Anaphylaxis in Schools 3rd Edition
Anaphylaxis in Schools 3rd Edition
Anaphylaxis in Schools 3rd Edition
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If an allergic person expresses any concern that a reaction might be start<strong>in</strong>g, the person should<br />
always be taken seriously. When a reaction beg<strong>in</strong>s, it is important to respond immediately, follow<strong>in</strong>g<br />
<strong>in</strong>structions <strong>in</strong> the person’s <strong>Anaphylaxis</strong> Emergency Plan. (See Appendix D.) The cause of the reaction<br />
can be <strong>in</strong>vestigated later. The most dangerous symptoms of an allergic reaction <strong>in</strong>volve breath<strong>in</strong>g<br />
difficulties caused by swell<strong>in</strong>g of the airways (<strong>in</strong>clud<strong>in</strong>g a severe asthma attack <strong>in</strong> those who have<br />
asthma) or a drop <strong>in</strong> blood pressure <strong>in</strong>dicated by dizz<strong>in</strong>ess, lightheadedness, feel<strong>in</strong>g fa<strong>in</strong>t or weak, or<br />
pass<strong>in</strong>g out. Both can lead to death if untreated.<br />
Consensus Statement<br />
What triggers anaphylaxis?<br />
Although many substances have the potential to cause anaphylaxis, the most common triggers are<br />
foods and <strong>in</strong>sect st<strong>in</strong>gs (e.g. yellow jackets, hornets, wasps, honey bees). In Canada, the most<br />
common food allergens that cause anaphylaxis are:<br />
• Peanut<br />
• Tree nuts (almonds, Brazil nuts,<br />
cashews, hazelnuts, macadamia nuts,<br />
pecans, p<strong>in</strong>e nuts, pistachios, walnuts)<br />
• Milk<br />
• Egg<br />
• Sesame<br />
• Soy<br />
• Wheat<br />
• Seafood<br />
<br />
Fish, e.g. trout, salmon<br />
<br />
Shellfish<br />
--<br />
Crustaceans, e.g. lobster, shrimp, crab<br />
--<br />
Molluscs, e.g. scallops, clams, oysters, mussels<br />
• Mustard<br />
Health Canada requires these ‘priority allergens’ to always be identified on food labels by their<br />
common names.<br />
Medications and exposure to natural rubber latex can also cause potentially life-threaten<strong>in</strong>g allergic<br />
reactions. A less common cause of anaphylaxis is exercise, which <strong>in</strong> some <strong>in</strong>dividuals can be triggered<br />
by the prior <strong>in</strong>gestion of a specific food which is not normally a problem. In some cases of anaphylaxis,<br />
the cause is unknown (‘idiopathic’).<br />
Note: For regulatory purposes, Health Canada uses the follow<strong>in</strong>g terms to describe seafood: fish (e.g. trout,<br />
salmon), shellfish (e.g. scallops, clams) and crustaceans (e.g. lobster, shrimp). Health Canada also <strong>in</strong>cludes<br />
sulphites (a food additive) as a priority allergen.<br />
How is a person identified as be<strong>in</strong>g at risk for anaphylaxis?<br />
Family doctors and emergency physicians are most often the first healthcare professionals to identify a<br />
person who has experienced an allergic reaction. They play an important role <strong>in</strong> discuss<strong>in</strong>g anaphylaxis<br />
management with <strong>in</strong>dividuals (e.g. allergen avoidance strategies), prescrib<strong>in</strong>g an ep<strong>in</strong>ephr<strong>in</strong>e auto<strong>in</strong>jector,<br />
and referr<strong>in</strong>g them to an allergist for evaluation. People thought to be at risk of life-threaten<strong>in</strong>g<br />
allergic reactions should be evaluated by an allergist.<br />
<strong>Anaphylaxis</strong> <strong>in</strong> <strong>Schools</strong> & Other Sett<strong>in</strong>gs<br />
Copyright © 2005-2014 Canadian Society of Allergy and Cl<strong>in</strong>ical Immunology 7