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5420-R2 Student Health Services - Anaphylaxis Regulation

  • 5000: Student Policies
5420-R2 Student Health Services - Anaphylaxis Regulation

The District will aspire to reduce an allergic child’s exposure to allergens within the school setting, while acknowledging that it is impossible to achieve an allergen-free environment. The District will work cooperatively with the student, their parent/guardian and healthcare provider to allow the child to participate as fully and as safely as possible in school activities.

Anaphylaxis:

Anaphylaxis is a severe, rapidly progressive allergic reaction that is potentially life threatening. It may occur in adults and children not previously known to be allergic or hypersensitive. The most common allergens in school aged children are peanuts, eggs, tree nuts (e.g., Cashews, almonds, pecans, walnuts, etc.), cow’s milk, fish and shellfish, wheat, soy, sesame, latex, certain insect stings and medication. In some cases, minute amounts of the food allergen, when eaten, touched or inhaled can make an allergic child extremely ill and put an allergic child at risk for life threatening anaphylaxis.

Purpose:

  • To provide guidance in managing students with food allergies at risk for anaphylaxis at school.
  • To provide an allergy safe and supportive environment which decreases the risk of exposure to allergens to those students with life threatening allergies.
  • To engage with parents/guardians of students at risk of anaphylaxis and medical provider in assessing risks, developing risk minimization strategies and management strategies for the student in the school setting.
  • To ensure that each staff member has adequate and appropriate knowledge about allergies, anaphylaxis and the school's policy and procedures in responding to an anaphylactic reaction.
  • To ensure the importance of evidence-based allergen avoidance and the availability and timely treatment of anaphylaxis with epinephrine by trained individuals.

A variety of measures and accommodations may be undertaken to minimize the health risks to students who suffer from food allergies. The District has identified the following as important members of the School Health Team to ensure the health information is complete, appropriate accommodations are prepared, and any necessary medication and environmental protocols are in place for students with food allergies and anaphylaxis, and are important partners in the implementation of this regulation: parents/guardians, students, District administrators, school nurse, teachers, food service workers, custodial staff, coaches, transportation personnel, and members of the District community.

Parent Responsibilities:

Parents/guardians are responsible for reporting a child’s food allergic/anaphylactic condition to the child’s school nurse.

When a food-allergic anaphylactic child has been identified by his/her parents/guardians and physician, the District will require that the parents:

  1. Inform the school nurse of the child’s allergies and condition and provide written medical documentation and update annually
  2. Provide the school nurse with medical instructions from the child’s physician
  3. Provide the school nurse with epi-pens or epi-pen jr if the student is less than 60 pounds and other medication, if appropriate, as prescribed by the physician
  4. Be encouraged to provide the child with the medical information bracelet or necklace to be worn at school that lists allergies
  5. Must participate in the development of the Health Plan
  6. Provide safe food for lunches and snacks. Parents must also determine the safety of a cafeteria school lunch for their food allergic child
  7. Are encouraged to assist at classroom parties
  8. Are encouraged to attend field trips if possible
  9. Teach their allergic child to recognize symptoms and communicate to the staff
  10. Instruct their allergic child not to share snacks, lunches, drinks, and utensils
  11. Consent to share photographs and medical information with necessary employees
  12. Maintain up to date emergency contacts and phone numbers
  13. Inform their child that they must sit at the designated nut-free table in the school cafeteria. Or provide medical documentation stating that their child no longer has a medical need to sit at an allergy free table
  14. Stay in contact with classroom teacher and school nurse to help provide a safer classroom

Student Responsibilities:

  1. Do not trade food
  2. Do not eat anything with unknown ingredients or known to contain allergens
  3. Notify an adult immediately if something is eaten that is believed to contain an allergen
  4. Notify an adult immediately of any signs or symptoms of an allergic reaction
  5. Always have your emergency medication on you (if designated self-carry)
  6. Notify the school nurse and coaches where your emergency medication is (if designated self-carry)

Individual Health Care Plans and Emergency Health Care Plans

The school nurse will develop a Nursing Care Plan including Nursing Diagnosis, intervention, and evaluation. An Emergency Health care plan shall be developed for each student identified with any food allergy with potentially serious health consequences. The School Nurse will develop a care plan and an Emergency Health care plan based on Board of Education Policy and in collaboration with the parents/guardian of the student, and the student's health care provider (If appropriate, student may also be involved in the plan). This shall be done immediately after the diagnosis is made. These plans should include both preventive measures to help avoid accidental exposure to allergens and emergency measures in the event of exposure.

An Individual Health Care Plan and Emergency Health Care Plan should be written in lay language and stress what action the school employee should take if a student suffers an allergic reaction. The plan should be basic but clear and contain the steps to follow in response to an allergic reaction. It is recommended that the student's picture be attached to the plan.

The plan should contain emergency contact information. It should also be noted that any child given an epi-pen injection be transported by ambulance immediately to nearest hospital emergency department, even if symptoms resolve, biphasic reactions often occur. After the call for 911, the parents/guardian and/or emergency contact will be called. A District employee will accompany the child during transport and stay with the child until a parent/guardian arrives.

Epi-pens-

Nonpatient specific orders written by the medical director will permit school RN’S to administer anaphylactic agents to treat anaphylactic symptoms in any person in school, on school property or at a school sponsored event.

Epi-Pens Emergency medical kits, with appropriate medications including epi-pens, will be supplied to the school nurse by the parents/guardians from their doctor’s prescription for a food-allergic/anaphylactic child. Kits will be put in places agreed upon by the school nurse/administrators and the parents/guardians. The child’s Health Plan will list where the epi-pens are kept in the school building. The school nurse and parent/guardian should periodically check epi-pen supplies and expiration dates. Self-Administering students will be allowed to carry their own epi-pens, provided written approval is supplied by the parent/guardian and physician, and the school nurse is made aware. All food allergic/anaphylactic students are encouraged to have a medical information bracelet or necklace. The Health Plan relies on having a school nurse/administrator on hand. The nurse will train staff in accordance with Commissioner’s Regulations on the administration of prescribed epinephrine auto injectors, including, but not limited to signs and symptoms of a severe allergic reaction warranting administration of epinephrine, and the steps for such administration. The nurse will keep a log of the training. A sheet showing how to administer an epi-pen will be distributed along with the Health Plan form.

Athletic and Extracurricular Activities / Before or After School Child Care

The coach or supervisor of food allergic/anaphylactic children with a Health Plan will be trained to administer an epi-pen by the school nurse as set forth above. The District will require parents of food-allergic/anaphylactic children who are enrolled in the Before or After School Child Care Program to expressly notify the Program supervisor of their children’s food allergies.

Lunch

It is the parent who must make the determination as to the safety of a cafeteria school lunch for their food-allergic child. They should discuss this with the Director of Food Services at (631) 434-2316.

Cafeteria

The school will designate and clearly mark certain cafeteria tables as “nut-free”. Prior to and after each lunch period, the designated tables and benches or seats will be cleaned with approved disposable towels. At the end of each school day, the designated and marked tables and benches or seats will be cleaned and closed by the custodian and isolated from use during any after school programs or other events. Children will be made aware of the importance of not sharing or trading food, utensils, or containers. At the designated tables, children without allergies with lunches purchased in the cafeteria may sit at the nut-free tables with permission from an aide but must not share food. A nut-free garbage pail will be designated in each cafeteria. After consultation with parents/guardians, their physician, the school nurse, and school administration arrangements may also be made for children with serious food allergies other than nuts.

Food Service

When a food-allergic child has been identified by his parents/guardians and physician, a student’s food allergy information will be shared with the food service staff. The School Lunch Director will continue to check ingredient labels for food products used in the School Lunch Program. Vending machine providers and School Store Advisors will check ingredient labels for food and drink products used. In addition, the School Lunch Manager will make a list of known technical, scientific, and alternate names for common food allergens to be shared with each school, vending company, and school store. School food service will make efforts to eliminate utilization of nut containing products.

Elementary Classrooms, Snacks, and Parties

Parents/guardians will be informed at the start of the school year as to those allergies identified within each classroom. Personally identifiable information will not be disclosed unless a parent/guardian gives prior written consent. Allergy information will be updated periodically throughout the school year. When the parent/guardian and family physician have informed the school nurse of a child with a serious food allergy, a letter will be sent home to the class notifying them not to bring in foods that contain nuts (or, where appropriate, other food allergens.) A follow-up reminder will be provided on Meet the Teacher Night.

Home baked goods and other foods prepared at home are only to be used for individual consumption. Food-allergic children may eat only food brought in from their home, as per their Health Plan. The teacher will discuss with children, in an age-appropriate manner, about the seriousness of food allergies and the importance of not sharing or trading snacks with a food-allergic classmate.

After any activity involving food, tables and seats will be thoroughly cleaned. If necessary, food-allergic students should keep the same desk and locker all school year, if the Health Plan warrants the same. When parents/guardians and their family physician notify the school about a food-allergic/anaphylactic child, the student’s teachers, including “special area” teachers, and other staff such as paraprofessionals, teaching assistants, monitors, clericals, will be informed on a need-to-know basis once written parental permission has been obtained.

Teachers should be mindful when using food that is part of the curriculum in lesson plans. These foods should not conflict with their students’ allergies or anaphylactic condition.

The District is also concerned about avoiding non-food sources of food allergies. Parents/guardians must notify the school nurse of any non-food source items that pose a threat to their child. These items include, but are not limited to; latex balloons, tennis balls, gym equipment, in particular stuffed toys, and bean bags; arts and crafts supplies such as play dough, paint, and crayons; cleaning supplies such as soaps. Staff members will avoid using peanut butter, nuts or any extracts or derivatives in any school activity.

Secondary Classrooms

There is a need for curriculum-based, food centered activities in classes such as Family and Consumer Science and world languages. The District food service provider is encouraged to be used. Signs will also be posted in the middle school and high school in areas where food is available, and at all fundraising activities involving food, to remind students that they must be aware of the possible presence of nuts or nut products.

Field Trips

Field trip permission forms should include a separate medical section. When a child identified with a serious medical condition, such as food allergies/anaphylaxis, has a field trip their parent/guardian will be requested and encouraged to accompany the child on all such trips. If a parent/guardian will not attend, a designated person trained in their use will be responsible for the child’s epi-pens and keep the child in their group. With parent permission, staff and chaperones will be briefed on the identity of the child, the specific allergies, and the symptoms to be aware of on a need-to-know basis. On every field trip, there will be access to a telephone, cell phone, or radio communication in case of an emergency. There will be no unnecessary eating on the school bus during a field trip. If the class will be eating at a restaurant, the food-allergic/anaphylactic child must bring their own food or provide written permission from the parent/guardian to eat out.

The District supplied “stock” emergency EpiPens will be retained on campus and not be taken on trips and school sponsored off-campus activities. Emergency 911 procedures will be followed during these activities.

District Wide Events

There will be written notification prior to non-classroom activities where food is present. Items from the safe snack list are encouraged which can be found at: www.snacksafely.com.

Substitute Teachers

The regular teacher will keep information about food-allergic/anaphylactic children with their substitute plans.

Use of Facilities by Outside Groups

All outside groups that use the District's facilities are discouraged from using peanut products at events or meetings for children. In addition, any outside groups' use of the District's facilities should not include use of the designated nut-free cafeteria tables. If food is available to children, signs must be posted warning of the possible presence of nuts or nut products.

Staff Development and Training

The school nurse is responsible for providing annual in-service training to staff responsible for identified students. The training will cover the following subjects:

  • Most common food allergens
  • Signs and symptoms of an anaphylactic reaction
  • Implementing an Emergency Action Plan for severe allergic reaction
  • How to administer an EpiPen
  • Planning for students who do not have an EpiPen in school
  • Working with EMS

ACTIONS FOR ANAPHYLAXIS

Students with life-threatening allergies may require emergency assistance from any staff member.

POSSIBLE SYMPTOMS OF AN ALLERGIC REACTION:

SEVERE SYMPTOMS:

  1. LUNG: Short of breath, wheeze, repetitive coughing
  2. HEART: Pale, blue, faint, weak pulse, dizzy, confused
  3. THROAT: Tight, itching, closure, hoarse, trouble breathing or swallowing, repetitive clearing of throat
  4. MOUTH: Obstructive swelling (tongue or lips)
  5. SKIN: Many hives over body
  6. COMBINATION OF SYMPTOMS – from different body areas

SKIN – Hives, itchy rash, swelling of lip/eyes

GUT – Vomiting, diarrhea, cramps

MILD SYMPTOMS:

  1. MOUTH – Itchy mouth
  2. SKIN – A few hives around mouth/face, mild itch
  3. GUT – Mild nausea/ discomfort

RESPONSE TO AN ALLERGIC REACTION

Any staff member who becomes aware a student is having an allergic reaction

  1. Stay with the student. NEVER LEAVE STUDENT UNATTENDED
  2. Administer EpiPen (call school nurse or trained personnel immediately) It is important not to delay the administration of EpiPen
  3. Contact 911
  4. Contact the Parents
  5. If the student is not conscious, turn the student on his/her side to keep the airway clear to prevent aspiration of fluids into the lungs
  6. Allow the student to sit upright (or ease the student to the floor, if necessary)
  7. Loosen tight clothing and place something soft and flat under head
  8. Move other students away from the area if possible
  9. Document incident

NOTE- Effects of EpiPen last only 10-20 minutes. Emergency medical care (911) must be obtained immediately.

Cross-ref: 5151-Homeless Students

5405-Student Wellness

5550-Student Privacy

8130-School Safety Plans and Teams

9700-Staff Professional Development

References:

New York State School Health Services Center- http://www.schoolhealthservicesny.com

Making the Difference: Caring for Students with Life-Threatening Allergies, New York State Department of Health, New York State Education Department, New York Statewide School Health Service Center, June 2008

Approved by the Board of Education: 09/26/24

Revision approved by the Board of Education: 07/08/25

Click here to view the PDF.