Co-op Academy Smithies Moor

Managing Allergies in School Policy

Allergy is a hypersensitivity to a foreign substance that is normally harmless, but which produces an immune response reaction in some people.  This can be a minor response such as localised itching or a severe response known as anaphylaxis or anaphylactic shock. Anaphylaxis is potentially life threatening, often explosive in onset with symptoms ranging from mild flushing to upper respiratory obstruction and collapse.  It occurs when the allergen enters the bloodstream, causing the release of chemicals throughout the body to protect it from the foreign substance.  Common triggers of an anaphylactic reaction are nuts and other foods including shellfish, sesame seeds and kiwi, insect stings or bites, drugs, latex, detergents/perfumes, blood products and sometimes exercise.  Anaphylaxis causes approximately 20 deaths per year in the UK.  

The Academy takes a serious approach to the risk of anaphylaxis. This policy outlines the responsibilities expected of those within the school community.

1. Preparedness

1.1 Parent Responsibilities

• On entry to the Academy, parents are asked to inform the Academy of any history of allergy, highlighting previous severe allergic reactions, and any history of anaphylaxis.
• Those parents will be invited into the Academy for a meeting with the Care Plan lead and if required alongside the School Nurse for completion of a Care Plan. Parents must sign to say they understand and are happy with the care it stipulates.
• Parents are responsible for ensuring any required medication (auto injector, inhalers and any specific antihistamine – Piriton is always kept on site) is supplied, in date and replaced as necessary.
• Where food allergy is a major concern, the Academy will liaise with the catering supervisor to ensure the details of the plan are clear and to reduce potential exposure. 
• If an episode of anaphylaxis occurs outside school, the Academy must be informed. Parents are requested to keep the Academy up to date with any changes in allergy management with regards to clinic summaries or re-testing and new food challenges.

1.2 Pupil responsibilities

• Pupils of any age must be familiar with what their allergies are and the symptoms they may have that would indicate a reaction is happening
• No pupil in the Academy may carry their own auto-injector however, the storage of these is immediately accessible and known to both the pupil and all relevant staff.

1.3 The responsibilities of the Care Plan Lead

• Once aware of an allergy the Care Plan Lead should ensure the parent and pupil complete an allergy care plan and that sufficient emergency supplies are kept on site. 
• A meeting should take place between the Care Plan Lead, parents and pupil if necessary, preferably prior to entry to the Academy, so they can discuss the plan and the individual pupil needs in school. The Catering Manager should also be involved if the allergy is a food allergy. 
• Spare auto injectors are kept in a designated area in the school office and clearly marked with each pupil’s name and also any other medication that might be used such as a spare inhaler.  A copy of their care plan will also be available in the medical boxes in the classrooms and on the shared google drive. Food Allergy information is also shared with the kitchen and photos and information regarding the allergen is on the wall.
• The Care Plan Lead will maintain an up to date allergy list for all staff to access. In addition, the allergy will be highlighted on the pupil’s electronic file on ARBOR and photo lists will be on display in the school kitchen.
• Care plans are available on the google drive in the Health Care plan folder; detailing the action to be taken in an emergency.  

1.4    Catering Department Responsibilities and Food Management across the School Please note that the Academy is not a nut-free environment as we believe this can lead to a false sense of security and we prefer that pupils and staff remain vigilant at all times. Our aim is to keep the Academy as a controlled allergy zone. However do request parents and staff support the academy in promoting a nut free environment and restrict nuts coming into school via lunchboxes.

• The catering department is aware of all individual pupil allergies and specific dietary requirements.
• The Catering Lead is available to meet with any parent wishing to discuss their child’s individual dietary requirements.
• The Academy can provide copies of the Academy’s weekly menu cycle.  
• These pupils are introduced to the Catering Team and at lunch times are encouraged to make themselves known to the team who will explain to them what is on the menu on that specific day and suitable for them to eat. Depending on the menu on the day, food may be cooked specifically that is devoid of generic allergens such as wheat.
• All catering staff are trained in Food Safety and Hygiene. All catering staff are trained in, Level 2 Food Allergen Awareness and Control, Level 2 Health & Safety and supported to attend professional development opportunities.   
• Parents are requested not to allow their child to bring in foodstuffs containing nuts to reduce the risk of cross-contamination. Reminders will be sent to parents at peak times of risk such as Christmas and Easter.
• Parents are also requested not to share homemade produce as this will not be allowed to be shared with pupils due to no labelling.
• Risk Assessments are completed by class teachers prior to any lessons involving items on the allergy list and for all those sessions involving the handling or consumption of food.

1.5    Training and Awareness

• Training in Allergy Awareness and the administration of an auto injector is provided for all staff annually through National College and on an ad-hoc basis for any new members of staff.  
• Auto injector instructions are on clear display within care plans.
• Pupil awareness of allergies is raised sensitively and if appropriate and within the classroom setting.

1.6     Individual Staff Responsibilities

• In line with health and safety guidelines a sufficient ratio of staff must attend training for anaphylactic emergency response and emergency first aid which must be refreshed every three years.  
• Staff must be aware at all times of the pupils in their care (regular or cover classes and trips) who have known allergies and must supervise any food-related activities with due caution.
• All leaders of school trips must ensure they are competent to act in case of anaphylaxis prior to the trip departure and ensure they carry all relevant emergency supplies. This includes educational visits and other off site visits.
• Any member of staff who feels their training needs to be refreshed prior to the annual training update is to contact the School Business Manager who will organise further training.  

1.7 Wider School Community Responsibilities

• Litter control is kept to a high standard in order to reduce risk of any accidental cross-contamination.

2. Action to be taken in the event of a mild allergic reaction

2.1 Symptoms of mild allergic reactions

• Rash
• Vomiting
• Abdominal cramps
• Localised tingling sensation
• Localised inflammation.

2.2 Treatment  

The priority should be removal of the allergen.  Remove stings or environmental causes. Wash with water where appropriate. For ingested allergens, rinse mouth thoroughly with water and spit out. Never induce vomiting. Our procedure is then to contact parents for them to provide antihistamines if they feel the child requires them.  

3. Management of an Anaphylactic Episode  

If symptoms occur in any individual, call the emergency services immediately. While waiting for their arrival, remove the allergen where possible and stay with the casualty to provide reassurance. Follow the care plan and office staff to immediately contact parents.

3.1 Symptoms of severe allergic reaction

• Swelling of the throat and mouth
• Difficulty in swallowing or speaking
• Difficulty in breathing due to severe asthma or throat swelling
• Hives anywhere on the body
• Generalised flushing of the skin
• Abdominal cramps, nausea and vomiting
• Sudden feeling of weakness, faintness caused by sudden drop in blood pressure
• Collapse and unconsciousness

When symptoms of anaphylaxis are seen in an unknown sufferer:

• If the casualty is conscious and breathing  - place in a sitting position, leaning forward
• If the casualty is unconscious and breathing – follow first aid training practices.  
• If the casualty stops breathing resuscitation should be carried out while awaiting the Emergency Services.

When symptoms of anaphylaxis are seen in a known sufferer:

• Remove the allergen where possible i.e. a sting or any remains of food in the mouth (and rinse mouth).
• Stay with and reassure the casualty.
• Send for Pediatric First Aiders or another member of staff to support to come with the emergency medication from the central location and the Care Plan.  
• Follow the instructions given on the Care Plan.  
• Whenever an auto injector is used, an ambulance must be called stating an anaphylactic episode. This is very important as the effect of the adrenalin may only be temporary.
• Stay with the casualty and observe the response to the auto injector until Emergency Services arrive.  
• While waiting for their arrival, place the casualty who is conscious and breathing in a sitting position, leaning forward to aid breathing, and the casualty who is unconscious and breathing in the Recovery Position.
• Be prepared to resuscitate if necessary (think about clearing immediate area). If the casualty stops breathing, resuscitation should be carried out while awaiting the Emergency Services. CPR should be given and the defibrillator machine brought with haste from its location in the school office.
• Inform the parents at a suitable moment when the situation is under control and clear information can be given.  
• Make sure the used auto injector and the Health Care Plan go with the casualty to the hospital.
• A member of staff will need to accompany the pupil to hospital and stay until parents arrive.

3.2 Location of Emergency Anaphylaxis Kit

• School Office

3.3 Instructions for using a volumatic or an aero-chamber device (spacers)

• A spacer device is to be used whenever available as it gives the best effect. It is particularly useful when a casualty is unable to coordinate inhalation with releasing the medication due to breathlessness or age.
• Shake the inhaler and then insert it into one end of the spacer and attach a face mask to the mouthpiece at the other end if required. If the pupil can make a good seal over the mouthpiece with their own lips, a mask is not required. If a face mask is used it should be placed over the nose and mouth of the pupil and held firmly to create a good seal.  
• Release one puff of reliever into the chamber. The medication is held in the chamber until the pupil releases it through breathing in and out of the mouthpiece. If a good seal is in place the valve near the mouthpiece will click.  
• Ensure the valve clicks 10 times on a larger volumatic device and 6 times on a smaller aero-chamber device to administer the medication from the chamber.  
• Repeat to administer the second puff.  

3.4 Instructions for giving an Auto injector  

The auto injector is pre-loaded and single-use only.  

• Remove the  safety cap  
• Hold the pen in the fist  
• With the tip of the pen at right angles to the casualty’s thigh, jab it into the outer part of the thigh from approximately 10 cm distance. This can be done through clothing. Do NOT waste time removing clothing.
• As you jab the auto injector firmly into the thigh (don’t worry – you can’t do any harm), a spring activated plunger will be released which pushes the needle hidden inside the auto injector into the thigh muscle and administers a dose of adrenaline over the following 10 seconds. You will hear a click as the auto injector is activated.

• Hold in place for 10 seconds – it is a metered dose that is released slowly

• Remove the pen and massage the area for a further 10 seconds.

Do not be surprised to find that most of the liquid (about 90%) remains in the auto injector after use.  Be advised that it cannot be reused.  The time at which the auto injector was administered should be noted on the pen and then taken with the casualty to hospital.

If symptoms are still present 15 minutes after the first injection, a second injection may be necessary. If at any moment after the first injection the condition of the pupil deteriorates, give a second injection regardless of the amount of time that has lapsed.

Following any anaphylactic episode, all staff involved will meet and discuss what occurred, offer support to each other, and look at how the Care Plan worked and take action to improve the planning if necessary.