1. Food Allergies MAPLEWOOD NURSING HOME JENIFER LA, KEENE STATE COLLEGE DIETETIC INTERN 2015

2. Overview  Become familiar with major food allergens and signs/symptoms of a food allergy  Understand how to read food labels  Understand the process to take when a resident has a food allergy  Understand the roles of the pre-meal, chef, FSD, server, aide, and diet roster  Become familiar with the procedures to take if a resident has a food allergy

3. Allergy 101 1) What is Maplewood’s food allergy policy? 2) What/Who are your resources for dealing with a food allergy? FSD, Cooks, nurse, RD, Diet Unit Assistant, Diet tickets, Pre-Meal meetings 3) How do you know which residents have a food allergy? Diet roster, Diet tickets, Charts, Care Plan 4) Who is responsible to ensuring a resident with a food allergy does not receive the food allergen Everyone! 5) What is at least one question that you hope is answered today?

4. What are food allergies?  Immune system response to a food that the body believes is harmful  Immune system releases chemicals and histamine to protect the body  These chemicals can trigger symptoms  Respiratory Symptoms  GI Symptoms  Skin  Cardiovascular Symptoms  Reactions can be deadly!

5. What are food intolerances?  A food reaction that does not involve the immune system  Focuses mainly on digestive symptoms  Body lacks enzymes needed to digest/process the food  i.e. Lactose Intolerance

6. What foods can cause food allergies?  ANY food can cause a food allergy  Common 8:  Peanuts  Fish  Shellfish  Milk  Tree Nuts  Soy  Eggs  Wheat

7. What is the leading cause of severe allergic reactions?  Peanuts are the leading cause of SEVERE reactions  Followed by:  Shellfish  Fish  Tree nuts  Eggs

9. What are the symptoms of a food allergy?  Symptoms can be mild to severe  Can occur within a few minutes up to two hours  Skin  hives, eczema, swelling of lips/face, itching  Respiratory Tract  swelling of throat/mouth, difficulty breathing, runny nose, watery eyes, wheezing, repetitive cough  GI Tract  abdominal cramps, vomiting, diarrhea

10. How many are at risk for a food allergic reaction?  12 million Americans (4% of the general population)  6.9 million Americans (2.3%) fish or shellfish allergy  3.3 million Americans (1.1%) peanuts or tree nuts  Food allergies are predicted to increase to 8% by 2020 (CDC)  Teens are at highest risk group  Estimated 150-200 people die each year due to food allergic reactions

11. What is anaphylaxis?  Severe reaction that is rapid in onset and potentially life threatening  Symptoms include:  Skin  hives, eczema, swelling of lips/face, itching  Respiratory Tract  swelling of throat/mouth, difficulty breathing, runny nose, watery eyes, wheezing, repetitive cough  GI Tract  abdominal cramps, vomiting, diarrhea  Drop in blood pressure  Loss of consciousness  Death

12. How is a reaction treated?  Mild reactions: antihistamine i.e. Benadryl  Severe/Anaphylactic Reactions via epinephrine  EpiPen, Twinject  Call Nursing staff IMMEDIATELY and 911

13. What is cross-contamination/cross- contact?  Occurs when one food comes into contact with another food and their proteins mix

14. Federal Allergen Labeling Law  Food labeling is important  January 1, 2006 – requires that the major food allergens be listed in simple language on all package food  “Milk” instead of “casein”  Life threatening food allergies is considered a disability  Rehabilitation Act of 1973, section 504  Individuals with Disabilities Education Act  American Disabilities Act and ADA Amendment 2008

15. Label Reading  Split into three groups  Look over the ingredient list  What are the major allergies?

16. Case Review  In your groups, discuss the case review and answer the following questions:  How did this event happen?  How could you prevent this from happening?

17. Summarize: True or False!  In your groups we will do a True or False speed round  Winner gets a prize!  Rules:  You cannot raise your hand until the entire question has been read  Only one hand can be raised per group

18. Conclusion  As a team, WE, can prevent food allergies from happening  Food allergies can be life threatening  Food label reading is crucial in protecting residents  FSD (Bethany), Diet Unit Assistant (Chris), RD (Eliza), and head cooks/supervisors (Ken, Heather, Meagan, and Deb) are your lead sources in identifying who has an allergy and what they are allowed and not allowed to have