Life Threatening Food Allergies in Schools and Educational Programs

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Life Threatening Food Allergies in Schools and
Educational Programs

• Why We Need State Mandated Guidelines
• Suzette Cyr, RN, BSN
• Jennifer Kelley, RN BSN
• Jeremy Beaulieu, RN, BSN

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What is a Food Allergy?

• When the bodys immune system mistakenly believes
  a harmless substance is harmful to the body. It
  tries to protect the body by releasing histamines
  and IgE antibodies to attack the substance.

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Food Allergy Response

• Chemical triggers like histamine and IgE
  antibodies are released in response to an
  allergen and can cause allergic reactions with a
  variety of symptoms
• Symptoms may vary from person to person and not
  all reactions appear the same

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Histamine Reaction
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Symptom Reactions

• Symptoms can range from mild to severe. Severe,
  life- threatening reactions are called
  anaphylaxis.
• 40-50 of people diagnosed with food allergies
  are judged to have a high risk of anaphylaxis.

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Symptoms of Anaphylaxis

• Tingling sensation in the mouth
• Swelling of the tongue and throat
• Difficulty breathing
• Hives
• Vomiting
• Abdominal cramps
• Diarrhea
• Drop in blood pressure
• Loss of consciousness
• Death (in rare cases)

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Common Food Allergies

• Peanuts
• Tree nuts
• Wheat
• Soy
• Milk
• Eggs
• Fish
• Shellfish

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Food Allergy Statistics

• There is no cure for food allergies. Strict
  avoidance of food allergens and early recognition
  and management of allergic reactions to food are
  important measures to prevent serious health
  consequences.
• More than 12 million Americans have food
  allergies. Thats one in 25, or 4 percent of the
  population.
• Approximately 2 million school-age children (ages
  5-17) have food allergies in the U.S.
• The CDC reported an average of 317,000 food
  allergy-related ambulatory care visits per year
  to emergency and outpatient departments and
  physicians offices for children under the age of
  18.

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Food Allergy Statistics

• In two published studies addressing fatal food
  anaphylactic reactions, more than half (59) of
  the individuals were age 19 or younger.
• In a study of 13 food allergy-induced
  anaphylactic reactions in school-age children,
  four of the six fatal reactions occurred in a
  school-type setting.

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Why Should Schools and Educational Programs Be
Prepared to Address Food Allergies?

• Schools and educational programs have a
  responsibility for the health and safety of
  children under their care.
• First food allergy reactions often occur in these
  settings.
• Fatalities can result from delaying
  administration of epinephrine and providing
  effective emergency care
• Food allergies could be a complicating factor
  when dealing with other conditions (i.e. asthma).
• Children with food allergies have unique social
  and emotional challenges.
• NSBAs School Health Programs (2010). Food
  Allergies and Schools Keeping students safe and
  ready to learn. Powerpoint Slides. Retrieved
  from http//static.cdn.esgn.tv/food_allergy_webca
  st_slides.pdf.

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What is Currently in Place for Maines
Educational Programs?

• Department of Education Manual of Policies
• Defines the role of school nurse
• Forms for food allergy action plans
• Student assessment form for epi-pen use
• 504 plans are implemented in schools for
  health/safety/environmental modifications
  necessary for students with disabilities
• State policy supports students right to carry
  and self-administer prescribed asthma/allergy/anap
  hylaxis medications in schools

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Issues That Need to Be Addressed in Maine Schools

• Quality of training/education provided to staff
  caring for children with food allergies
• Assessment of signs and symptoms of reaction and
  potential for anaphylaxis
• Assessment of signs and symptoms of children with
  asthma and other co-morbidities
• Competency of staff and their knowledge of food
  allergies (i.e. safety, prevention, food
  handling, recognizing symptoms, and responding to
  reactions)

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Issues That Need to Be Addressed in Maine Schools

• Schools responsibility toward understanding
  social and emotional challenges of children with
  food allergies
• Importance of disseminating general educational
  information on food allergies to staff, parents,
  and children
• Information provided to parents about prepared
  food ingredients, food preparation, and cleaning
  practices

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Lack of Consistency in Maine Schools

• A review of several schools found the following
• Scarborough Written regulations regarding
  students diagnosed with food allergies/sensitiviti
  es (adopted 9/3/09)
• SAD 6 No written policy verbal guidelines exist
• Auburn No written policy follow state
  department of education guidelines for school
  nurses
• Portland No written policy could be located

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Problems With Relying Only On 504 Plans

• Plans are individualized, therefore there are no
  standardized guidelines for managing allergic
  reactions and assisting parents with developing
  plans based on childs needs
• Stigmatization may prevent parents from making
  requests for their childs needs to schools

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What Needs to Be Done

• Legislation with mandated guidelines for managing
  life threatening food allergy reactions in
  school/educational settings.
• A collaborative training approach involving
  school staff and services to identify and monitor
  students with food allergies, established health
  care plans, and emergency care plans

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What Needs to Be Done

• Establish written emergency protocols to prepare
  for and respond to food allergy emergencies
• Implement practices that minimize exposure to
  allergens

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Resources Available for Funding State Mandated
Guidelines

• FDA Food Safety Modernization Act (2010)
• Section 112 Food allergy and anaphylaxis
  management
• Establishment of voluntary food allergy and
  anaphylaxis guidelines
• Local and state agencies can receive grants for
  developing school-based food allergy management
  programs