Anaphylaxis in Schools 3rd Edition

If an allergic person expresses any concern that a reaction might be starting, the person should
always be taken seriously. When a reaction begins, it is important to respond immediately, following
instructions in the person’s Anaphylaxis Emergency Plan. (See Appendix D.) The cause of the reaction
can be investigated later. The most dangerous symptoms of an allergic reaction involve breathing
difficulties caused by swelling of the airways (including a severe asthma attack in those who have
asthma) or a drop in blood pressure indicated by dizziness, lightheadedness, feeling faint or weak, or
passing out. Both can lead to death if untreated.
Consensus Statement
What triggers anaphylaxis?
Although many substances have the potential to cause anaphylaxis, the most common triggers are
foods and insect stings (e.g. yellow jackets, hornets, wasps, honey bees). In Canada, the most
common food allergens that cause anaphylaxis are:
• Peanut
• Tree nuts (almonds, Brazil nuts,
cashews, hazelnuts, macadamia nuts,
pecans, pine nuts, pistachios, walnuts)
• Milk
• Egg
• Sesame
• Soy
• Wheat
• Seafood
Fish, e.g. trout, salmon
Shellfish
--
Crustaceans, e.g. lobster, shrimp, crab
--
Molluscs, e.g. scallops, clams, oysters, mussels
• Mustard
Health Canada requires these ‘priority allergens’ to always be identified on food labels by their
common names.
Medications and exposure to natural rubber latex can also cause potentially life-threatening allergic
reactions. A less common cause of anaphylaxis is exercise, which in some individuals can be triggered
by the prior ingestion of a specific food which is not normally a problem. In some cases of anaphylaxis,
the cause is unknown (‘idiopathic’).
Note: For regulatory purposes, Health Canada uses the following terms to describe seafood: fish (e.g. trout,
salmon), shellfish (e.g. scallops, clams) and crustaceans (e.g. lobster, shrimp). Health Canada also includes
sulphites (a food additive) as a priority allergen.
How is a person identified as being at risk for anaphylaxis?
Family doctors and emergency physicians are most often the first healthcare professionals to identify a
person who has experienced an allergic reaction. They play an important role in discussing anaphylaxis
management with individuals (e.g. allergen avoidance strategies), prescribing an epinephrine autoinjector,
and referring them to an allergist for evaluation. People thought to be at risk of life-threatening
allergic reactions should be evaluated by an allergist.
Anaphylaxis in Schools & Other Settings
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