Ensure the at risk child wears shes at all times utdrs. Quickly manage any instance f insect infestatin. It may be apprpriate t request exclusin f the child at risk child during the perid required t eradicate the insects. Staff Licensee Staff Licensee Latex allergies Cking with children Avid the use f party ballns r cntact with latex glves. Ensure parents/guardians f the at risk child are advised well in advance Activities and ingredients used are cnsistent with the risk minimisatin plan. Staff Licensee/staff Reviewed: August 2011 Page 17 f 17