Becoming a Food Allergy–Aware School Community

Food allergies in schools have become an increasingly serious concern for students, teachers, and school personnel.

As an educator, you likely didn’t plan on providing medical care for students, but the reality is that almost half of severe allergic reactions, called anaphylaxis, that happen at school occur in the classroom on your watch (Hogue, 2017).

It isn’t enough to just have a plan for students in your class that are known to have an allergy because one out of every four food allergy reactions that happen at school happen to students with no known history of a food allergy (McIntyre et al., 2005; Sicherer et al., 2001). While rare, students have died from the effects of suffering an allergic reaction and not receiving the life-saving medication called epinephrine soon enough (Schoessler & White, 2013; Robinson & Ficca, 2011; Sicherer & Simons, 2007).

What can you do to prepare for the possibility of a food allergy reaction happening in your class? You can become allergy-aware by learning the signs and symptoms of a reaction, responding to a potential allergic reaction, and preventing allergic reactions from happening.

Signs and symptoms of an allergic reaction

The early symptoms may be mild but can quickly become life threatening. The following chart from the Epinephrine Policies and Protocols Workgroup of the National Association of School Nurses (2014) provides guidance for educators.

Are any of these signs and symptoms present and severe? Or is there a COMBINATION of symptoms from different body areas?
LUNG: Short of breath, wheeze, repetitive cough SKIN: Hives, itchy rashes, swelling (eyes, lips)
HEART: Pale, blue, faint, weak pulse, dizzy, confused GUT: Vomiting, cramping pain, diarrhea
THROAT: Tight, hoarse, trouble breathing/swallowing HEENT*: Runny nose, sneezing, swollen eyes, phlegmy throat
MOUTH:  Obstructive swelling (tongue and/or lips) OTHER: Confusion, agitation, feeling of imp

ending doom

SKIN: Hives all over body [OR Hives visible on body] If YES, quickly follow the student’s emergency action plan or your school’s policies and procedures.

*Head, eyes, ears, nose, and throat.

How to respond to an allergic reaction

Once it is clear that an allergic reaction may be occurring (or even if you think, “I wonder if this might be an allergic reaction.”), take action quickly.

For a student with a known allergy, refer to the student’s emergency action plan. For a student with no known allergy, contact the school nurse if your school has one and take action according to your school’s policies and procedures.

Students experiencing anaphylaxis need emergency epinephrine. Every state and every school district has different rules and regulations about which school personnel can administer this life-saving medication. If you are not allowed to use an epinephrine auto-injector, get someone who can quickly.

If you are allowed to use an epinephrine auto-injector, take heart because epinephrine auto-injectors are very easy to use. Demonstration videos are available online:

If an epinephrine auto-injection is required, immediately dial 911 or call your emergency services. Contact your school nurse if he or she is not already on the scene, as well as a parent or guardian.

Preventing food allergy reactions

No plan is fool-proof. Even the most meticulous person cannot avoid all potential exposures to allergens, especially food allergens. However, some simple steps can decrease the likelihood of a student’s exposure to his or her allergen.

: https://attendee.gotowebinar.com/register/6292635169625597441

About the Author
Andrea Tanner, MSN, RN, NCSN, is a National Association of School Nurses (NASN) Epinephrine Resource School Nurse, Anaphylaxis Community Expert, National Certified School Nurse, selected as one of the 2015 Robert Wood Johnson Foundation’s Breakthrough Leaders in Nursing, and Coordinator of Health Services in southern Indiana. Mrs. Tanner served on a committee with the American Academy of Pediatrics to develop national guidance for school allergy policies and procedures. She has presented on food allergy policies, procedures, and staff training at state and national conferences, and has published articles on the topic in Principal Leadership and NASN School Nurse.

References

Epinephrine Policies and Protocols Workgroup of the National Association of School Nurses. (2014). Sample protocol for treatment of symptoms of anaphylaxis – Epinephrine autoinjector administration by school health professionals and trained personnel. Retrieved from https://www.nasn.org/portals/0/resources/Sample_Anaphylaxis_Epinephrine_Administration_Protocol.pdf

Hogue, S, et al. Abstract 696. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 3-6, 2017; Atlanta.

McIntyre, C., Sheetz, A., Carroll, C., & Young, M. (2005). Administration of epinephrine for life-threatening allergic reactions in school settings. Pediatrics, 116(5), 1134-1140.

Robinson, J. & Ficca, M. (2011).  Managing the student with severe food allergies.  Journal of School Nursing, 28(3), 187-194.  doi: 10.1177/1059840511429686.

Schoessler, S. & White, M.  (2013) Recognition and treatment of anaphylaxis in the school setting:  The essential role of the school nurse.  NASN School Nurse, 29: 407-415.  doi:  10.1177/1059840513506014

Sicherer, S., Furlong, T., DeSimone, J., & Sampson, H. (2001). The US Peanut and Tree Nut Allergy Registry: Characteristics of reactions in schools and day care. Journal of Pediatrics, 138(4), 560-565.

Sicherer, S. & Simons, F.E. (2007).  Self-injectable epinephrine for first aid management of anaphylaxis.  Pediatrics, 119(3), 638-646.  doi: 10.1542/peds.2006-3689.

From the Classroom to the US DOE: How to Have a Voice at All Levels

From the Classroom to the US DOE: How to Have a Voice at All Levels” is the third Webinar in the advocacy series from KDP’s Public Policy Committee.  It aired live on June 13. You can find the previous two Webinars on the Public Policy site: http://www.kdp.org/aboutkdp/publicpolicy.php.

How do you have a voice? What ways would you like to become more involved in advocacy?

Karen Allen, for the Public Policy Committee

A Powerful Voice

You are invited to attend our first kdpedpolicy live Webinar, “A Powerful Voice in Critical Times,” on Monday, March 19 at 8 PM EDT. We’d love to have your voice with us. If you can’t join us Monday, revisit this link after Monday for the recorded Webinar.

Register here.

P.S. Kappa Delta Pi offers other topical Webinars, known as eChapter Events, on its eChapter Communities site.