1. Managing Life Threatening Allergies in the School AISD Student Health Services School Year 2013-2014

2. Allergies Definition: A potentially serious immune- mediated response that develops after ingesting or coming into contact with foods, insect sting or medication A Life Threatening reaction can occur within minutes to hours after ingestion or sting

3. Allergic Reactions Can occur anywhere Cafeteria Classroom Arts and crafts projects (may contain food allergens) Playground Field Trips (Emergency medications including Epinephrine must accompany student)

4. Anaphylaxis Definition: A serious reaction that is rapid in onset and may result in death Prompt identification of an allergic reaction can save a person's life!

5. School Nurse Responsibilities Identify students with severe allergies Schedule meeting with parent(s)/guardian(s) Obtain necessary orders and consents Develop individualized care plan/emergency plan Discuss specifics with classroom teacher(s), cafeteria staff and other school personnel that need to know. Conduct AISD staff training

6. Allergies: Facts Children with asthma are at a higher risk for life threatening reaction Approximately 12 million Americans have food allergies * 4 out of 50 children have a food allergy *The number of children with food allergies is on the rise Approximately 2 million Americans have allergies to the venom of stinging insects

7. Common Food Allergens ANY food can cause an allergy 90% of food allergies are caused by these 8 foods: Peanuts Tree Nuts Cow’s Milk Wheat Eggs Fish Shellfish Soy

8. Common Insect Allergens More allergic reactions are associated with insects that sting Stinging insects include several groups Bees *Honeybees *Bumblebees Stinging ants *Fire ants Wasps *Yellow jackets *Hornets *Paper wasps

9. Early Recognition An allergic reaction might be a medical emergency if one or combination of symptoms are present. Some examples:  Tightening of throat or chest  Difficulty breathing  Hives on the skin with stomach pain  Low blood pressure  Metallic taste in mouth

10. Symptoms of Anaphylaxis

11. Treatment is Essential! It may take only one to two minutes for a mild allergic reaction to escalate to anaphylaxis Epinephrine is the treatment for severe, life-threatening allergic reactions Make sure Epinephrine auto-injector is readily available in an unlocked location

12. Epinephrin e Prescribed for students at risk for life threatening allergic reactions Easy to use Several Brands Epi-Pen Auvi-Q Adrenaclick School nurse will provide training

13. Treatment if Epinephrine is available at school 1.Give epinephrine via the auto-injector (Epi-pen, Auvi-Q or Adrenaclick ). 2. Call 911 and state that a child is having an anaphylactic reaction. 3. If symptoms have not improved within 10-15 minutes a second auto-injection should be given. 4. Have the child lie down with legs raised to improve blood flow.

14. Treatment if no Epinephrine available is available at School 1. Call 911 and state child is having an anaphylactic reaction to ensure that the first responder is equipped with epinephrine.

16. Auvi-Q Overview

17. Prevention Good handwashing with soap and water is essential! o Hand Sanitizers do NOT remove allergens o Wash hands before and after eating- 20 seconds Limit use of food products in which children have allergies for arts & crafts and science projects Avoid cross-contamination

18. Cafeteria Prevention Occurs when food allergen is transferred from one item to another Ensure proper cleaning of supplies Example: Preparing a peanut butter sandwich in the kitchen. The counter and plate where the sandwich is prepared/placed is contaminated The knife used to cut it is contaminated The person's hands that prepared it are contaminated MUST wash hands and all items thoroughly for 20 seconds with soap and water to remove allergen!

19. Classroom Prevention Limit foods in the classroom Avoid using food as rewards Teach children to avoid sharing food Carefully control snacks brought into the classroom Ensure proper cleaning

20. School Prevention Be aware of environment & inspect school grounds for insect hives or nests. Notify AISD pest control as needed.

21. Allergy Management Team Sally Freeman, Director of Student Health Services Dr. Pont, Medical Advisor Clinical Managers: Anne Cady, Cindy Cobia and Laura Cotton School Nurse Tracy Lunoff, AISD, Assistant Director of Coordinated Health Services Chris Carrillo, AISD Director of Child Nutrition Services Kourosh Hafezi, AISD Director of Transportation

22. Please contact your school nurse if you have questions regarding allergies or Student Health Services at (512) 324- 0195. Additional information can be found at: www.AllergyReady.com It provides a comprehensive free online training program specifically designed for teachers www.AllergyReady.com