Allergies in School and How to Manage Them

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Allergy  &  Special  Diet  Policy  and  Guidelines  

The following guidelines have been prepared with reference to policy developed by the Liberty Public School District in Liberty, Missouri:

http://www.schoolnutrition.org/uploadedFiles/School_Nutrition/104_CareerEducation/ContinuingEducat ion/Webinars/FoodAllergyWebinar-Allergy_policy_guidelines.pdf?n=9295.

District 11’s Food and Nutrition Procedures for Accommodating Special Dietary Needs are available at http://www.d11.org/fns/specialdiets.htm.

District 11’s Guidance on Children With Special Dietary Needs:

http://www.d11.org/fns/Special%20Dietary%20needs/CSSD11GuidanceonChildrenwithSpecialDietaryN eeds%20101909.pdf.

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Contents  

Food and Allergy Policy and Guidelines ... 1  

Allergy Management Policy ... 3  

Life-Threatening Allergy Guidelines... 3  

Responsibilities for Care of Students... 6  

Responsibilities of AcademyACL Custodian ... 13  

Responsibilities/Protocol during Field Trip Transportation ... 14  

Responsibilities for Field Trips...Error! Bookmark not defined.   Responsibilities of Before/After Care and After-School Activity Personnel ... 15  

Responsibilities During Recess, Physical Fitness & Fun, and Physical Education... 15  

Definitions... 20  

Key Points for Parents, Students, and Staff ... 21  

This is an Allergy-Controlled Zone... 36  

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Page | 3 Allergy Management Policy

AcademyACL is committed to providing a safe, supportive, and challenging learning environment for its students. We understand the increasing prevalence of Life-Threatening Allergies among school populations. Because the risk of accidental exposure to allergens can be reduced in the school setting, we are committed to working in cooperation with parents, students, and physicians to minimize risks and provide a safe educational environment for all students. The focus of allergy management at AcademyACL will be on prevention, education, awareness, communication and emergency response.

The goals for allergy management at AcademyACL include:

1. Defining a formal process for identifying, managing, and ensuring continuity of care for students with Life-Threatening allergies in our building.

2. Maintaining the health and protecting the safety of children who have Life-Threatening allergies in ways that are developmentally appropriate, promote self-advocacy and competence in self-care, and provide appropriate educational opportunities. Our LifeSkills curriculum in particular will target these areas.

3. Ensuring that interventions and individual health care plans for students with Life-Threatening allergies are based on medically accurate information and evidence-based practices, and that each student’s right to privacy is protected as well.

4. Supporting children who have debilitating but not necessarily Life-Threatening food and environmental allergies so that their symptoms are mitigated and they are able to work in our school environment as successfully as possible.

In accordance with applicable law, it is the policy of the AcademyACL to provide all students, through necessary accommodations where required, the opportunity to participate in all school programs and activities. The Academy Director will act affirmatively and work closely with parents to ensure that the needs of children with documented allergies are taken into

consideration in planning for school programs. The Academy Director will also work with staff and the supervising nurse/designee of the AcademyACL program to ensure that the allergy management plan is reviewed annually and updated appropriately.

Life-Threatening Food Allergy Guidelines

Background

Allergic food reactions can span a wide range of severity of symptoms. The most severe and potentially Life-Threatening reaction is anaphylaxis. Anaphylaxis (an-a-fi-LAK-sis) is a serious allergic reaction that is rapid in onset and may cause death (American Academy of Allergy, Asthma and Immunology, www.aaaai.org). This protocol is to be used for students who are at

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Page | 4 risk for anaphylaxis and in circumstances where a previously undiagnosed Life-Threatening

allergic response occurs. When a physician assesses that a child’s food allergy will result in anaphylaxis, the child’s condition meets the definition of “disability” and is covered under the Federal American’s with Disability Act (ADA), Section 504 of the Rehabilitation Act of 1973, if the allergy management affects the student’s ability to make educational progress.

AcademyACL requires that each student who has such a condition also has the appropriate medication available at all times in the school office and/or in the child’s main classroom as appropriate. Additionally, each student must have all required forms returned; some of which require a physician’s signature.

Academy ACL’s Allergy/Food Management Packet contains:

Food and Allergy Policy and Guidelines in effect at AcademyACL  Allergy and Anaphylaxis Plan to be completed by a physician

HIPAA-Compliant Authorization Form for Exchange of Health & Education

Information, must be completed by family and returned to both school & physician

Student Medication Form to be completed by a physician, for any additional

medications other than emergency treatment

Student Self-Administration Form to be completed by a physician if applicable  Eating and Feeding Evaluation Form in the CSSD11 Guidance on Children

with Special Dietary Needs, to be completed by a physician

Allergy Plan for non-Life-Threatening Conditions to be completed by a

physician

 A PAL (Protect A Life) brochure to share with students and their friends

AcademyACL does not have a full-time school nurse on staff, but will contract with a school nurse who will provide guidance for appropriate protocols and health systems in our school. The nurse could require us to have epinephrine on hand for use with students who have unknown allergies and develop anaphylactic response and for those students with known allergies when on rare occasions their personal medication is found to be flawed. Families of children with Life-Threatening Allergies are required to supply appropriate amounts in the appropriate dosage, properly labeled, for AcademyACL to have on hand.

Anaphylaxis refers to a collection of symptoms affecting multiple systems in the body, the most

dangerous of which are breathing difficulties and a drop in blood pressure.

Foods that most commonly cause anaphylaxis, a Life-Threatening allergic reaction, are peanuts, tree nuts, shellfish, milk, wheat, soy, fish, and eggs.

These severe allergic reactions can occur within minutes of digestion or a reaction can be delayed for up to two hours. Some reactions are “biphasic” in nature with an initial period of symptoms and a symptom-free period of 2-3 hours followed by severe shock-like symptoms. At present there is no cure for food allergies and strict avoidance is the key to preventing reactions. Exposure may occur by eating the food or by contacting the person’s skin with the food. There are some lotions with nut oil that will cause the same Life-Threatening reaction.

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Page | 5 Medications

The most commonly prescribed medications for the treatment of anaphylaxis are:

Epinephrine- Brand names include, but are not limited to EpiPen®, EpiPen Jr®, Twinject® autoinjectors. Parents usually bring epinephrine to school in the form of an EpiPen® (0.3 mg), EpiPen Jr® (0.15 mg), or Twinject® (0.3 or 0.15 mg) auto injectors. Note: The EpiPen® is a single dose auto-injector, while the Twinject® contains two doses of epinephrine- the first does is an auto-injector and the second does in the form of a traditional injection.

In all instances, the procedures outlined by the individual student’s physician on the Student Medication Form should be specifically and carefully followed.

Care Plan Considerations & Options

There are a variety of student accommodation and care plans that are appropriate for use at AcademyACL for students who experience health conditions that may impact a student’s school day and academic program. The most common options are as follows:

Allergy Action Plan- a plan completed by the student’s licensed physician or physician’s

designated license extender (Nurse Practitioner, Physician’s Assistant) that is designed for use by both nursing and school personnel. It outlines the care that a student could need in an emergency situation and used as a guide to respond to a student who is experiencing a potentially critical situation.

Individual Healthcare Plan for Accommodations- a documented developed by

AcademyACL’s supervisory nurse in collaboration with parents and the school team to identify reasonable accommodations for the child’s needs throughout the school day. This type of plan contains the specifics throughout the day for students with Life-Threatening allergy

accommodation needs, but may also be used for students with allergies that are not

Life-Threatening but interfere enough (without accommodations) with the child’s function in school to merit such a plan, as indicated by the family physician.

Section 504 Plan- The intent of Section 504 of the Rehabilitation Act of 1973 is to provide students with disabilities equal access to educational programs, services, and activities. Students with disabilities may not be denied participation in school programs and activities solely on the basis of the disability. The use of this plan will depend on Colorado’s and Colorado Springs District 11 (D11)’s implementation of 504 plans.

There are substantial differences across the country in legal interpretations and school district practices regarding Section 504, its definition of a qualified person with a disability, and the eligibility of students with Life-Threatening food allergies. Since the law provides that a team of knowledgeable persons must make eligibility determinations on a case-by-case basis, these guidelines cannot provide specific guidance on the eligibility question. Nevertheless, schools and districts have an obligation to provide reasonably safe environments for all students. Whether students with Life-Threatening food allergies are identified under Section 504 as disabled

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Page | 6 individuals or not, AcademyACL will provide these students with individualized health care

plans to address their health and safety needs. Responsibilities for Care of Students

The following lists outline the reasonable expectations that each member of the student’s support team should meet in order to provide sufficient care for students with Life-Threatening Allergies, and other levels of allergies (and food sensitivities and special diets) as applicable.

Parent/Guardian of an Anaphylactic Student

Each parent/guardian of a child with a Life-Threatening Allergy will be expected to: 1. Take responsibility for the safety of your own child, and teach your child to:

a. Recognize the first symptoms of a food allergic/anaphylactic reaction. b. Communicate with school staff as soon as he/she feels a reaction is starting. c. Carry his/her own epinephrine auto-injector when appropriate.

d. Not share snacks, lunches, drinks or utensils.

e. Understand the importance of hand-washing before and after eating.

f. Report teasing and/or bullying that may related to the child’s disability/allergy.

2. As your child gets older, teach him/her to:

a. Use positive self-advocacy to share the seriousness of the allergy to adults and peers.

b. Communicate symptoms as soon as they appear to the school nurse and teacher. c. Read labels and become knowledgeable about the safety of ingredients.

d. Administer his/her own epinephrine auto-injector and be able to train others in its use.

e. Develop awareness of surrounding environments, including allergy-controlled zones, and practice age-appropriate behavior regarding health and safety. 3. Inform the school office of your child’s allergies prior to the first day of school, or as

soon as possible after diagnosis. All food allergies must be verified by documentation from the child’s physician or physician’s designated license extender (Nurse

Practitioner (NP) or Physician’s Assistant (PA).

4. Work with the school team collaboratively to develop the Individual Health Plan for Accommodations in the classroom, in the cafeteria, in after-care programs, during school-sponsored activities, and provide an Allergy Action Plan. Medical information from the child’s treating physician must be provided as needed to write these plans. (A licensed physician is defined for the purposes of these allergy plans as a doctor of medicine, M.D. or doctor of osteopathy, D.O.).

5. Work positively with other parents to encourage a warm and supportive school culture that recognizes and adapts to the needs of children. When there are concerns, parents are expected to approach them in a proactive and positive, problem-solving manner,

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Page | 7 recognizing that there is a wide range in levels of understanding about life-threatening

allergies, and school personnel may ask for support in providing training

6. Work with AcademyACL staff and your family’s physician to create an Allergy Action Plan that also promotes increasing age-appropriate independence (beginning at least at age eight) as the student grows and matures. In determining age-appropriate

independence the student’s level of autonomy and their ability to function autonomously will be considered.

7. Complete and submit all required medication and other forms. A physician’s signature is required on allergy action plans and self-administration plans. Parents need to sign the release (HIPAA) for school personnel to consult with family physician/allergist and all medical providers.

8. Maintain current emergency contact numbers and medical information; provide the school with current cell phone, pager, etc.

9. Provide the school nurse/designee with up-to-date emergency medications (including epinephrine) so that they can be placed in all required locations for the current school year. Medications will comply with the school medication policy of proper labeling of prescription name, student name, and expiration date.

10. Consider providing a medical alert bracelet for your child. Nationally accepted bracelets may be found at: Medic Alert, 1-888-633-4298; 2323 Colorado Avenue, Turlock, CA 95382; www.medicalalert.org.

11. Complete appropriate forms requested by other programs such as Before/After Care, field trips, et cetera.

12. Provide epinephrine/emergency medication on field trips. 13. Attend your student’s field trips if possible and if requested.

14. Provide ‘Safe Snacks’ for your student’s classroom so that there is always something your child can choose from during an unplanned special event; and consider snacks/food supplies for a crisis/lock-down situation where no food can be brought in.

15. Encourage your child to wash hands before and after handling food. Encourage your child to identify allergy-controlled zones when eating and utilize easy access to soap in or near classrooms.

16. Inform the school of any changes in the child’s Life-Threatening Food Allergy Status. 17. Provide the school with the physician’s statement if the student no longer has food

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Page | 8 Students with Life-Threatening Allergies

Each student with a Life-Threatening Allergy will be expected to:

1. Develop a relationship with the school nurse/designee and/or another trusted adult in the school to assist in identifying issues related to the management of the food allergy in the school. (Trusted adults are people who respect your feelings will listen and help work out a solution to any problem you may have. Trusted adults will provide guidance and

support.)

2. Use proper hand-washing before and after eating and throughout the school day. 3. Avoid sharing or trading foods/sharing utensils with others. Take responsibility for

avoiding food allergens.

4. Avoid eating anything with unknown ingredients, those known to contain any allergen, and those that may have come into contact with an allergen.

5. Avoid putting anything in his/her mouth such as writing utensils, fingers, or other foreign objects.

6. Be proactive in the care and management of their food allergies and reactions based on their developmental level. Learn to recognize personal symptoms.

7. Notify an adult immediately if he/she eats something they believe may contain the food to which they are allergic.

8. Notify an adult if he/she is being picked on or threatened by other students because of his/her food allergy.

9. Keep emergency epinephrine with the student, in the nurse’s office, or in the classroom. If the student is authorized to carry the emergency medication with him/herself at all times, he/she will demonstrate responsibility of this practice by completing the skills checklist with the school office (found in the Allergy Management Packet).

10. Develop an awareness of his/her environment and allergy-controlled zones.

11. Know the overall Individual Healthcare Plan and understand the responsibilities of the plan, and the accommodations needed in each environment.

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Page | 9 Academy Director

AcademyACL’s Academy Director shall ensure the following:

1. Follow all applicable federal laws, including ADA, Section 504, and FERPA, as well as all state laws and district policies/guidelines that may apply.

2. Make available the appropriate allergy and health forms to families and explain that the required forms must be returned and approved by the supervisory school nurse/designee prior to the child attending school.

3. Meet with parents and listen to their needs and concerns.

4. Present the HIPAA Compliant Authorization for Exchanged of Health & Education to parents for signature to provide needed communication between the supervising physician and school for effective implementation of the plan.

5. Establish a core team comprised of Parent, Director, Teacher, Student, Supervisory Nurse/Designee, D11 Food Manager, and any other personnel deemed necessary to make decisions about food allergies.

6. Create an emergency action plan for addressing Life-Threatening food-based allergic reactions with consultation from the supervisory school nurse/designee, students parents/guardians, and physician.

7. Ensure school-wide mandatory in-service training and education for all staff to include, but not necessarily be limited to, the following topics:

a. Reducing Life-Threatening allergy risks.

b. A description/definition of severe allergies and discussion of the most common foods causing allergic reactions.

c. Signs and symptoms of food allergy symptoms and anaphylaxis. d. Correct use of an Epinephrine.

e. Specific steps to follow in the event of an emergency.

In addition, parent/staff severe allergy educational meetings may be scheduled as medical personnel are available.

8. Reinforce a no-food and no-utensil trading/sharing food policy. Post a sign informing students that they are expected to neither trade nor share food or utensils.

9. Ensure that the supervisory school nurse/designee in consultation with suggestions from students’ parents/guardians and physician/designated licensed extender will prepare the Individual Health Plan for accommodations. The physician will prepare and sign off on the Allergy Action Plan.

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Page | 10 10. Establish Life-Threatening allergy safe zones as needed in each eating area that students

use. These zones will be designated by a universal symbol and cleaned/sanitized as per the appropriate protocol. This protocol will include a separate cleaning bucket for allergy-free areas, de-greasing soap/cleanser, and/or an approved spray cleanser. 11. Ensure the Individual Health Plan for Accommodations is available in the front office

and in the student’s homeroom.

12. Recommend that parents/guardians attach a photograph of their student with a Life-Threatening Food Allergy to their Individual Health Plan for Accommodations. When appropriate and permitted by parents, students’ photos will be placed in the kitchen only for kitchen staff to view as an extra protective measure. Pictures will be out of view of other students and carried out in accordance with patient confidentiality regulations. 13. When appropriate, enforce the policy that students are allowed and encouraged to carry

their epinephrine on their person, as permitted and documented in his/her Allergy Management Plan and Self-Administration Epinephrine Authorization Plan. 14. Ensure that information is in an organized, prominent and accessible format for a

substitute teacher with the universal symbol displayed for ease of access. A bright colored label will be on the outside of sub folders (MEDICAL ALERT). The medical issue will be filled in the blank specific to the student.

15. When appropriate, familiarize teachers with the Individual Health Plan for

Accommodations of their students and any other staff member who has contact with student on a need-to-know basis.

16. Instruct and reinforce with AcademyACL’s custodian a cleaning protocol to ensure that the threat of allergens is minimized.

17. Establish procedures to ensure letters are sent to all parents of children assigned to a classroom where one of the students has been identified with a Life-Threatening Allergy in accordance with patient confidentiality regulations.

18. Post the school’s emergency protocol on Life-Threatening Emergencies in appropriate locations, including the main office, and in back-to-school newsletters and/or orientation manuals and family handbooks.

19. Notify staff of the locations of epinephrine in the school.

20. Ensure that a contingency plan is in place using designated building staff and understood by all staff and students in the event that the supervisory nurse/designee is not in the office or building. Staff will call 911 in all instances of Epinephrine administration.

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Page | 11 School Health Professionals

AcademyACL does not have a full time nurse, but contracts with a supervising nurse who will review student records, consult with AcademyACL staff, and ensure that the proper protocols and guidelines are followed. The nurse will designated one or more office staff as his/her designee to monitor and implement the required protocols.

The supervisory nurse/designee will have the following responsibilities:

1. Meet with parents/guardians of a student with a Life-Threatening Allergy to develop an Individual Health Plan for Accommodations for the student, which may include the use of MEDIC-ALERT bracelets and other methods of identification for students with Life-Threatening Allergies to staff when there is a need-to-know basis.

2. Maintain updated AAP/Individual Health Plan for Accommodations in the school office, in the classroom when appropriate, with Epinephrines that are carried by identified students, and with copies that will travel with Epinephrines on school sponsored field trips.

3. Assist the Academy Director in providing information about students with Life-Threatening Allergies to staff when there is a need-to-know basis.

4. In conjunction with the Academy Director, provide yearly in-service training and education for staff regarding Life-Threatening Allergies, symptoms, risk reduction procedures and emergency procedures including demonstration of how to use the epinephrine. The AcademyACL office shall maintain annual documentation of those personnel who have received training.

5. Familiarize teachers/substitutes with the Individual Health Education Plan for

Accommodations of their students any other staff member who has contact with students on a need-to-know basis.

6. In emergency situations, the Department of Health guidelines governing the

administration of prescription medications will be followed. Regulations that permit registration of non-licensed personnel to be trained and proper procedures to administer emergency medications such as Epinephrine will be followed.

7. Educate parents with the appropriate locations for storing the epinephrine and the possibility of receiving more than one epinephrine as necessary. Locations for storage will follow the manufacturer’s guidelines for avoidance of light and extreme

temperatures.

8. Inform the Academy Director and parent/guardian if any student experiences an allergic reaction that has not been previously diagnosed.

9. Ensure contingency plans are in place in the event that the supervisory nurse/designee is not in the building/office so that trained and identified back-up personnel are utilized.

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Page | 12 Teachers

Each teacher shall have the following responsibilities:

1. Knowledge of the signs and symptoms of several of severe allergic reaction as provided in the student’s health care plan, and awareness of and implementation of the emergency plan if a reaction is suspected.

2. Review the Individual Health Plan for Accommodations in a setting with the nurse and parents/guardians of any student in your classroom with Life-Threatening allergies along with relevant staff members.

3. Participate in in-service training about students with Life-Threatening allergies including demonstration on how to use the epinephrine.

4. In collaboration with the nurse and parents/guardians of the allergic child, set a classroom protocol regarding the management of food in the classroom. This protocol will be

communicated by the teacher to the students and parents/guardians of the affected class, and will include an allergy-free table and cleansers/cleaning bucket specific to that table as well as procedures for the rest of the classroom.

5. Participate in the planning of a student’s re-entry into school after an anaphylactic reaction.

6. Notify parents by written communication in advance of any school-related activity that requires the use of food. Limit use of food for instructional lessons.

7. Before announcing potential instructional use of food to parents or students, collaborate with administration, nurse/designee, and parents of student/s with allergies prepare an announcement letter. Send the letter to all families in the class of an individual with a Life-Threatening Allergy.

8. Reinforce appropriate classroom hygiene practices/hand-washing before and after eating. 9. Reinforce a no food-sharing policy, and edecuation the rest of the class on ways to be a

PAL (Protect a Life) with the PAL brochures and information.

10. Respond immediately to reports of students being teased or bullied about their food allergies.

11. Follow Allergy Action Plan and call 911 when Life-Threatening allergy-related symptoms occur.

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Page | 13 Nutrition Services through District 11

District 11 Food and Nutrition Services Department functions separately from AcademyACL. However, the AcademyACL Academy Director will discuss the possibility of the following or similar guidelines in place.

1. Provide in-service training to nutritional service employees regarding safe food handling practices to avoid cross contamination with potential food allergens.

2. Food service employees will wear non-latex gloves. Gloved hands will be washed or changed during extended use to avoid cross contamination with potential food allergens. 3. Maintain a list of students with food allergies within the food service area with a photo of

the student wherever possible (not for public viewing/viewing within sight of other students) as permitted by parents/guardians.

4. Maintain knowledge of which food products contain allergens.

5. Provide allergen-safe zones at schools in conjunction with AcademyALC staff, identified with a universal symbol, where students with applicable food allergies may eat.

6. Participate with in-service training for students with Life-Threatening allergies, including demonstration of Epinephrine use.

7. With parental approval, set up reasonable procedures for eating areas regarding students with Life-Threatening allergies, including entering student’s allergy/allergies into the computerized database. Information will remain confidential and shared on a need-to-know basis in compliance with federal privacy regulations.

8. Respond appropriately to all complaints/concerns from any student with a Life-Threatening allergy, including allowing student to see school nurse/designee if complaining of any potential symptoms. AcademyACL staff needs to be notified immediately if there is any type of hazing or inappropriate behavior on the part of other students.

AcademyACL Custodian

Under the direction of the AcademyACL Director and Business Manager as appropriate: 1. Use a separate wash bucket and cloth with district-approved cleaning agents solely for

the cleaning of allergen-safe zones. This will include disinfecting solution and PH7 all-purpose soap as effective cleaning solutions.

2. Receive training on allergen zone maintenance areas.

3. Participate in in-service training for students with Life-Threatening allergies including demonstration of Epinephrine use.

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Page | 14 Field Trip Organizers

AcademyACL will use the following protocol and guidelines for Field Trips with students who have Life-Threatening Food Allergies:

1. Consideration will be given for the type of trip being planned and the opportunity to limit allergen exposure.

2. For every field trip, whether it is by foot in the area or by a bus/vehicle, each student with a Life-Threatening allergy will travel with a copy of his/her Allergy Management Plan and appropriate medication. Each bus driver/transportation provider will be notified of the Life-Threatening Allergy and the location of the Allergy Management Plan, with appropriate protection of confidential information.

3. AcademyACL staff will verify that functioning emergency communication devices will be present on each bus/vehicle (e.g. cell phones, two-way radios, etc) or with the team leader (for trips/excursions by foot).

4. AcademyACL staff will ensure that every student who is present on the field trip will have up-to-date contact information for parents/guardians, and that those same parents/guardians, if attending the field trip as well, are present in the same transport vehicle as the student. Parental attendance is encouraged.

5. AcademyACL staff will ensure that there is no food eating on the bus/vehicle except for those with medically documented needs such as diabetes or hypoglycemia. In cases of medically documented needs, those students must bring allergen-safe foods for eating on the bus (at the very least, no nuts- or lotion containing nut oil- since physical contact with the oil left on a seat or another area a student could touch creates the likelihood of an allergic reaction).

6. Students with Life-Threatening allergies should sit immediately behind and to the right side of the bus driver when transporting to/from the field trip/excursion.

7. Bus drivers will not hand out food treats even on special occasions.

8. Meals of children with food allergies will be stored separately as much as possible to minimize cross-contamination, and remind all students of the no food-sharing policy. 9. An in-serviced trained AcademyACL employee such as the classroom teacher will

accompany the class on the field trip and will maintain each applicable student’s epinephrine and will follow the child’s Allergy Action Plan.

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Page | 15 Before/After Care and After-School Activity Personnel

Persons in charge of various extracurricular activities shall have the following responsibilities: 1. Ensure that the Allergy Action Plan will be available for parents to copy and give to

others who assume responsibility for their child. Personnel may include: a. Before/after school enrichment opportunities instructors

b. Coaches

c. Before/After Care personnel

d. Overnight trip sponsors/chaperones

e. Clubs, programs, and/or sports will maintain a list of students with severe Life-Threateningallergies including demonstration of Epinephrine at least annually. The training will be documented and put on file.

2. Remind all students of the no food-sharing policy, and encourage frequent hand-washing. 3. Designate an allergy-safe zone for snacks and meals, and ensure that it is cleaned with a

separate allergy-free cleaning bucket and the appropriate supplies (include a grease-fighting soap/cleanser and/or spray).

4. Ensure that a cell phone or walk-talkie is present when the student is outside the building, and that epinephrine is easily accessible as outlined in the Allergy Action Plan.

Recess, Physical Fitness & Fun, and Physical Education

During recess and physical education classes for a student with a Life-Threatening Allergy, AcademyACL shall have the following responsibilities:

1. Children will be under the supervision of at least one adult. The epinephrine packet will be taken outside if specified in the child’s Allergy Action Plan/Individual Health Plan for Accommodations. The epinephrine will be carried by designated district employee or by the student with a completed Epinephrine Self-Administration Packet for Anaphylaxis.

2. Emergency communication device (walkie-talkie, cell phone) will be accessible and functional.

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Page | 16 Asthma Management Policy

Asthma is an extremely prevalent chronic disease in children, with hospitalizations and absences from school every year that often could be prevented with certain factors in place. According to a National Association of Nurses survey, asthma is the most frequent childhood disease to cause disruption to school routines (Michigan, 2006). Approximately one out of eleven students suffers from this condition (National Heart, Lung, and Blood Institute). AcademyACL’s asthma policy focuses on asthma management and support systems so that students are able to work

successfully throughout the day. This allergy policy has been developed with ideas from a template prepared by the state of Michigan, available at:

http://www.michigan.gov/documents/MDE_Asthma_Policy_Board_10_2004_115301_7.pdf. 1. Families of a student with asthma will follow the appropriate protocol for ensuring that

medical paperwork is on hand signed by the student’s physician, including an Asthma Action Plan and the necessary, appropriately labeled medication.

2. Mandatory staff training will include policy on the basics of asthma, acute and routine management of asthma, including information on signs of an asthma attack, asthma medication and administration, asthma triggers, and emergency protocols for handling asthma exacerbations in “unusual” situations such as field trips.

3. A healthy school environment will be promoted to reduce asthma triggers, including: a. Enforcing a tobacco-free school policy that is 24-hours per day, 7 days a week on

all school property, in any form of school transportation, and at school-sponsored events both on and off school property.

b. Implementing best practice policies for common indoor and outdoor air quality problems by such as: preventative maintenance on heating/cooling systems; construction and remodeling projects; integrated pest management techniques and pesticide application notification; cleaning practices that address fumes, dust mites, and molds; proper chemicals and solutions storage; and specific protocol for the presence of warm-blooded animals in the classroom.

c. Limiting students’ outdoor activity on high ozone and extremely cold days. 4. Students with documented Asthma Action Plans will immediately be sent to the office or

to the location of his/her inhaler, with another student or adult as appropriate, if they complain of asthmatic symptoms, trouble breathing, or request use of an inhaler; protocol in his/her Asthma Action Plan will be followed carefully. When in doubt, any student with persistent, troublesome coughing or complaints of breathing difficulty should be sent to the office.

5. Students with documented Asthma Action plans will be provided with safe, enjoyable physical education and activity opportunities, including:

a. Full participation in physical activities when students are well.

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Page | 17 c. Access to preventative medications before activity as described by the Asthma

Management Plan and immediate access to emergency medications during activity.

d. Communications concerning student health status between physicians and appropriate AcademyACL personnel and before/after care and enrichment personnel.

6. Smoking prevention and cessation programs will be developed and provided for staff and students.

7. If there is any concern that a child might not be able to make it to the office, walking of his/her own accord beside a classmate or another adult, the classroom teacher will call the office for assistance.

8. An adult working with a child in breathing distress should make every effort to keep the child as calm as possible, to encourage breaths out (even though the child will feel as though he/she needs to continue pulling air in), and to get help from other adults and call 911 and/or follow the Asthma Management Policy for inhaler usage.

9. When an emergency inhaler has been used, as opposed to a routine dosage during the day, parents will be notified as soon as possible.

10. If a child stops breathing, CPR procedures will be started and 911 will be called immediately.

11. Efforts will be made to educate the school community, staff, and families on asthma management and community resources that are available (asthma programs, health care specialists, social service agencies, etc.).

Further information can be found at the National Heart , Lung, and Blood Institutde, at

http://www.nhlbi.nih.gov/health/public/lung/asthma/resolution.htm).

12. The same guidelines for Food-Allergy responsibilities and guidelines will be followed for students with Asthma, as applicable.

Bee-Sting & Insect Life-Threatening Allergy

In instances where students are allergic to bees and/or other types of insect stings/bites, epi-pen procedures, including required documentation from a physician, will be followed. Exposure to these types of insects will be limited when possible, such as remaining indoors if there is a high incidence of them on a given day.

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Page | 18 Latex Allergy

“Latex allergy is a reaction to certain proteins found in natural rubber latex, a product

manufactured from a milky fluid that comes from the rubber tree. If you have a latex allergy, your body mistakes latex for a harmful substance.

Latex allergy may cause allergic reactions ranging from sneezing or a runny nose to anaphylaxis, a potentially life-threatening condition.” – www.MayoClinic.com

When AcademyACL has a student with a latex allergy, procedures similar to peanut oil allergies will be followed and adapted to the needs of the student. This policy will be updated and further developed with information as needed.

Non-Life Threatening Food Allergy & Sensitivity Management

Information from the American Dietetic Association relates that:

Approximately one in 25 people suffers from a food allergy. They are slightly more common in young children and in people who have a family history of them. Most food allergies develop early in life, and many are outgrown. Food allergies occur when your body's immune system reacts to a substance in a food, usually a protein, your body sees as harmful. This sets off a chain reaction within your body. Symptoms can occur within minutes and can be mild – such as a runny nose or itchy eyes to severe and even life-threatening. A food intolerance is not the same as a food allergy.

An intolerance occurs when your body is unable to digest a certain component of a food, such as lactose, a sugar found in milk; monosodium glutamate; or sulfites, a preservative. Though symptoms of intolerance may be unpleasant, including abdominal cramping or diarrhea, they are not life-threatening. More than 160 foods are known to cause food allergies. However, eight foods account for 90 percent of all food-allergic reactions (milk, egg, peanuts, tree nuts (walnuts, cashews), fish, shellfish, soy and wheat).

http://www.eatright.org/Public/content.aspx?id=5539

There are some allergies and food sensitivities/intolerances that, while not Life-Threatening in terms of immediate anaphylactic shock, create a great deal of emotional and physical distress with students that interfere with their optimal learning.

Parents/guardians of students with food allergies and sensitivities should complete all necessary forms in the Allergy Management Packet, including a physician’s action plan for the allergy and the paperwork for District 11’s food and nutritional services.

Classroom teachers in consultation with the supervising school nurse/designee may prepare an abbreviated Allergy Management Plan for students with non-Life Threatening food allergies, if needed, in coordination with parents.

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Page | 19 Special Diets

Some students and families may follow particular diets such as a kosher, vegetarian or vegan diet. According to Medline Plus,

A vegetarian diet focuses on plants for food. These include fruits, vegetables, dried beans and peas, grains, seeds and nuts. There is no single type of vegetarian diet. Instead,

vegetarian eating patterns usually fall into the following groups:

• The vegan diet, which excludes all meat and animal products

• The lacto vegetarian diet, which includes plant foods plus dairy products • The lacto-ovo vegetarian diet, which includes both dairy products and eggs

People who follow vegetarian diets can get all the nutrients they need. However, they must be careful to eat a wide variety of foods to meet their nutritional needs. Nutrients vegetarians may need to focus on include protein, iron, calcium, zinc and vitamin B12.

http://www.nlm.nih.gov/medlineplus/vegetariandiet.html

According to a kosher foods website,

Kosher food is often termed a Jewish food. Jewish followers are the most common kosher food consumers, but they are not the only ones. There are individuals who eat kosher food simply because the food is often considered better than traditional food. Jewish law is used to determine exactly what food is kosher and what is not.

http://www.whatskosher.com/

There are very strict guidelines for what qualifies as kosher food. If a student/family follows a kosher diet, families are asked to send the approved food with their student and/or work with the District 11 staff to find suitable choices.

When students follow a particular diet, parents/guardians need to let his/her homeroom

teacher/divisional teachers know about the diet so that any food planned for special events may be able to take this diet into consideration. Parents are also asked to return paperwork to the District 11 food service so that they are aware of these diets, and to provide meals in accordance with the necessary dietary guidelines for this diet whenever possible.

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Page | 20 Definitions

ADA:

Americans with Disabilities Act. The Americans with Disabilities Act gives civil rights

protections to individuals with disabilities similar to those provided to individuals on the basis of race, color, sex, national origin, age, and religion. It guarantees equal opportunity for individuals with disabilities in public accommodations, employment, transportation, state and local

government services, and telecommunications. http://www.ada.gov/

FERPA:

Family Educational Rights and Privacy Act. The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99) is a Federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the U.S. Department of Education. FERPA gives parents certain rights with respect to their children's education records. These rights transfer to the student when he or she reaches the age of 18 or attends a school beyond the high school level. Students to whom the rights have transferred are "eligible students." http://www2.ed.gov/policy/gen/guid/fpco/ferpa/index.html.

HIPAA:

Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules. The Office for Civil Rights enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety. http://www.hhs.gov/ocr/privacy/

504:

Section 504 of the Rehabilitation Act of 1973 is a national law that protects qualified individuals from discrimination based on their disability. The nondiscrimination requirements of the law apply to employers and organizations that receive financial assistance from any Federal department or agency. http://www.hhs.gov/ocr/civilrights/resources/factsheets/504.pdf

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Key  Points  for  Parents,  Students,  and  Staff  

• You are never alone. It takes a team to ensure the best for our students. Help is usually just a phone call away.

• Educate, Educate, Educate. This is an ongoing process that changes with the students’ needs and as the staff changes. Food bans do not work because it creates a false sense of security. Today, processed foods contain trace amounts of food items that are not always identified on the food label. The best plan is to educate our school community about the issues that face students with Life-Threatening allergies.

• Special Events/Non-routine Days. The greatest risk for a Life-Threatening allergic reaction exists when the normal routine is broken. Examples are classroom parties, field trips, a substitute teacher, and after-school events. Be prepared. Always have Allergy Action Plans available and think ahead to prevent possible exposures to a food allergen. • Symptoms vary greatly. Call 911 when uncontrolled anaphylactic symptoms occur or if ingestion is strongly suspected. Use emergency medication (i.e. Epinephrine) if needed, and follow the AAP.

• Be safe, not sorry. Take all complaints from children with food allergies very, very seriously. It is important to respect the needs and rights of each student.

• A child with a Life-Threatening food allergy should NEVER eat unexamined food. • In the event that a student has an allergic reaction at school, call 911 and administer

emergency medication (i.e. antihistamine and Epinephrine) as ordered by the student’s physician. Key staff members should be trained to use emergency medications and know the location of those medications at school and on any special function. If epinephrine is used, the student should be taken to the hospital for evaluation even if the allergic reaction symptoms subside. The Academy Director, supervising nurse/designee, and parent/guardian should be notified as soon as feasible. 911 should be called for all

suspected food allergy reactions. No one can predict how a reaction will progress. A mild reaction can blossom into a full blown anaphylactic reaction very quickly or over several hours. A reaction can also appear to subside or even appear to be under control and can blossom again into a more severe reaction.

• Cross contamination. It only takes a trace amount of the food protein to cause an allergic reaction. To prevent exposure to an allergen, hand washing and washing of surfaces (tables, chairs, mixing bowls, etc) where an allergen has been used is necessary. Soap and warm water are most effective for cleaning surfaces.

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Page | 22 Resources:

The Food Allergy and Anaphylaxis Network (FAAN). FAN is a great resource for current

research, informational newsletter, support groups, and information of food products. Their

phone number is 800-929-4040, and the Web address is: www.foodallergy.org

American Academy of Allergy, Asthma and Immunology. (AAAAI). http://www.aaaai.org

National Association of School Nurses. http://www.nasn.org

Asthma & Allergy Foundation of America. http://www.aafa.org • The Food Allergy & Anaphylaxis Network (FAAN)

FAAN is a great resource for current research, informational newsletter, support groups, and information of food products. Their phone number is 1-800-929-4040.

Allergy, Asthma Information Association of Canada (AAIA)

American Academy of Allergy, Asthma & Immunology (AAAAI)

National Association of School Nurses (NASN)

Asthma & Allergy Foundation of America (AAFA)

Food & Drug Administration's Website

Food Anaphylaxis Education's Website

FORMS:

Epinephrine Fact Sheet

Sample Parent Letter

Food Allergy and Epinephrine Training In-Service Sheet

Epinephrine Self-Administration Authorization Packet for Anaphylaxis

Food Allergy Action Plan

Epinephrine/Twinject Medication Self-Administration Form

Epinephrine/Twinject Student Skills Checklist

Transportation/Food Services Letter to Parents

Substitute Notice

Allergen-Safe zone sign

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Epinephrine Self-Administration

Authorization Packet for Anaphylaxis

(A new packet must be completed yearly)

Packet Contents:

1. Anaphylaxis Medication Self-Administration Form (requires

physician and parent/guardian signature)

2. Anaphylaxis Student Skills Checklist

3. Severe Allergy Action Plan (requires physician and

parent/guardian signature)

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Page | 24 HIPAA-Compliant Authorization for

Exchange  of  Health  &  Education  Information  

 

This  form  is  required  for  students  with  medical  conditions  that  school  personnel  will  need  to  

accommodate  and  monitor,  including  but  not  limited  to  Life-­‐Threatening  allergies  and  restrictions  on   physical  activity.  We  have  a  supervising  nurse  and  our  office  staff  will  function  as  nurse’s  designee  as   needed  to  follow  up  with  health  records  and  protocols.  There  is  an  additional  form  that  needs  to  be   completed  for  medication  to  be  dispensed  during  school  hours.  

 

Patient/Student  Name  :  

_____________________________________________________________________   Date  of  Birth:______________________  

 

I  hereby  authorize  [insert  health  care  provider  name  &  title]  

______________________________________________________________    

and  the  AcademyACL  nurse/nurse  designee  to  exchange  health  and  education  information/records  for   the  purpose  listed  below.  

address  and  telephone  of  health  care  provider:      

 

Description:  

The  health  information  to  be  disclosed  consists  of:    

     

The  education  information  to  be  disclosed  consists  of:    

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Purpose:  This  information  will  be  used  for  the  following  purpose(s):   1.  Educational  evaluation  and  program  planning  

2.  Health  assessment  and  planning  for  health  care  services  and  treatment  in  school.   3.  Medical  evaluation  and  treatment  

4.  

Other:________________________________________________________________________________   _____________________________________________________________________________________    

Authorization  

This  authorization  is  valid  for  one  calendar  year.  It  will  expire  on  [insert  date  ].  I  understand  that  I  may   revoke  this  authorization  at  any  time  by  submitting  written  notice  of  the  withdrawal  of  my  consent.  I   recognize  that  health  records,  once  received  by  the  school  district,  may  not  be  protected  by  the  HIPAA   Privacy  Rule,  but  will  become  education  records  protected  by  the  Family  Educational  Rights  and  Privacy   Act.  I  also  understand  that  if  I  refuse  to  sign,  such  refusal  will  not  interfere  with  my  child’s  ability  to   obtain  health  care.  

 

Parent  Signature:  _________________________  Printed:  _____________________Date:  ___________    

Student  Signature*:  _______________________  Printed:  _____________________Date:  ___________  

*If  a  minor  student  is  authorized  to  consent  to  health  care  without  parental  consent  under  federal  or  state  law,  only  the   student  shall  sign  this  authorization  form.    

Copies:    

 Parent  or  student*  

 Physician  or  other  health  care  provider  releasing  the  protected  health  information    School  official  requesting/receiving  the  protected  health  information  

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EPINEPHRINE/TWINJECT MEDICATION SELF-ADMINISTRATION

FORM

Student Name: ____________________________________Grade: _____ School Year: ____________

The Missouri Safe Schools Act of 1996 provides for students to carry and self-administer life-saving medications when the following criteria are met:

(1) A licensed physician prescribed or ordered the medication for use by the child and instructed such child in the correct and responsible use of the medication.

(2) The child has demonstrated to the child’s licensed physician or the licensed physician's designee, and the school nurse, if available, the skill level necessary to use the medication and any device necessary to administer such medication prescribed or ordered.

(3) The child's physician has approved and signed a written treatment plan for managing asthma or anaphylaxis episodes of the child and for medication for use by the child. Such plan shall include a statement that the child is capable of self-administering the medication under the treatment plan.

(4) The child’s parent or guardian has completed and submitted to the school any written documentation required by the school, including the treatment plan required in (3) above and the liability statement required in below.

(5) The child’s parent or guardian has signed a statement acknowledging that the school district and its employees or agents shall incur no liability as a result of any injury arising from the self-administration of medication by the child or the self-administration of such medication by school staff. Such statement shall not be construed to release the school district and its employees or agents from liability for negligence. (Missouri Revised Statute; Chapter 176; Pupils and Special Services; Section 167.627; 08-28-2006).

MEDICATION NAME ______________Dose _____________Time or Interval______________ Route/Inhalation device______________________Instructions_________________________ MEDICATION NAME ______________Dose _____________Time or Interval______________ Route/Inhalation device______________________Instructions_________________________ ALLERGIES: List known allergies to medications, foods, or air-borne substances

____________________________________________________________________________ ____________________________________________________________________________

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Epinephrine/TwinJect Student Skills Checklist

Student __________________________________ Age _______ Grade/Team _____________ I, the parent or legal guardian of the student listed above, give permission for this child to carry and self-administer the above listed medications. I have instructed my child to notify the school staff anytime this device is used. I understand that, absent any negligence, the school shall incur no liability as a result of any injury arising from the self-administration of medication by my child.

Signature of parent or legal guardian_________________________________ Date_________ Parent/Guardian:

Name: ______________________________________Home phone: ____________________ Address: ____________________________________ Work and cell phones: _____________ Name: _____________________________________ Home phone: ____________________ Address: ___________________________________Work and cell phones: ______________ Emergency Contact:

Name: ____________________________________ Phone #’s: ________________________ I, a licensed physician or nurse practitioner, certify that this child has a medical history of severe allergic reactions, has been trained in the use of the listed medication, and is judged to be capable of carrying and self-administering the listed medications(s). The child should notify school staff anytime the medication/injector is used. This child understands the hazards of sharing medications with others and has agreed to refrain from this practice.

Signature of Health Care Provider _____________________________ Date ______________ Name of Health Care Provider ___________________ Phone: ____________ Fax: _________ Address: ______________________________ City: ________________ Zip: _____________

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Page | 30 School Nurse Signature ______________________________________ Date ______________

Epinephrine Pen Trainer Skills Checklist:

_____ Requires Supervision _____ Performs Independently

 CONFIRM THAT LABEL STATES TRAINING DEVICE. Remove the gray safety cap.

 Firmly hold the Epi-Pen with the black tip near the outer aspect of the thigh.

 Swing and jab firmly into outer thigh and hold the Epi-Pen against the thigh for 10 seconds.

 Remove the Epi-pen unit and massage injection area for 10 seconds.

 Replace the gray cap.

 You may practice again.

 Verbalize that you will tell the school nurse whenever you use the Epinephrine. If the school nurse is unavailable, you will tell the principal or appropriate district personnel. Twinject Trainer Skills Checklist:

_____ Requires Supervision _____ Performs Independently

 Pull off green end cap, then red end cap.

 Put gray cap against outer thigh, press down firmly until needle penetrates. Hold for 10 seconds,then remove.

 Verbalize that you will tell the school nurse whenever you use the Twinject. If the school nurse is unavailable, you will tell the principal or appropriate district personnel.

4. Second dose administration:

 After you have found the appropriate personnel and if your symptoms don’t improve after 10 minutes, administer second dose:

 Unscrew gray cap and pull syringe from barrel by holding blue collar at needle base.

 Slide yellow or orange collar off plunger.

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Notice to All Substitutes

***IMPORTANT***

Our building has several students who have severe, LIFE-THREATENING

food allergies. For these students, eating or touching any nuts or products

containing nuts or other food allergens such as dairy or shellfish could

result in a potentially fatal allergic reaction.

As you begin today

, immediately check with the office professionals or

person to who you report to learn about Life-Threatening allergies or

students with other health concerns with whom you will work. If you are a

substitute, check the appropriate sub-folder for further information. All

health information is CONFIDENTIAL.

Our staff is trained in how to respond to students with food allergies in the

event of an accidental exposure, but prevention is the most important

action we can all take.

To help reduce the risk of exposure for students with severe allergies,

please:

1. Wash your hands after eating or touching any foods.

2. Do not eat or bring any food items into classrooms or specials

classrooms without first checking with the teacher of that room.

3. Observe the signs posted outside ALL rooms or areas that indicate that

no nuts or other allergens are allowed in those areas.

4. Do not offer food to any student.

5. Children should not engage in sharing of food.

6. Do not let students take food out to the playground.

Thank you for your cooperation in this important matter.

Questions? Contact school nurse:_____________________________ Pager:______________

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Managing  Students  with  Food  Allergy  during  a  Shelter-­In-­Place  

Emergency  

School schools and schools across the country, along with the federal government1, are

developing emergency plans in the event of an occurrence that would shelter children and staff in place rather than evacuating them in the event of a crisis. Some schools may refer to this as a “lockdown” or “shelter-in-place” where no one is permitted to leave the premises for a period of time (1 to 3 days, perhaps).

Such emergencies may result from a disaster involving hazardous materials outside of the school building(s), a threat of terrorism, or an act of God (earthquake, tornado, hurricane). Clearly, the safety of all children during a lockdown is paramount; this document, however, pertains to an increasing medical concern among our nation’s children: life-threatening food allergies.

Parents have expressed concern that such emergency plans may not take into account the special needs of children with medical conditions, including food allergy. Of particular concern is the risk posed to children with food allergies when the emergency food supply could be harmful to them, for example, with peanut butter sandwiches for children with peanut allergy. The Food Allergy & Anaphylaxis Network (FAAN)1 offers the following suggestions to those planning for emergency situations to ensure the safety of all food-allergic children during the event of a lockdown situation. Several of these suggestions would be applicable to students with other medical conditions that require access to specific foods and medications.

FOOD

• Schools should work with the parents of children with food allergy (and parents of children with other medical conditions) to ensure an adequate supply of safe, non-perishable foods for that child, and an ample supply of medications needed in case of an allergic or other physiological reaction.

• Schools should educate the staff about food allergies and make the necessary

arrangements to ensure that each student have an adequate supply of safe food, as well as, action plans to address any physiological reactions. School emergency planners should consider placing stickers on the food containers

identifying the presence of particular allergens, and schools should request that the parents of children with food allergies help assure that the allergen stickers are appropriate and visible.

1

The National Advisory Committee on Children and Terrorism (NACCT) has been meeting since March 2003 to develop recommendations to HHS Secretary Thompson about ways to assure that children are reflected in preparedness, response and recovery plans related to terrorism. Moreover, the U.S. Department of Education has released a new guide, Practical Information on Crisis Planning: A Guide for Schools and Communities, to help schools plan for any emergency, including natural disasters, violent incidents and terrorist acts.

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Page | 33 • Parents of students with food allergies should provide a 3 day supply of safe food from

home in case the food at school is not safe or supplies of certain safe food run low during the emergency.

• Every effort should be made to have all children wash their hands with soap and water or use an antibacterial hand-cleaning product before and after each meal/snack.

MEDICATIONS

• An individual student action plan that includes all medications provided to the school by the student’s parents/guardians should include written instructions, signed by a physician, indicating how and when the medicine is to be administered during a reaction.

• Where allowed by state laws, rules and regulations and not in violation of union contracts, an emergency bag filled with the student’s individual action care plan, medications, and written instructions should be created for students with special medical needs. The bag should be assembled in collaboration with the parent, student, private health care provider, school personnel and the school nurse. This bag would need to travel with the child at school and to school-related activities.

• Proper disposal methods of an exposed needle, such as an EpiPen® auto-injector, should follow current OSHA standards.

• Many children with food allergy also have asthma. Battery-powered nebulizers may be needed to treat asthma.

• The school’s emergency plans for addressing medical emergencies need to consider where medication is to be kept, how medical treatment can quickly be given, and by whom, in case a food-allergy induced reaction or other medical emergency occurs. Schools may wish to hold scheduled documented drills to ensure the safe care of students experiencing a medical emergency.

For further assistance or information, please contact:

The Food Allergy & Anaphylaxis Network 11781 Lee Jackson Hwy., Suite 160

Fairfax, VA 22033-3309 Tel: (800) 929-4040 / E-mail: faan@foodallergy.org

American Academy of Allergy, Asthma & Immunology (AAAAI) 611 East Wells

Street Milwaukee, WI 53202 Tel: (414) 272-6071 / E-mail: info@aaaai.org

The American College of Allergy, Asthma & Immunology 85 W. Algonquin Road,

Suite 550 Arlington Heights, IL 60005-4425 Tel: (800) 842-7777 / E-mail: mail@acaai.org

National Association of School Nurses

Western Office: 1416 Park Street, Suite A Castle Rock, CO 80109 Tel: (866) 627-6767 /

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The National Association of Elementary School Principals 1615 Duke Street

Alexandria, VA 22314 Tel: (800) 386-2377 / E-mail: naesp@naesp.org

National Association of Secondary School Principals 1904 Association Drive Reston,

VA 20191-1537 Tel: (703) 860-0200

National School Boards Association 1680 Duke Street Alexandria, VA 22314 Tel:

(703) 838-6722 / E-mail: info@nsba.org

American School Food Service Association 700 South Washington Street, Suite 300

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This is an

Allergy-Controlled

Zone.

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This is an

Allergy-Controlled

Classroom.

Figure

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References

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Outline : Emergency