Are Anaphylaxis Policies in Place at Your Child's School?
By Yvonne Rousseau, AAIA BC/Yukon Regional Coordinator
I. What to expect in September
If you are enrolling your child in school for the first time or if you have moved and are registering your child at a new school, you will be given a registration form that requests basic health information. If you indicate that your child has life-threatening allergies, you should expect to receive another form which must also be filled out for the school. This is an individual emergency care plan* for your child. It outlines what your child is allergic to, the avoidance measures needed, the symptoms of a reaction, the steps to follow should an emergency occur and information on how to contact you once the emergency steps have been followed. You may also be given a form that you must take to your family doctor or allergist for him/her to fill out and sign before returning it to the school.
If your child has been recently diagnosed with a life-threatening allergy, you must inform the school and complete the required forms. The school cannot protect your child if you do not inform them.
When moving from one school to another, the school records will be transferred but errors do occur. Do not assume the new school will be fully informed about your child’s allergy. The parent or older student must inform the new school.
If your child is now leaving elementary school to attend a middle or secondary school, again do not assume that the new school will be fully informed about your child’s medical needs. Parents or students must take the responsibility to inform the middle or secondary school where the student will be attending. Once you have done this, expect to again receive an individual emergency care plan form and a form for the doctor to fill out.
If your child is remaining in the same school and your child’s medical condition has remained the same, many schools will still require a yearly update or review of the above mentioned forms.
If you do not receive these kinds of forms from the school, it may mean that your school, school board or province/territory does not have a policy to manage life-threatening allergies at school. Talk to the principal and ask what policies are in place to protect your child.
*Note: The individual emergency care plan may have a different name in your school but the content should be much the same.
II. What to ask for if your school does not have an anaphylaxis policy in place
School anaphylaxis plans are designed to ensure that children at risk are identified, strategies are in place to minimize the risk of accidental exposure and staff and key volunteers are trained to respond in an emergency situation.
If there is no established policy in place in your school, here are some steps to start with. First, make your principal aware of the following Web sites.
- Anaphylaxis in Schools and Other Settings www.allergyfoundation.ca
- Prince Edward Island Ministry of Education —Anaphylactic Shock in Schools www.gov.pe.ca/educ/index.php3?number=76608
- New Brunswick Department of Education – Health and Safety, Policy 704 www.gnb.ca/0000/policies.asp
- Ontario Sabrina’s Law, 2005 www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_05s07_e.htm
Next, inform your principal about the recently published book, Anaphylaxis in Schools and Other Settings put out by the Canadian Society of Allergy and Clinical Immunology. This book outlines the importance of a school anaphylaxis policy and the elements that need to be included in such a policy. The AAIA Regional Offices have copies of these books for sale for $15 plus shipping or talk to your Regional Coordinator and ask for information about this and other anaphylaxis resources to be mailed directly to the principal or board, etc.
Go to the above sites yourself and find an example of how to make up an individual emergency care plan for your child and take it in to the principal. Be sure to include a recent photo of your child on this form. Meet with the teacher before school starts.
Copies of your child’s emergency care plan and photo should be posted in key areas so that all staff can become familiar with and identify your child and be aware of the procedure to follow in an emergency. For example, this can be posted in the classroom, or in the teacher’s daybook, the office, the photocopy room and school cafeteria staff areas. This becomes very tricky as the child gets older and does not want everyone to know about his/her allergies. Emergency care plans must then be posted more discreetly. Having a copy of the emergency care plan in the teacher’s daybook is very important as that is the most likely place that a substitute will see it.
Ask the principal for yearly (and preferably twice a year) training for all staff. Training needs to include an overview of anaphylaxis, allergen avoidance measures, signs and symptoms of an anaphylactic reaction and a demonstration on the use of the epinephrine auto-injector as well as hands-on practice with the auto-injector training device. Encourage teachers to practice throughout the year with the trainer.
The AAIA has an excellent resource available for staff training – The Anaphylaxis Reference Kit. You can offer to do the training yourself or you can also call your Regional AAIA office to see if there is someone in your area who could go into the school and do the training. Another option is to contact your local Public Health Nurse to see if she would be able to do the staff training (where applicable).
A system needs to be set up to ensure that substitute teachers are made aware of children with anaphylaxis and their individual emergency care plans. They must also be trained in the use of the auto-injector. Bus drivers also need this information and training.
You will have to work together with the principal, teacher and/or school health nurse on how to implement strategies to reduce the risk of exposure to allergens.
In talking to the principal and teachers we suggest you avoid using phrases such as ‘peanut-free’, ‘nut-free’, ‘guarantee’ or ‘ban’ as these terms tend to be misleading and may cause the school community to react negatively. It is impossible to guarantee or ensure compliance with a food ban.
The AAIA suggests you use the term ‘allergy aware’. It is through the education of other parents, students and school staff that you will provide the second greatest measure of safety for your child. The first measure is in teaching your child some basic rules to keep safe.
It is important to communicate information about your child’s allergies to the other students and parents. Sample letters are outlined in “Anaphylaxis in Schools and Other Settings”. This of course will require the cooperation of the teacher and principal. Communication letters to other parents should indicate that while anaphylaxis has the potential to cause severe reactions and death, risks can be greatly reduced through effective cooperation and management strategies and emergency procedures.
Teaching your child’s classmates about life-threatening allergies has, for instance, produced wonderful results in that these children often go home and tell their parents that they do not want to take a food item to school because their classmate is allergic. Education is a more effective means of protecting your child than asking for a food ban.
Field trips require extra consideration and preparation when there is a child with anaphylaxis in the class, i.e. what is the likelihood of the child being exposed to their allergen, all teachers/supervisors must be aware of the allergic child and what to do in an emergency, auto-injectors must be taken and preferably with the child carrying them on his/her person. A second injection needs to be available in case it is needed. A cell phone and emergency contact numbers should be taken along.
Your child should wear a MedicAlert® bracelet or medical alert identification. This will indicate the allergies and that the child carries an auto-injector. This will greatly assist first responders or paramedics.
III. What to ask for when advocating for a school board or provincial Anaphylaxis Policy
Even if you have obtained cooperation from the principal and teacher at your school, you may still want to see a school, school board or provincial anaphylaxis policy put in place.
Bill 3, also known as Sabrina’s Law, went into effect in Ontario on January 1, 2006. This new law addresses an important health and safety issue that deeply impacts the physical and emotional health of young children living with life-threatening allergies during their years in school. New Brunswick and Prince Edward Island have province-wide school policies for anaphylaxis. In Quebec, school nurses are required to identify children at risk and do staff training.
At the present time however, many parents in other provinces still have to struggle to get their child’s school to implement a school policy on anaphylaxis. In some provinces there is NO consistent standard to protect these children. When a family moves, the parents have to educate staff at the new school about the dangers of anaphylaxis, the importance of keeping an epinephrine auto-injector handy and the need to train all staff and teachers in the proper use of the injector. Uniform procedures would avoid much of “the stress and struggle” parents face in getting cooperation on procedures to ensure the safety of their child.
If you want to focus on a local school or school board policy, write to your school authorities. Meet with them and let them know that you want an anaphylaxis policy that includes the following eight elements. You may be able to gain the support of the Public Health Nurses. Work together with other parents who have children with anaphylaxis.
If your province or territory does not have a consistent province-wide policy, write and let your government know that you want the same protection for your children, to be provided by the provincial government, as parents in Ontario, New Brunswick and Prince Edward Island receive for their children.
Write letters to inform your government about the need for all schools to have an emergency plan in place to protect children with anaphylaxis. Anaphylaxis plans must include the following elements.
- Indicate the need for all schools to have a plan and that principals should be responsible for ensuring that all elements of the plan are in place.
- Request annual (and preferably semi-annual) staff training about life-threatening allergies. Any staff supervising students identified as anaphylactic would be fully informed about their particular allergies, and be trained in monitoring and appropriate treatment methods. Outline the benefits of training twice a year.
- Emergency procedure instructions for each anaphylactic student. The school should also keep a current file about his or her medications, treatment and an emergency contact list.
- Strategies to reduce exposure to allergens in the classroom and common areas.
- Storage of epinephrine auto-injectors at the school.
- Communication strategies for disseminating information on life-threatening allergies to parents, students and staff.
- Enrolment procedures that would require parents to supply information about life-threatening allergies.
- A provision allowing school staff, in an emergency, to administer epinephrine to an anaphylactic student without parental consent.
- Write to your Premier, Minister of Education and Minister of Health.
- Phone, write or visit your local MLA. Inform him/her about living with life-threatening allergies. Inform your MLA of the actions you, your family and child’s care providers must follow to stay safe. Personal contact and stories have impact.
- Solicit letters of support from your doctor, community groups such as Rotary, Lions, Kiwanis, City, etc. Make your community aware of this issue. Keep writing, phoning and e-mailing your government until they put a policy in place.
Children with anaphylaxis live with stress that is foreign to most children. These children need to feel safe in order to learn and grow emotionally. All children deserve a safe school environment.
Reference: Anaphylaxis in Schools and Other Settings
from Allergy & Asthma News, Issue 3 2006