CCSD School Nurses. Support of Students with Life Threatening Allergies

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1 CCSD School Nurses Support of Students with Life Threatening Allergies

2 The Clark County School District is committed to provide a safe, supportive environment in which all students can learn and achieve. This presentation will discuss the safe and sensitive management of students with life threatening allergies in the school setting.

3 *Food allergy is increasing among children CDC reports 18% increase in food allergies from Peanut allergies tripled from Up to 8% of students are affected (2 or more per class). Top eight food allergens: peanuts, tree nuts, soy, milk, egg, wheat, fish and shellfish. *Anaphylaxis occurs in schools Children have suffered fatal reactions at school. Many are first time reactions. Reactions can be caused by food, insects, latex or medication. Every food allergic reaction has the potential to develop into a life threatening reaction.

4 January 2012, Ammaria ate a peanut during recess at school. By the time emergency crews arrived, Ammaria was in cardiac arrest. She died a short time later at a Virginia hospital.

5 *Schools are a high risk setting for accidental exposure Food is everywhere in schools: classroom snacks, birthday & holiday parties, rewards & incentives, field trips, science & art projects, cafeteria, playground, buses, fundraisers, snack shack. Risk of cross contamination on desks, keyboards, shared classroom supplies, door knobs, etc. Risk of exposure due to sharing food, hidden ingredients in foods, hidden ingredients in art and science materials, latex is a component of many art, PE, and classroom supplies/equipment. Many students with known allergies carry auto-injectable epinephrine or have medication in the health office. Autoinjectable epinephrine (stock epinephrine) is available on all school campus sites.

6 * Strict avoidance is the only way to prevent a reaction. * Special attention is needed to protect the safety of students with life threatening allergies. * Eliminate or reduce the presence of identified and/or potential allergens in classrooms. * Avoid the use of food items for parties, projects, celebrations, demonstrations or labs. * A nut-free table should be available in the cafeteria where students with food allergies can sit with their friends. This table must be cleaned with separate cleaning supplies to avoid cross contamination.

7 *Substitute teachers must be alerted to students with severe allergies or other significant health problems. The School Nurse will provide the medical alert to the responsible designee at the school who will place Medical Alerts in the Sub folders. *Encourage hand washing with soap and water, particularly after lunch. Hand sanitizer is not effective in removing allergens from the skin. *Written management plans (medical alerts, 504 Plans, emergency action plans) are appropriate for students with severe allergies. *Open communication can help prevent reactions.

8 *Enforce zero tolerance for bullies who threaten or tease students with allergies. *The student should participate in all classroom projects with his/her peers. *For projects or experiments, avoid singling out the affected student by requiring him/her to use a different item. For example, if nuts are being used for a project, substitute a safe item for all of the students to use. EXCLUDE THE FOOD, NOT THE CHILD.

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10 *Substances that can cause allergic reactions include, but are not limited to: FOOD: Peanuts, tree nuts, milk, shellfish, fish, eggs, soy, wheat VENOM: Bee, ant, wasp, spider bites or stings LATEX: Balloons, some paints, erasers, glue, art supplies, sports equipment DRUGS: Penicillin, iodine, sulfa, insulin, other drugs

11 *Definition: A hypersensitive response of the immune system to a substance (allergen). *Reactions can vary from mild to severe. *Food allergies are the primary cause of allergic reactions. *28% of severe reactions occur for the first time in persons without known allergies. *Rapid onset usually indicates a more severe reaction. *Reactions can occur within minutes to several hours after exposure to the allergen.

12 * Medical research emphasizes that early recognition and treatment of symptoms saves lives. * Allergic reactions are unpredictable; they may present and progress differently than previous reactions AND a seemingly mild reaction can turn serious quickly. * A student experiencing anaphylaxis may show no skin symptoms-no hives, no rash, no swelling.

13 Mouth Itchy, tingling, swelling of lips/tongue Nose Hay fever-like symptoms: runny, itchy nose; sneezing; and/or watery, red eyes Skin Hives, rash, redness, itching Flushing (redness and warmth) Swelling of face or extremities Gut Cramps/pain Nausea, vomiting, diarrhea Throat Hoarseness Tightening of throat, difficulty swallowing Hacking cough Lungs Shortness of breath, wheezing Repetitive, hacking cough Heart Low blood pressure, weak pulse Pale, blue color Dizzy, fainting Mental Anxiety, sense of impending doom Lethargy

14 * Prompt administration of epinephrine. Per Nevada state law, stock epinephrine is now available in all CCSD schools for ANY student experiencing a severe allergic reaction. * Call 911! Notify site administrator, school nurse, and parent/guardian. * Have student lie down; elevate student s feet. * An adult must stay with the student. * Trained person present to monitor symptoms and initiate CPR, if needed. * Student must be transported to the Emergency Room and monitored for a minimum of four hours. Student can have a recurrence of the allergic reaction (biphasic reaction).

15 *Epinephrine is kept secure, but unlocked and readily accessible in Health Office. *CCSD Allergy Management Guidelines are being developed.

16 *Children experiencing signs and symptoms of an allergic reaction must be accompanied by an adult at all times. *For severe symptoms call 911. For milder symptoms contact the front office. *Do not send students suspected of having an allergic reaction home on the bus or walking. They must be picked up by a parent. *Review medical alerts provided by the school nurse. You are responsible for this information. *Contact your school nurse with any other questions or concerns.