ANAPHYLAXIS POLICY 2023
Help for non-English speakers
If you need help to understand the information in this policy please contact Reservoir East Primary School on 9460-1569.
Purpose
To explain to Reservoir East Primary School parents, carers, staff and students the processes and procedures in place to support students diagnosed as being at risk of suffering from anaphylaxis. This policy also ensures that Reservoir East Primary School is compliant with Ministerial Order 706 and the Department’s guidelines for anaphylaxis management.
Scope
This policy applies to:
· all staff, including casual relief staff and volunteers
· all students who have been diagnosed with anaphylaxis, or who may require emergency treatment for an anaphylactic reaction, and their parents and carers.
Policy
School Statement
Reservoir East Primary School will fully comply with Ministerial Order 706 and the associated guidelines published by the Department of Education and Training.
Anaphylaxis
Anaphylaxis is a severe allergic reaction that occurs after exposure to an allergen. The most common allergens for school-aged children are nuts, eggs, cow’s milk, fish, shellfish, wheat, soy, sesame, latex, certain insect stings and medication.
Symptoms
Signs and symptoms of a mild to moderate allergic reaction can include:
· swelling of the lips, face and eyes
· hives or welts
· tingling in the mouth.
Signs and symptoms of anaphylaxis, a severe allergic reaction, can include:
· difficult/noisy breathing
· swelling of tongue
· difficulty talking and/or hoarse voice
· wheeze or persistent cough
· persistent dizziness or collapse
· student appears pale or floppy
· abdominal pain and/or vomiting.
Symptoms usually develop within ten minutes and up to two hours after exposure to an allergen, but can appear within a few minutes.
Treatment
Adrenaline given as an injection into the muscle of the outer mid-thigh is the first aid treatment for anaphylaxis.
Individuals diagnosed as being at risk of anaphylaxis are prescribed an adrenaline autoinjector for use in an emergency. These adrenaline autoinjectors are designed so that anyone can use them in an emergency.
Individual Anaphylaxis Management Plans
All students at Reservoir East Primary School who are diagnosed by a medical practitioner as being at risk of suffering from an anaphylactic reaction must have an Individual Anaphylaxis Management Plan. When notified of an anaphylaxis diagnosis, the Principal of Reservoir East Primary School is responsible for developing a plan in consultation with the student’s parents/carers.
Where necessary, an Individual Anaphylaxis Management Plan will be in place as soon as practicable after a student enrols at Reservoir East Primary School and where possible, before the student’s first day.
Parents and carers must:
· obtain an ASCIA Action Plan for Anaphylaxis from the student’s medical practitioner and provide a copy to the school as soon as practicable
· immediately inform the school in writing if there is a relevant change in the student’s medical condition and obtain an updated ASCIA Action Plan for Anaphylaxis
· provide an up-to-date photo of the student for the ASCIA Action Plan for Anaphylaxis when that Plan is provided to the school and each time it is reviewed
· provide the school with a current adrenaline autoinjector for the student that has not expired;
· participate in annual reviews of the student’s Plan.
Each student’s Individual Anaphylaxis Management Plan must include:
· information about the student’s medical condition that relates to allergies and the potential for anaphylactic reaction, including the type of allergies the student has
· information about the signs or symptoms the student might exhibit in the event of an allergic reaction based on a written diagnosis from a medical practitioner
· strategies to minimise the risk of exposure to known allergens while the student is under the care or supervision of school staff, including in the school yard, at camps and excursions, or at special events conducted, organised or attended by the school
· the name of the person(s) responsible for implementing the risk minimisation strategies, which have been identified in the Plan
· information about where the student's medication will be stored
· the student's emergency contact details
· an up-to-date ASCIA Action Plan for Anaphylaxis completed by the student’s medical practitioner.
Review and updates to Individual Anaphylaxis Management Plans
A student’s Individual Anaphylaxis Management Plan will be reviewed and updated on an annual basis in consultation with the student’s parents/carers. The plan will also be reviewed and, where necessary, updated in the following circumstances:
· as soon as practicable after the student has an anaphylactic reaction at school
· if the student’s medical condition, insofar as it relates to allergy and the potential for anaphylactic reaction, changes
· when the student is participating in an off-site activity, including camps and excursions, or at special events including fetes and concerts.
Our school may also consider updating a student’s Individual Anaphylaxis Management Plan if there is an identified and significant increase in the student’s potential risk of exposure to allergens at school.
Location of plans and adrenaline autoinjectors
A copy of each student’s Individual Anaphylaxis Management Plan will be stored with their ASCIA Action Plan for Anaphylaxis in the Sick Bay cupboard together with the student’s adrenaline autoinjector. Adrenaline autoinjectors must be labelled with the student’s name.
Risk Minimisation Strategies
Due to the age of our students it is not reasonable to assume the students will take appropriate precautions to minimise the risks of anaphylactic reactions by their peers.
Therefore REPS will take all possible action to advise the school community to not include nuts and nut products in their child’s recess or lunch food items.
Classrooms
1. Keep a copy of student Individual Anaphylaxis Management Plans in the appropriate classrooms. Be sure the ASCIA Action Plan is easily accessible.
2. Liaise with Parents about food-related activities ahead of time.
3. Use non-food treats where possible, but if food treats are used in class it is recommended that Parents of students with food allergy provide a treat box with alternative treats. Treat boxes should be clearly labelled and only handled by the student.
4. Never give food from outside sources to a student who is at risk of anaphylaxis.
5. Treats for the other students in the class should not contain the substance to which the student is allergic. It is recommended to use non-food treats where possible.
6. Products labelled 'may contain traces of nuts' should not be served to students allergic to nuts. Products labelled ‘may contain milk or egg’ should not be served to students with milk or egg allergy and so forth.
7. Be aware of the possibility of hidden allergens in food and other substances used in cooking, food technology, science and art classes (e.g. egg or milk cartons, empty peanut butter jars).
8. Ensure all cooking utensils, preparation dishes, plates, and knives and forks etc. are washed and cleaned thoroughly after preparation of food and cooking.
9. Have regular discussions with students about the importance of washing hands, eating their own food and not sharing food.
10. The Principal should inform casual relief teachers and volunteers of the names of any students at risk of anaphylaxis, the location of each student’s Individual Anaphylaxis Management Plan and Epipen, the School’s Anaphylaxis Management Policy, and each individual person’s responsibility in managing an incident. I.e. seeking a trained staff member.
11. Statistics show that peanuts and nuts are the most common trigger for an anaphylactic reaction and fatality due to food anaphylaxis. To minimise the risk of a first time reaction to peanuts and nuts, Schools should carefully consider the use of peanuts, nuts, peanut butter or other peanut or nut products during in-school and out-of-school activities. It is recommended that school activities don’t place pressure on student to try foods, whether they contain a known allergen or not.
Yard
1. School Staff on yard duty must be trained in the administration of the EpiPen to be able to respond quickly to an anaphylactic reaction if needed.
2. The EpiPen and each student’s Individual Anaphylaxis Management Plan are easily accessible from the yard, and staff should be aware of their exact location.
3. All staff on yard duty must be aware of the School’s Emergency Response Procedures and how to notify the general office of an anaphylactic reaction in the yard.
4. Yard duty staff must also be able to identify, by face, those students at risk of anaphylaxis.
5. Students with anaphylactic responses to insects should be encouraged to stay away from water or flowering plants. School staff should liaise with parents to encourage these students to wear long-sleeved garments when outdoors.
6. Keep lawns and clover mowed and outdoor bins covered.
7. Students should keep drinks and food covered while outdoors.
Special events (e.g. sporting events, incursions, class parties, etc.)
1. Sufficient school staff supervising the special event must be trained in the administration of an EpiPen to be able to respond quickly to an anaphylactic reaction if required.
2. School Staff should avoid using food in activities or games, including as rewards.
3. For special occasions, school staff should consult parents in advance to either develop an alternative food menu or request the parents to send a meal for the student.
4. Parents of other students should be informed in advance about foods that may cause allergic reactions in students at risk of anaphylaxis and request that they avoid providing students with treats whilst they are at school or at a special school event.
5. Party balloons should not be used if any student is allergic to latex.
Canteens
1. Canteen staff (whether internal or external) should be able to demonstrate satisfactory training in food allergen management and its implications on food-handling practices, including knowledge of the major food allergens triggering anaphylaxis, cross-contamination issues specific to food allergy, label reading, etc.
2. Canteens should provide a range of healthy meals/products that exclude peanut or other nut products in the ingredient list or a ‘may contain...’ statement.
Field trips/excursions/sporting events
1. Sufficient school staff supervising the special event must be trained in the administration of an EpiPen and be able to respond quickly to an anaphylactic reaction if required.
2. A school staff member or team of school staff trained in the recognition of anaphylaxis and the administration of the EpiPen must accompany any student at risk of anaphylaxis on field trips or excursions.
3. School staff should avoid using food in activities or games, including as rewards.
4. The EpiPen and a copy of the Individual Anaphylaxis Management Plan for each student at risk of anaphylaxis should be easily accessible and school staff must be aware of their exact location.
5. For each field trip, excursion etc., a risk assessment should be undertaken for each individual student attending who is at risk of anaphylaxis. All school staff members present during the field trip or excursion need to be aware of the identity of any students attending who are at risk of anaphylaxis and be able to identify them by face.
6. The School should consult Parents of anaphylactic students in advance to discuss issues that may arise; to develop an alternative food menu; or request the Parents provide a meal (if required).
7. Parents may wish to accompany their child on field trips and/or excursions. This should be discussed with Parents as another strategy for supporting the student who is at risk of anaphylaxis.
8. Prior to the excursion taking place school staff should consult with the student's Parents and Medical Practitioner (if necessary) to review the student’s Individual Anaphylaxis Management Plan to ensure that it is up to date and relevant to the particular excursion activity.
Camps and remote settings
1. Prior to engaging a camp owner/operator’s services the school should make enquiries as to whether it can provide food that is safe for anaphylactic students. If a camp owner/operator cannot provide this confirmation to the school, then the school should consider using an alternative service provider.
2. The camp cook should be able to demonstrate satisfactory training in food allergen management and its implications on food-handling practices, including knowledge of the major food allergens triggering anaphylaxis, cross-contamination issues specific to food allergy, label reading, etc.
3. Schools must not sign any written disclaimer or statement from a camp owner/operator that indicates that the owner/operator is unable to provide food which is safe for students at risk of anaphylaxis. Schools have a duty of care to protect students in their care from reasonably foreseeable injury and this duty cannot be delegated to any third party.
4. Schools should conduct a risk assessment and develop a risk management strategy for students at risk of anaphylaxis. This should be developed in consultation with Parents of students at risk of anaphylaxis and camp owners/operators prior to the camp dates.
5. School Staff should consult with parents of students at risk of anaphylaxis and the camp owner/operator to ensure that appropriate risk minimisation and prevention strategies and processes are in place to address an anaphylactic reaction should it occur. If these procedures are deemed to be inadequate, further discussions, planning and implementation will need to be undertaken.
6. If the school has concerns about whether the food provided on a camp will be safe for students at risk of anaphylaxis, it should also consider alternative means for providing food for those students.
7. Use of substances containing allergens should be avoided where possible.
8. Camps should avoid stocking peanut or tree nut products, including nut spreads. Products that ‘may contain’ traces of nuts may be served, but not to students who are known to be allergic to nuts.
9. The student's EpiPen, Individual Anaphylaxis Management Plan, including the ASCIA Action Plan for Anaphylaxis and a mobile phone must be taken on camp. If mobile phone access is not available, an alternative method of communication in an emergency must be considered, e.g. a satellite phone.
10. Prior to the camp taking place school staff should consult with the student's parents to review the students Individual Anaphylaxis Management Plan to ensure that it is up to date and relevant to the circumstances of the particular camp.
11. School Staff participating in the camp should be clear about their roles and responsibilities in the event of an anaphylactic reaction. Check the emergency response procedures that the camp provider has in place. Ensure that these are sufficient in the event of an anaphylactic reaction and ensure all school staff participating in the camp are clear about their roles and responsibilities.
12. Contact local emergency services and hospitals well prior to the camp. Advise full medical conditions of students at risk, location of camp and location of any off-camp activities. Ensure contact details of emergency services are distributed to all school staff as part of the emergency response procedures developed for the camp.
13. Schools should consider taking an EpiPen for General Use on a school camp, even if there is no student at risk of anaphylaxis, as a backup device in the event of an emergency.
14. Schools should consider purchasing an EpiPen for General Use to be kept in the first aid kit and including this as part of the Emergency Response Procedures.
15. The EpiPen should remain close to the student and school staff must be aware of its location at all times.
16. The EpiPen should be carried in the school first aid kit; however, schools can consider allowing students, particularly adolescents, to carry their EpiPen on camp. Remember that all school staff members still have a duty of care towards the student even if they do carry their own EpiPen.
17. Students with anaphylactic responses to insects should always wear closed shoes and long-sleeved garments when outdoors and should be encouraged to stay away from water or flowering plants.
18. Cooking and art and craft games should not involve the use of known allergens.
19. Consider the potential exposure to allergens when consuming food on buses and in cabins.
Adrenaline autoinjectors for general use
Reservoir East Primary School will maintain a supply of adrenaline autoinjectors for general use, as a back-up to those provided by parents and carers for specific students, and also for students who may suffer from a first time reaction at school.
Adrenaline autoinjectors for general use will be stored in the sickbay cupboardand labelled “general use”.
The Principal is responsible for arranging the purchase of adrenaline autoinjectors for general use, and will consider:
· the number of students enrolled at Reservoir East Primary School at risk of anaphylaxis
· the accessibility of adrenaline autoinjectors supplied by parents
· the availability of a sufficient supply of autoinjectors for general use in different locations at the school, as well as at camps, excursions and events
· the limited life span of adrenaline autoinjectors, and the need for general use adrenaline autoinjectors to be replaced when used or prior to expiry
· the weight of the students at risk of anaphylaxis to determine the correct dosage of adrenaline autoinjector/s to purchase.
Emergency Response
In the event of an anaphylactic reaction, the emergency response procedures in this policy must be followed, together with the school’s general first aid procedures, emergency response procedures and the student’s Individual Anaphylaxis Management Plan.
A complete and up-to-date list of students identified as being at risk of anaphylaxis is maintained by Ashlea Griffin and stored For camps, excursions and special events, a designated staff member will be responsible for maintaining a list of students at risk of anaphylaxis attending the special event, together with their Individual Anaphylaxis Management Plans and adrenaline autoinjectors, where appropriate.
If a student experiences an anaphylactic reaction at school or during a school activity, school staff must:
Step
Action
· Lay the person flat
· Do not allow them to stand or walk
· If breathing is difficult, allow them to sit
Be calm and reassuring
Do not leave them alone
Seek assistance from another staff member or reliable student to locate the student’s adrenaline autoinjector or the school’s general use autoinjector, and the student’s Individual Anaphylaxis Management Plan, stored in the sickbay cupboard
If the student’s plan is not immediately available, or they appear to be experiencing a first time reaction, follow steps 2 to 5
Administer an EpiPen or EpiPen Jr
· Remove from plastic container
· Form a fist around the EpiPen and pull off the blue safety release (cap)
· Place orange end against the student’s outer mid-thigh (with or without clothing)
· Push down hard until a click is heard or felt and hold in place for 3 seconds
· Remove EpiPen
· Note the time the EpiPen is administered
· Retain the used EpiPen to be handed to ambulance paramedics along with the time of administration
OR
Administer an Anapen® 500, Anapen® 300, or Anapen® Jr.
· Pull off the black needle shield
· Pull off grey safety cap (from the red button)
· Place needle end firmly against the student's outer mid-thigh at 90 degrees (with or without clothing)
· Press red button so it clicks and hold for 10 seconds
· Remove Anapen®
· Note the time the Anapen is administered
· Retain the used Anapen to be handed to ambulance paramedics along with the time of administration
Call an ambulance (000)
If there is no improvement or severe symptoms progress (as described in the ASCIA Action Plan for Anaphylaxis), further adrenaline doses may be administered every five minutes, if other adrenaline autoinjectors are available.
Contact the student’s emergency contacts.
If a student appears to be having a severe allergic reaction but has not been previously diagnosed with an allergy or being at risk of anaphylaxis, school staff should follow steps 2 – 5 as above.
Schools can use either the EpiPen® and Anapen® on any student suspected to be experiencing an anaphylactic reaction, regardless of the device prescribed in their ASCIA Action Plan.
Where possible, schools should consider using the correct dose of adrenaline autoinjector depending on the weight of the student. However, in an emergency if there is no other option available, any device should be administered to the student.
Communication Plan
This policy will be available on Reservoir East Primary School’s website so that parents and other members of the school community can easily access information about REPS’s anaphylaxis management procedures. The parents and carers of students who are enrolled at REPS and are identified as being at risk of anaphylaxis will also be provided with a copy of this policy.
The principal is responsible for ensuring that all relevant staff, including casual relief staff, canteen staff and volunteers are aware of this policy and REPS’s procedures for anaphylaxis management. This plan will be included in Staff Induction packs and in Casual Relief Teaching folders. Casual relief staff and volunteers who are responsible for the care and/or supervision of students who are identified as being at risk of anaphylaxis will also receive a verbal briefing on this policy, their role in responding to an anaphylactic reaction and where required, the identity of students at risk.
The Principal is also responsible for ensuring relevant staff are trained and briefed in anaphylaxis management, consistent with the Department’s Anaphylaxis Guidelines.
Staff training
The Principal will ensure that the following school staff are appropriately trained in anaphylaxis management:
· School staff who conduct classes attended by students who are at risk of anaphylaxis
· School staff who conduct specialist classes, admin staff, first aiders and any other member of school staff as required by the Principal based on a risk assessment.
Staff who are required to undertake training must have completed:
· an approved face-to-face anaphylaxis management training course in the last three years, or
· an approved online anaphylaxis management training course in the last two years.
REPS uses the following training course: ASCIA anaphylaxis e-training VIC 2021-2 in conjunction with practice using a training Anapen and Epipen.
Staff are also required to attend a briefing on anaphylaxis management and this policy at least twice per year (with the first briefing to be held at the beginning of the school year), facilitated by a staff member who has successfully completed an anaphylaxis management course within the last 2 years. Each briefing will address:
· this policy
· the causes, symptoms and treatment of anaphylaxis
· the identities of students with a medical condition that relates to allergies and the potential for anaphylactic reaction, and where their medication is located
· how to use an adrenaline autoinjector, including hands on practice with a trainer adrenaline autoinjector
· the school’s general first aid and emergency response procedures
· the location of, and access to, adrenaline autoinjectors that have been provided by parents or purchased by the school for general use.
When a new student enrols at REPS who is at risk of anaphylaxis, the Principal will develop an interim plan in consultation with the student’s parents and ensure that appropriate staff are trained and briefed as soon as possible.
A record of staff training courses and briefings will be maintained through the school’s online Emergency Management Plan.
The Principal will ensure that while students at risk of anaphylaxis are under the care or supervision of the school outside of normal class activities, including in the school yard, at camps and excursions, or at special event days, there is a sufficient number of school staff present who have been trained in anaphylaxis management.
Further information and resources
The Department’s Policy and Advisory Library (PAL):
· Allergy & Anaphylaxis Australia
· ASCIA Guidelines: Schooling and childcare
· Royal Children’s Hospital: Allergy and immunology
· https://www.reps.vic.edu.au/policies/health-care-needs
POLICY REVIEW AND APPROVAL
Policy last reviewed May 2023
Approved by Principal, James Cumming
Next scheduled review date May 2024
The Principal will complete the Department’s Annual Risk Management Checklist for anaphylaxis management to assist with the evaluation and review of this policy and the support provided to students at risk of anaphylaxis.