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Anaphylaxis: Responsibilities
Health Issue Category
Anaphylaxis
Date of Issue
Revision Date
February, 2006
Related Policies, Administrative Procedures and Forms:
 

A) Responsibilities of the Limestone District School Board
The Limestone District School Board has developed Administrative Procedure 315: The Safety of Anaphylactic Students to comply with Bill 3: Sabrina’s Law, Ontario January 2006. HR - Academic and HR- Support Staff will ensure that appropriate training for occasional staff has been completed.
B) Responsibilities of Tri-Board Transportation
With the cooperation of the school principal or designate, Tri-Board Transportation Services will communicate with its contracting companies and DSB owned busses that an anaphylactic student is on the bus. Tri-Board Transportation Services will be responsible for the training of the personnel under their supervision. Bus drivers must be provided with the student's Emergency Medical Alert Form (from the school).
C) Responsibilities of the Parents of an Anaphylactic Child
The parent(s)/guardian(s) of the allergic student shall inform the school of their child’s allergies and comply with the Limestone District School Board Administrative Procedures - AP 210 Safe Environments, AP-314 The Administration of Medication and/or Medical Procedures to Students, and AP 315 The Safety of Anaphylactic Students by providing the school, (before the child’s first day of attendance), with the following:

Required:

• A completed and signed by physician, Authorization and Request for Administration of Prescribed Medication/Medical Procedures (LDSB - AP Form 314-A1).

• A completed and signed by parent, Authorization and Request Form for the Administration of Prescribed Medication (LDSB - AP Form 314-A2).

• A completed and signed by parent, The Administration of Medication and/or Medical Procedures to Students (LDSB - AP Form 314-B1).

• Photos of the student for Emergency Medical Alert Form, (LDSB - AP 314-D3)

(The above information and documentation will assist the school in developing an Emergency Medical Alert Form for your child.)

• Epinephrine, and/or any other required medication plus a second/backup dose of epinephrine to be available in case of locational or functional problems and/or expiration. Medic Alert identification (e.g. bracelet, necklace, watch) for their child, to be worn at all times.

• Up to date emergency contact information and telephone numbers. This will assist in reviewing and updating the school emergency plan as needed.

Strongly Recommended:

• Provide support to the school and teachers as requested.

• Provide information about anaphylaxis ie symptoms of past reactions, and avoidance strategies for student safety.

• Assist in school communication plans.

• Attempt to attend all out-of-school field trips with the anaphylactic child if possible, or provide a knowledgeable adult friend or relative to do so.

• Be willing to provide "safe" foods or alternative foods for special occasions.

• Welcome other parents’ calls with questions about safe foods.

• Teach their child:

- to recognize the first symptoms of an anaphylactic reaction, and to stop and alert a trusted individual, whether sure or unsure a reaction is occurring;

- to communicate clearly when he or she feels a reaction starting, or is concerned it could be starting ie "I am ..."  "I think I am ... " ;

- to know where medication is kept, and who can get it, as well as give it (medication may be carried in a fanny-pack, pocket, backpack, or commercially available belt for carrying epinephrine)

- not to share snacks, lunches or drinks, and understand that the "air space" over their food should be free from other food and drinks;

- to understand the importance of hand-washing/cleaning, before and after meals (especially during off site trips etc. -consider hand washing/cleaning or carry hand wipes NB: Sanitary gel is not effective);


- to take as much responsibility as possible for his/her own safety.
D) Responsibilities of the School Principal
Required:

• Ensure that upon registration all parents/guardians and/or pupils be asked to supply information on life-threatening allergies School Registration Form

• Ensure that a School Emergency Response Plan (AP 140-A), Medical Safety Plan and an Emergency Medical Alert Form (AP 314-D3)for each anaphylactic student be developed which outlines the sequence of actions that should occur subsequent to an emergency situation on Board property.

• Ensure all required forms from Limestone District School Board Administrative Procedures 140, 210, 314 and 315 are completed and filed in the student’s OSR.

• Develop and maintain an ORANGE file for each anaphylactic student in the main office visible and accessible to all. It must include the School Emergency Response Plan(AP 140-A), the Medical Safety Plan and the Emergency Medical Alert Form (AP 314-D3 with the student’s photo) and Epi-pen. A 911 script could be included as well. NOTE: All emergency contact information must be kept up to date by the parent(s)/guardian(s).

• Ensure a copy of the Emergency Medical Alert Form (AP 314-D3) is posted in the office(s), staff rooms(s), and other strategic area(s) in the school and is provided to the classroom teacher(s), bus driver(s), and others as per the Distribution List on the bottom of the form.

• Store auto-injectors, labelled with the student’s name, in safe, unlocked and easily accessible locations (ref: ORANGE file) known to all staff even if child carries it on their person (i.e. fanny pack).

• Check, on a regular basis, that expiration dates are valid on auto-injector kits or other stored medication.

• Establish safe procedures to reduce risk and avoid anaphylaxis in classrooms, common areas, cafeterias, field trips, sports events and other extra-curricular activities, including snack and lunch periods. See Practical Strategies for Avoidance: Minimizing the Risk at School.

• Ensure all teachers and school staff including office staff, educational assistants, custodians, bus drivers, yard duty supervisors and cafeteria staff receive Anaphylaxis Training (Awareness, Avoidance and Action) including the use of an auto-injector. Training may be provided by Public Health or included in First Aid Certification Courses. See www.eworkshop.on.ca/allergies for more information.

• Principals shall forward a copy of the Sabrina’s Law Training Confirmation (AP 315-A & -B) for both academic and support staff to the appropriate superintendent by September 30 of each school year.

Implement an emergency drill taught and practice by the principal, teachers, school staff, volunteers and appropriate parents, regarding the correct procedures to be followed in the event of an emergency. The risk of death has been shown to be greater when such a system is not in place. This is no different from fire drills. Lives are at stake.

• Ensure that all occasional staff - teacher, EA, office staff, custodian, bus driver and any other staff who would be part of the student’s Emergency Response Team are informed of the presence of an anaphylactic child, and have been adequately trained to deal with an emergency.

• A Principal Checklist for the above tasks is available as AP 315- C

Strongly Recommended:

• Work as closely as possible with the parents of an anaphylactic child.

• Notify the school community of the anaphylactic child, the allergens, ways to help protect and the treatment. The principal shall ensure that all student contacts are aware of a particular student’s allergy by sending a Letter of Awareness to other parents.

• Take precautions when housing a class with an anaphylactic child in a portable that may not be equipped with running water necessary for washing/cleaning hands and desks.
E) Responsibilities of the Anaphylactic Student’s Teachers
Required:

• Understand the 3 A’s (Awareness, Avoidance and Action) and receive annual Anaphylaxis Training.

• Review all emergency procedures and be sure the teacher can recognize symptoms and knows when and how to administer medications.

• Keep information about the anaphylactic student in an organized, prominent and accessible format so an occasional teacher(s) will be immediately aware of it.

• Share info with other teachers (such as art, music, physed or drama) so they know who the student is and what safeguards are necessary.

• Follow the school procedures for increasing awareness and reducing risk for anaphylaxis in classrooms and common areas. Consider times when food and drinks (including all classroom activities, special events, crafts, science projects, cooking etc.) are available in the classroom. Consider Avoidance when planning for fund raising and celebrations. Include in Medical Safety Plan.

• Examine all classroom activities, events and trips, crafts, science projects, cooking, etc. for possible allergens, food or otherwise, and replace with alternatives.

• Discuss the Emergency Response Plan (AP 140-A) for any off-site activity (eg. field trips, sports events) with the parent(s)/guardian(s) and the student to ensure that avoidance strategies and action plans are in place. Epinephrine MUST be taken.  ( Check for 911 availability, distance away from closest hospital, does cell phone work ? and who has one ? emergency vehicle, wet wipes and ensure supervision with meals and set up check-in times)

• Support preventative measures for the anaphylactic student such as: He/she eats and/or drinks only what he/she brings from home and follows the rule, “NO EPINEPHRINE, NO FOOD, NO BEVERAGE.”

Strongly Recommended:

• Use the parent’s expertise in food allergies.

• Facilitate communication with other parents.

• Discuss anaphylaxis with the class, in age-appropriate terms.

• Encourage and reinforce washing/cleaning of hands before and after meals. This will not only help avoid cross-contamination from snacks or other class foods, but it will also help reduce the spread of germs.

• Examine seating arrangement for anaphylactic student, so that his/her desk is kept clean from food allergens. Seat away from garbage and food storage areas. Washing common tables after meals may be necessary, starting with a clean cloth or paper towel.

• Discourage students from sharing lunches,trading snacks and cross-contaminating "safe" meals and drinks (ie unsafe food in student's air space or flicking food items).
F) Responsibilities of Anaphylactic Students
• Take as much responsibility as possible for avoiding allergens. As age appropriate, teach friends how they can help and to recognize symptoms and what to do in an emergency.

• Eat only food and drinks brought from home.

• Take responsibility for checking labels and monitoring intake (older students).

• Wash/clean hands before and after eating.

• Learn to recognize symptoms of an anaphylactic reaction and promptly inform an adult, as soon as an accidental exposure occurs or symptoms appear.

• Know where their medication is kept at all times and know where epi-pens are located in the school. Wear an Epi-pen as age appropriate.

• Know how to use their auto-injector.

Live by the rule – “NO EPINEPHRINE, NO FOOD, NO BEVERAGE” Share your situation with close friends

Wear Medic-alert identification
G) Responsibilities of All Students
• Learn to recognize symptoms of anaphylactic reaction, the importance of seeking help immediately, and how they can help keep their friend safe.

• Avoid sharing food, especially with anaphylactic children.

• Follow school procedures about keeping allergens out of the classroom and washing/cleaning hands. No food or beverages on the playground, on the buses or in common areas.
H) Responsibilities of Public Health/Unit Staff
• Upon request, consult with and provide information to parents, students and school personnel.

• Participate in planning the school response to an emergency.

• Provide in-service and auto-injector training for school staff as time permits.

• Provide resources (e.g. video and fact sheets) for teachers to use.


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