Effective Date: January 2008
Revised: August 2008
Responsibility: Superintendent of Program and Schools (Elementary)
1.1 This Administrative Guideline supports Bill 3, Chapter 7, Statutes of Ontario, 2005- An Act to protect anaphylactic pupils. The Act requires that every school board establish and maintain an anaphylactic policy.
1.2 “Anaphylaxis” means a severe systemic allergic reaction which can be fatal resulting in circulatory collapse or shock, and “anaphylactic” has a corresponding meaning; (“anaphylaxie”, “anaphylactique”). Anaphylactic shock can be triggered by the mere touch or smell of the antigen (e.g. peanut butter). Anaphylaxis is a hypersensitivity resulting from sensitization to particular “antigens”, such as wasp or bee sting venom, nuts or penicillin.
1.3 This Administrative Guideline provides direction to Principals/Vice-Principals and school personnel for developing the proper school plan for dealing with anaphylaxis including a plan and file for individual anaphylactic students.
1.4 This Administrative Guideline is essential for school personnel, students and parents/guardians to assist in developing a strategy to reduce the risk of exposure to anaphylactic causative agents.
2.0 Statement of Principles
2.1 As with other medical conditions that may require an emergency response, parents/guardians and/or, where appropriate, students are responsible for fully informing the Principal/Vice-Principal that a student requires prescribed medication in order to respond to an emergency and, in addition, that assistance in reducing environmental risks is required in order for the student to attend school.
2.2 Parents/guardians and/or where appropriate students, are obliged to ensure information kept in the file is up-to-date including the medication that their child is taking. Schools will provide the opportunity on an annual basis to update a student’s file.
2.3 Principals/Vice-Principals and school personnel shall, where the Principal/Vice-Principal deems it appropriate, assist in attempting to reduce environmental risks for anaphylactic students.
2.4 Principals/Vice-Principals and other school personnel shall also encourage parents/guardians to participate in reducing environmental risks for anaphylactic students.
2.5 Principals/Vice-Principals and school personnel cannot and shall not be expected to completely eliminate all antigens affecting an anaphylactic student.
2.6 Principals/Vice-Principals and school personnel shall require students to comply with School Anaphylaxis Plans developed in accordance with this Administrative Guideline.
3.0 General Guidelines
3.1 The Principal/Vice-Principal shall be responsible for ensuring that all necessary steps on the part of school personnel are taken to implement the requirements of the Anaphylactic Plan.
3.2 This Guideline is based on “Anaphylaxis in Schools and Other Setting” copyright 2005 Canadian Society of Allergy and Clinical Immunology (referenced in Appendix A) to develop school and individual student plans for all aspects of anaphylaxis including the administration of medication. All other types of medication and administration of medication are subject to the Administration of Medication Procedures Manual.
4.0 School Plan
4.1 Each school must develop a school wide anaphylaxis plan dealing with all of the issues outlined in Appendix H. The plan must be updated each year.
4.2 Information and Training-The Principal/Vice-Principal shall ensure that, upon registration, parents, guardians and pupils shall be asked to supply information on life threatening allergies including the authorization to administer emergency medication (Appendix B).
4.3 Information and Training- The Principal/Vice Principal shall advise Parents/guardians and/or where appropriate students provide two injectors be brought to school- one kept on the person and one stored by the school subject to written instructions in the contrary by the parent/guardian.
4.4 Administration of Medication- Employees may be preauthorized to administer medication or supervise a pupil while he or she takes medication in response to an anaphylactic reaction if the school has up-to-date treatment information and the information and the consent of the parent, guardian or pupil as applicable.
4.5 Emergency Administration of Medication- If an employee has reason to believe that a pupil is experiencing an anaphylactic reaction, the employee may administer an epinephrine auto-injector or other medication prescribed to the pupil for the treatment of an anaphylactic reaction, even if there is no preauthorization to do so.
4.6 Information and Training- The Principal/Vice-Principal shall organize, in co-operation with the parent(s), where appropriate, dissemination of information on life threatening allergies to parents, pupils and employees. Parents, pupils, employees and volunteers shall be made aware of the antigens banned from the school. Information sessions, displays, school websites or newsletters to assist parents/guardian and students in the understanding of the situation may be useful. (Appendix C, D, E and G)
4.7 Information and Training- All staff members (teaching and non-teaching) shall be made aware that a student with anaphylaxis is attending the school and the student should be identified, either individually or at a staff meeting, before school begins, if possible.
4.8 Information and Training- The school’s anaphylaxis plan must include annual training following a specific training schedule on dealing with life threatening allergies for all employees (school administration, teachers, secretaries, EAs, CDCs, custodians, library technicians/librarians) and others who are in direct contact with pupils on a regular basis. Training should include the information in Appendix H and provide a demonstration of an injection.
4.9 Information and Training- In addition to any training required in order to administer emergency medication, the Principal/Vice-Principal, may where appropriate, consult with the parent(s)/guardian(s) and/or, the student to arrange for school personnel to be provided with training to understand the nature of the antigen, the symptoms of anaphylactic shock, the potential severity of anaphylactic shock, and methods of reducing environmental risk for the student with anaphylaxis.
4.10 Information and Training- When the antigen is found in food, all cafeteria staff shall receive training on cross-contamination and labeling issues in the cafeteria setting. Foods classes teachers will also receive training in cross-contamination and ensure that antigens are not part of the class(es).
4.11 Information and Training- Parents/guardians, students and other members of the school community should be encouraged by school personnel to bring questions or concerns to the Principal/Vice-Principal, and not to the anaphylactic student or his or her parent(s)/guardian(s).
4.12 Information and Training- The cafeteria menu and the vending machines shall be in accordance with the updated school plan. Allergenic food or products shall not be used in Foods or other classes in accordance with the School Anaphylaxis Plan (antigens banned from the school).
4.13 Information and Training- Where the anaphylactic student’s class will be ordering in commercial food or attending outings at commercial food outlets, appropriate precautions be taken to reduce the environmental risk for the anaphylactic student.
4.14 Information and Training – The Principal/Vice-Principal shall specify a means of ensuring that all community users of the school facilities are aware of any restrictions on food use and the reason for these restrictions.
4.15 Information and Training - For the purpose of a class trip the place(s) of destination should be informed if an anaphylactic student is attending.
5.0 Individual Plan and File
5.1 Emergency Administration of Medication- In particular, even when precautions are taken, an anaphylactic student may come into contact with an antigen while at school. An individual plan for each student who has an anaphylactic allergy shall be developed by the Principal/Vice-Principal for each anaphylactic student.
5.2 Information and Training- Every school principal is required to develop an individual plan for each pupil who has an anaphylactic allergy.
The plan shall include:
- Details informing employees and others who are in direct contact with the pupil on a regular basis of the type of allergy, monitoring and avoidance strategies and appropriate treatment (Appendix B).
- A readily accessible emergency procedure for the pupil, including emergency contact information (Appendix B). Parents/guardians and/or where appropriate students shall be advised to provide 2 injectors to be brought to school- one kept on the person and one to be stored by the school subject to written contrary instructions by the parent/guardian.
- Epinephrine auto-injectors shall be stored in a safe, accessible environment in the school where the temperature does not fall below zero. The Principal/Vice Principal shall determine a plan to monitor expiry dates and replacement of injectors however it is the parent/guardian’s and/or student’s where appropriate responsibility to replace.
5.3 Information and Training- Every school principal is required to maintain a file for
each anaphylactic pupil of current treatment and other information, including a copy of any prescriptions and instructions from the pupil’s physician or nurse and a current emergency contact list (Appendix B).
5.4 Anaphylactic Plan- The Principal/Vice-Principal shall, in consultation with the anaphylactic student’s parent(s)/guardian(s) and/or, where appropriate, the student, as well as school personnel deemed appropriate by the Principal/Vice-Principal, develop an Anaphylactic plan to establish procedures for reducing environmental risks for the anaphylactic student. If possible, the Anaphylactic Plan shall be developed prior to the first day of attendance at school.
5.5.1 Where the anaphylactic student is a secondary student or in the Principal’s view, sufficiently mature, provide that the anaphylactic student shall assume responsibility for avoiding contact with the antigen and shall comply with the School Anaphylaxis Plan.
5.5.2 Where appropriate, provide that the anaphylactic student shall not participate in school yard cleanup or garbage disposal (e.g. those students who react to antigens in food).
5.5.3 The Principal/Vice-Principal shall undertake to inform all individuals and corporations involved in transportation of the anaphylactic student’s condition and the requirements of the School Anaphylaxis Plan, including any additional requirements applicable to circumstances (e.g. the bus driver shall not allow food to be eaten on the bus).
5.5.4 The School Anaphylaxis Plan will be reviewed and updated as early in the school year as possible. If there is any change in the anaphylactic student’s medical information, the parent(s)/ guardian(s) and/or the student, where appropriate, shall advise the school and the School Anaphylaxis Plan shall be reviewed for necessary changes.
5.6 Procedures to Address Anaphylaxis- When it is determined that an anaphylactic student reacts to food products, the Principal/Vice-Principal shall provide that:
5.6.1 The anaphylactic student eats only the foods that the student brings from home and washes his or her hands before and after eating.
5.6.2 On the first day the anaphylactic student attends class, school personnel shall advise all students and those likely to interact with the anaphylactic student that trading and sharing of food is not allowed and that students are not to share cups or straws.
Students shall also be required to wash their hands after eating. School personnel shall remind students of these rules, as necessary. Signs shall be posted as reminders of these expectations.
5.6.3 If deemed necessary in consultation with the parent(s)/guardian(s) and/or, where appropriate, the anaphylactic student, provide for antigen-free areas within the school. All reasonable precautions shall be taken to provide a safe environment for medically-at-risk students but it is not possible to provide an absolute guarantee for elimination of all risks.
5.6.4 In consultation with the parent(s)/guardian(s) and/or, where appropriate, the anaphylactic student, the school shall send out letters on the first day the anaphylactic student attends class or as soon as possible thereafter to all parents/guardians and/or students, as appropriate, explaining that specified foods or foods containing specified ingredients and other identified antigens are banned from the school and why.
Reminder letters or other communications shall be provided throughout the year. The letters shall not identify the anaphylactic student without the written consent of the student’s parent(s)/guardian(s) and/or, where appropriate, the anaphylactic student. All secondary students shall be consulted prior to identification.
If deemed necessary, and with the consent and consultation of the parent(s)/guardians(s) and/or the anaphylactic student, where appropriate, including consultation with all secondary students, provide that students in the anaphylactic student’s class shall be given information on anaphylactic and the antigen affecting the anaphylactic student on the first day of attendance at school or as soon as possible thereafter and be asked to co-operate. This should be done in a way that is appropriate to the students’ age and maturity.
APPENDIX A: RESOURCES FOR INFORMATION SESSIONS
APPENDIX B: INDIVIDUAL ANAPHYLAXIS PLAN 2008-2009
APPENDIX C: SAMPLE LETTER ELEMENTARY
APPENDIX D: SAMPLE LETTER SECONDARY
APPENDIX E: NEWSLETTER SAMPLE
APPENDIX F: GENERAL STEPS FOR EMERGENCY SITUATION RELATED TO ANAPHYLAXIS
APPENDIX G: TRIGGERS FOR ANAPHYLAXIS
APPENDIX H: SUGGESTIONS ON HOW TO CREATE AN ALLERGEN SAFE ENVIRONMENT