1. Anaphylaxis Training for Substitutes and/or Designees Presented by: Student Health and Wellness

2. Rev. 4/9/15 What is Anaphylaxis? Life Threatening Allergic Reactions A severe, allergic reaction that can affect the whole body Occurs in approximately 20 per 100,000 person annually

3. Rev. 4/9/15 Anaphylaxis Legislation (MN Statutes 121A.22) This legislation requires that all public and non- public schools that are subject to ADA must provide the following information to school staff: There is an increasing incidence of children with a history of Anaphylaxis School is responsible for providing for student safety and making reasonable accommodations Students must have access to their emergency medications during the school day Staff must be trained to recognize symptoms of Anaphylaxis and how to provide emergency care

4. Rev. 4/9/15 Stock Epinephrine All schools currently have stock “EpiPens” (Epi Jr. and regular dose of Epinephrine auto injectors) available to be used on school grounds, based on the SPPS protocol. Saint Paul Public Schools (SPPS) protocol will apply to: Anaphylaxis resulting from an allergic reaction to foods, substances, and insect bites during the school day and for Extended Day for Learning (EDL) programs. Without a Health Care Provider (HCP) order/diagnosis, a nursing assessment would be necessary for administration. Trained staff may use stock EpiPen if: Current orders and diagnosis are in place, symptoms are consistent with Anaphylaxis, and there is no available home supply of epinephrine.

5. Rev. 4/9/15 What Causes Anaphylaxis? Having a severe allergy to: a.Foods b.Insect stings c.Medications d.Substances such as latex Food allergy is the most common in children Peanuts and tree nuts are the most common foods to cause a severe reaction

6. Rev. 4/9/15 Why Should You be Concerned? We can not predict how severe an allergic reaction will be Severity of symptoms can change quickly Each episode is potentially life threatening

7. Rev. 4/9/15 Work to Prevent Exposure to Allergens Hand washing: Wash hands with soap and water. Hand sanitizers remove some germs, but do not remove the small particles that cause food allergies. Before and after eating to remove the germs on your hands that may make you sick and to remove the residue of food allergens that may be on your hands Food Storage: Monitor access to food stored in the classroom Dispose of perishable food Store non-perishable food in a container with a tight lid

8. Rev. 4/9/15 Work to Prevent Exposure to Allergens (Continued) Snack Time: Food and beverages should not be shared or traded Clean surfaces where food has been eaten with a disposable wipe; obtain disposable wipes from Nutrition Services Be Aware and Prepared: Be aware of students in the classroom with known food allergies and Anaphylaxis. Follow Individual Health Plans (IHP) developed for students Limit classroom celebrations and projects that involve food

9. Rev. 4/9/15 Potential Food Allergens in the Classroom Of food allergy reactions occurring at school, over 79% occur in the classroom, most often due to food used for projects or celebrations Cupcake: Milk, egg, wheat, soy Pizza: Milk, egg, wheat, soy Candy: Milk, soy, wheat, nuts, tree nuts Paper mâché: Wheat Bird feeder: Nuts, tree nuts Play- Dough: Wheat

10. Rev. 4/9/15 Allergy Awareness 1.Know the Top 8 Food Allergens:

11. Rev. 4/9/15 Allergy Awareness (continued) 2.Recognize an allergic reaction in its early stages: Mouth: Itching/swelling of the lips and tongue Throat: Itching, tightness, hoarseness, cough Skin: Hives, itchy rash, swelling of face Lungs: Trouble breathing, coughing, sneezing Stomach: Nausea, cramps, vomiting diarrhea

12. Rev. 4/9/15 Recognize Symptoms

13. Rev. 4/9/15 Allergy Awareness (continued) 3.Know when to use emergency medication. The Epinephrine Auto-Injector is the treatment of choice for Anaphylaxis. This is a prescription medication and can only be used for the student it is prescribed to.

14. Rev. 4/9/15 For Students with Medication at School Follow Individual Health Plan ( IHP )/ Emergency Care Plan (ECP) developed for the student IHP/ECP’s are developed with orders from the Health Care Provider (HCP) and input from the parent/guardian

15. Rev. 4/9/15

16. For Students without Medication at School If a student has never been diagnosed with Anaphylaxis, but you suspect a severe allergic reaction: Call 911 immediately

17. Rev. 4/9/15 Allergy Awareness (continued) 4.Know where to find the student’s EpiPen: EpiPens are generally kept in the Health Office EpiPens are sent with students on field trips EpiPens should be stored at room temperature

18. Rev. 4/9/15 Allergy Awareness (continued) 5.Learn how to use an EpiPen: EpiPens are easy to use and designed for self administration in emergencies The medication in an EpiPen works quickly to reverse the symptoms of Anaphylaxis, but the effects only last for 10 – 15 minutes

19. Rev. 4/9/15 What Should You Do? This video shows how to use an EpiPen. *Please view this video. The school nurse has training devices for practice. 1.Form a fist around the auto injector and remove the blue cap which will unlock the safety device 2.Swing the EpiPen into the outer thigh and push in the orange tip firmly until you hear it click 3.Hold it there for 10 seconds to make sure all medication is delivered

20. Rev. 4/9/15

21. What Should You Do? (continued) 4.Get emergency medical attention right away; effects of the EpiPen only lasts for 10 – 15 minutes 5.Call the parent/guardian of the student and inform them of the allergic reaction 6.Call the Licensed School Nurse (LSN)

22. Rev. 4/9/15 Summary If a student is exposed to their allergen and/or If you see signs of a severe allergic reaction then 1.Give EpiPen in the thigh muscle 2.Call 911 3.Call parent/guardian 4.Call the Licensed School Nurse (LSN)

23. Rev. 4/9/15 References Minnesota Office of the Reviser or Statutes: https://www.revisor.mn.gov/statutes/?id=121A.2205 https://www.revisor.mn.gov/statutes/?id=121A.2205 Accommodating Children with Special Dietary Needs in the School Nutrition Programs: Guidance for School Food Servide Staff, United States Department of Agriculture Food and Nutrition Service, Fall 2001 NASN—National Association of School Nurses: www.nasn.orgwww.nasn.org EpiPen Instructional Video: http://www.epipen.comhttp://www.epipen.com Food Allergy and Anaphylaxis Network: www.foodallergy.orgwww.foodallergy.org Anaphylaxis and Food Allergy Association of Minnesota: http://www.minnesotafoodallergy.org http://www.minnesotafoodallergy.org

24. Rev. 4/9/15 Contact Information Student Placement Center Health Office 651-632-3763 Mary Yackley, RN, LSN, Supervisor Student Health and Wellness 651-767-8380 or mary.yackley@spps.org