• Worthington City Schools Procedures for Addressing

    Life-Threatening Allergies

    These procedures are designed to assist school staff in developing and providing a safe school environment for all students including students with known life-threatening food allergies. The intent is:

    1. To protect the student with allergies from allergen exposure at school.
    2. To provide educational information and training to staff regarding students with life-threatening food allergies.

    Introduction

    There are many causes of life-threatening allergic reactions. Some can be attributed to food allergen ingestion. Accidental ingestion of a food at school by a child with a known food allergy can result in a life-threatening, emergency situation. To avoid a reaction it is critical for the child with food allergies to avoid, to the extent necessary for the individual child, all known foods or suspect products that might contain the food allergen. However, even with an avoidance plan in place, accidental ingestion or exposure can occur.

    Symptoms of a life-threatening allergy can occur within minutes or several hours following an exposure. The child’s teacher(s), health clinic staff, other staff in contact with the child and bus driver(s) must be able to recognize the symptoms of a life threatening allergic reaction, called ANAPHYLAXIS. The attached Emergency First Aid Procedures for anaphylaxis should always be followed, as appropriate, as well as any additional “Specialized Health Care and/or Emergency Medical Care Plan (“Anaphylaxis Emergency Care Plan” / “Individual Food Allergy Action Plan”) developed pursuant to the District’s procedures for “Provision of Specialized Health Care or Emergency Medical Care to Student.” (Attachment A)

    These are general procedures. The procedures below will be provided to the extent required by law, but will only be used if a student or students in a building require such procedures. The procedures will not apply if no student requires them.

    These procedures regarding life-threatening food allergies can be adapted, as appropriate, to other life-threatening allergies such as insect bites, medications and latex allergies.

    Parent Responsibilities

    1. Notify school principal, school nurse and bus driver of child’s food allergy.
    2. Provide written medical documentation and instructions for allergy management and emergency procedures. Provide prescribed emergency medication and self- administration authorization forms (if applicable) to the school.
    3. Sign a release for exchange of information between school and child’s physician
    4. Update Emergency Medical Information on Infinite Campus and provide school with parent and physician emergency contact numbers
    5. It is suggested that the parent provide child with a medic alert bracelet or necklace.
    6. Refer to the extra-curricular section of this document if the child participates in any school-sponsored before or after school activity.
    7. Continue to educate their child in the self-management of his/her food allergy to include:

    a.    Child’s selection of “safe” foods at school

    b.    Strategies child can use to avoid unsafe foods at school

    1)    At school parties only eat snack foods sent in by parent

    2)    Do not share/trade food at lunch/snack times

    3)    Rapid self-identification of symptoms and notification of school personnel of a possible allergic reaction including but not limited to:

    ·         Hives, itchy red rash

    ·         Tightening in throat or difficulty swallowing

    ·         Swelling of lips/face/tongue/throat

    ·         Difficult breathing

    ·         Gut reaction; nausea, vomiting, diarrhea, stomach ache

    4)    Teach child to read food labels for ingredients (age appropriate)

    5)    Child should know not to eat foods with unknown ingredients 

    District Level Administrative Responsibilities

    1. Assure that all staff who interact with life-threatening food allergic students on a regular basis understand the allergies, can recognize symptoms, know what to do in an emergency and work with the other school staff to provide reasonable accommodations to eliminate the use of allergens in the allergic student’s meals and other food, educational tools, arts and craft projects or other school activities.
    2. Provide Level One on-line training (Public School Works) for all employees. Training will include:
      1. How to identify symptoms of an allergic reaction.
      2. The location of emergency medication. The general storage location may change pursuant to the specifics of the Anaphylaxis Emergency Care Plan.
      3. Appropriate access to/how to notify emergency medical services.
    1. Provide Level Two training to staff who have direct contact with life-threatening food allergy students. These may include:
      1. Food service staff
      2. Custodial staff
      3. Teachers
      4. Aides and office staff
    1. Level Two training will include:

    a.    Risk reduction procedures specific to the job.

    b.    Allergens that cause life threatening allergies.

    c.    Symptoms of allergic reactions to foods

    d.    Emergency procedures including appropriate access to or notification to emergency medical services.

    e.    Epinephrine auto-injector (Epipen, Auvi-Q, etc...) administration.

    1. Enforce a “no eating” rule on school buses. Exceptions will be made, as required, to accommodate students with disabilities or health care needs. This is a requirement of OAC 3301-83-08 as the general rule for student behavior on buses.
    2. Review policies and plan with team members identified in #3 above if a reaction has occurred.
    3. Follow federal/state/district laws, policies and regulations regarding sharing medical information about the student.
    4. Support building administrators in enforcing applicable harassment laws, policies and student code of conduct provisions.

    Building Level Administrative Responsibilities 

    If there are students in the building who have life-threatening food allergies, the building principal is responsible for assuring, to the extent required by law, that the following are addressed for food-allergic children:

    1. Create a school environment where food allergic children are safe.
    2. Educate students and staff as to the significance of life-threatening food allergies.
    3. Request that the parent provide up-to-date written medical information from the student’s doctor on the child’s food allergy and treatment.
    4. Request a written release from parents permitting exchange of information between the school and student’s doctor.
    5. Provide Level One training for all staff and Level Two training for staff who interact with an allergic student on a regular basis.
    6. Provide risk reduction strategies for life threatening allergies
      1. Consider hand washing before and after lunch when necessary and reasonable.
      2. Designate certain tables in the lunchroom to be peanut (or allergen free) zones as needed. 
      3. Ensure that cleaning of restricted tables be done with a clean towel or sponge to avoid cross contamination from another table top or another surface.
      4. Take reasonable steps so that teachers, parents or students not bring any student allergens into the school for classroom use.
      5. Restrict food trading.
    1. Track Level Two training attendance to assure full participation of those required to participate in the training.
    2. Inform parent/guardian of any student exposures and allergic reactions at school.
    3. Ensure that the life-threatening allergic student is placed in a classroom where the teacher is trained to administer an epinephrine auto-injector (Epipen, Auvi-Q, etc...), if needed.
    4. Notify school nurse of new personnel in the building to assure training is received. (Substitutes will receive Level One training at the District level.)
    5. Enforce applicable harassment laws, policies and student code of conduct provisions.

     

    School Nurse’s Responsibilities

    1. Following the District’s procedures for “Provision of Specialized Health Care or Emergency Medical Care to students,” develop an Anaphylaxis Emergency Care Plan for each life-threatening food allergic student and share the Anaphylaxis Emergency Care Plan and these Procedures for Addressing Life-Threatening Food Allergies with school personnel that are with the student on a regular basis. The Anaphylaxis Emergency Care Plan may include, but not be limited to:
      1. Physician’s Information for Specialized Health Care or Emergency Medical Care to Students” form. (Attachment B)
      2. Locations(s) where student’s emergency epinephrine auto-injector(s) (Epipen, Auvi-Q, etc..) is (are) kept.
      3. Photo of the child attached to the Anaphylaxis Emergency Care Plan.
      4. Allergen and symptoms of allergic reaction
      5. Emergency procedures
      6. Any required signatures
      7. Completion of the District’s form for Administration of Prescription Drugs for the use of epinephrine auto-injector (Epipen, Auvi-Q, etc...) or other prescription medication. (Attachment C)
    1. Notify staff (on a need to know basis) of all students with life threatening allergies.
    2. Provide educational materials for staff regarding a student’s life threatening allergens, symptoms, risk reduction procedures, emergency procedures and how to administer an epinephrine auto-injector.
    3. Provide ongoing training for epinephrine auto-injector (Epipen, Auvi-Q, etc...) administration and management of life threatening allergies for staff working in the health office. 
    4. Assist administration in education of new personnel as needed

    Responsibilities of Supervising Classroom Teachers and Specialists

    1. Supervising classroom teachers and specialists are those teachers, grades PK-12, who interact with allergic student in school settings as part of the routine school day.
    2. As determined by the School District, participate in meetings for identified students and, as required, complete District Level One and Level Two trainings.
    3. Include the Anaphylaxis Emergency Care Plan and photo of students with life-threatening allergies with classroom roster and daily lesson plans. Emphasize the Anaphylaxis Emergency Care Plan with lesson plans for substitute teachers.
    4. Inform any school staff who work in the classroom with the life-threatening allergy student including educational assistants, student teachers, specialist and substitute teachers of the student’s food allergies and necessary safeguards.
    5. Consult with parent if requested and consider providing a lesson plan about food allergies for students and discuss anaphylaxis in age appropriate terms.
    6. Enforce applicable harassment laws, policies and student code of conduct provisions.
    7. Provide lesson plans and academic activities that will not use items containing known student allergens or notify parents, if not reasonably possible, and provide an alternative educational activity.
    8. Inform parents of life-threatening allergic students of any “in-class” activities where food will be served and notify custodian for any necessary appropriate cleaning after activity,
    9. Recognize the potential of student’s allergens being present in substances other than food for human consumption such as pet food, and apply the appropriate precautions.
    10. Monitor foods that enter the classroom for evidence of obvious food allergens (read the label) and limit exposure as required.
    11. Provide student an eating area in the classroom that is free from food to which child is allergic when consuming food in the classroom.
    12. Consider hand washing before and after eating, when necessary and reasonable.
    13. In the event of an allergic reaction follow the Anaphylaxis Emergency Care Plan including identified emergency procedures and contact building principal. A District incident report should be completed.
    14. Consider providing non-food rewards for class work and achievements. 

    Field Trips

    The teacher will:

    1. Notify parents of field trip and obtain consent from parents.
    2. If food exposure is a concern, encourage parents of food allergic student to attend field trip. If parents are unable to participate, the teacher will make reasonable accommodations.
    3. Collect the student’s Anaphylaxis Emergency Care Plan and medication including an epinephrine auto-injector.
    4. Review instructions on method of administration of epinephrine auto-injector (Epipen, Auvi-Q, etc...).
    5. Do not delegate emergency medications to chaperones or parent volunteers on field trips, including epinephrine auto-injectors and other medications included on student’s Anaphylaxis Emergency Care Plan.
    6. Ensure access to emergency services by cell phone or other communication device during field trip.
    7. Review plans for eating while on field trip to prevent exposure to student’s life-threatening foods.
    8. Consider locations for students to wash hands before and after eating.
    9. Prevent exposure of epinephrine auto-injector (Epipen, Auvi-Q, etc...) to direct sunlight or extreme heat. If prevention of exposure of the epinephrine auto-injector (Epipen, Auvi-Q, etc...) is not reasonably possible, discuss with parents and, if needed, physician.
    10. Return epinephrine auto-injector (Epipen, Auvi-Q, etc...) and medication to the health office or other designated storage area after field trip.

    Bus Drivers

    1. Complete Level One training. In addition, review job specific risk reduction procedures, recognition of allergic reaction and implementation of bus emergency plan procedures.
    2. Enforce no eating policy on all buses except students with disabilities or health concerns that require food.
    3. Secure and organize emergency medical cards for Life-Threatening Allergic students.
    4. Call 911 for all medical emergencies
    5. Utilize cell phone, radio, walkie-talkie or other means of communication for emergency calls.

    Custodians

    1. Complete Level One and Level Two training.
    2. A designated cloth and bucket of soap and water should be used to avoid cross contamination for tables and desks of Life-Threatening Allergic students. Disposable disinfectant wipes could also be used.
    3. After each meal service, all table and chairs should be thoroughly washed as stated above avoiding cross-contamination.

    Food Services Staff

    1. Provide designated area for easy access to a child’s Anaphylaxis Emergency Care Plan.
    2. Provide designated area for quick access regarding guidelines to reading labels for common food allergies.
    3. Provide menus (breakfast, lunch) of the food sold in the school cafeteria to all food allergy children. Menus will be posted on the District website.
    4. Allow parents access to lists of ingredients used in all food prepared and served by the school cafeteria upon request.
    5. Maintain food labels from each food served to a child with allergies for 24 hours.
    6. Have available contact information for vendors or suppliers to access food content information.
    7. Use safe food handling techniques to prevent cross contamination while preparing foods.
    8. Participation in Level One and Level Two anaphylaxis training. 

    School Sponsored Extra-Curricular Activities

    1. Reasonable accommodations will be provided for extra-curricular activities. Parents should initiate a meeting with the activity coordinator to discuss any needed accommodations.

    FORMS FOR SCHOOL:  

    Anaphylaxis Emergency Care Plan Required for School:  Anaphylaxis Emergency Care Plan