Anaphylaxis in Schools 3rd Edition
Anaphylaxis in Schools 3rd Edition
Anaphylaxis in Schools 3rd Edition
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• Have the child wear medical identification (e.g. MedicAlert ® bracelet). The identification could<br />
alert others to the child’s allergies and <strong>in</strong>dicate that the child carries an ep<strong>in</strong>ephr<strong>in</strong>e auto-<strong>in</strong>jector.<br />
Information accessed through a special number on the identification jewelry can also assist the local<br />
emergency medical services (e.g. paramedics) to access important <strong>in</strong>formation quickly.<br />
Appendix C<br />
Availability and Location of Ep<strong>in</strong>ephr<strong>in</strong>e Auto-<strong>in</strong>jectors (“auto-<strong>in</strong>jectors”)<br />
• Children at risk of anaphylaxis who have demonstrated maturity should carry one auto-<strong>in</strong>jector with<br />
them at all times and have a back-up available <strong>in</strong> the school. Most children are able to carry their<br />
own auto-<strong>in</strong>jector and asthma <strong>in</strong>haler (if needed) by grade one to two. For children with st<strong>in</strong>g<strong>in</strong>g<br />
<strong>in</strong>sect allergy, this would not have to be for the full year but dur<strong>in</strong>g <strong>in</strong>sect season (warmer months).<br />
• Posters which describe signs and symptoms of anaphylaxis and how to give an ep<strong>in</strong>ephr<strong>in</strong>e auto<strong>in</strong>jector<br />
will be placed <strong>in</strong> relevant areas, e.g. classrooms, office, staff room, lunch room or cafeteria.<br />
Additional auto-<strong>in</strong>jectors should be brought on field trips. It is recommended that the organizer of<br />
the field trip carry a cell phone and know the location of the closest medical facility.<br />
Emergency Protocol<br />
• An <strong>in</strong>dividual <strong>Anaphylaxis</strong> Emergency Plan can be signed by the child’s physician, if required. With<br />
parental permission, a copy of this Plan will be placed <strong>in</strong> designated areas such as the classroom<br />
and office.<br />
• Adults must be encouraged to listen to the concerns of the child who usually knows when a reaction<br />
is occurr<strong>in</strong>g, even before signs appear. It cannot be assumed that children will be able to properly<br />
self-adm<strong>in</strong>ister their auto-<strong>in</strong>jector. (Children may be fearful of gett<strong>in</strong>g a needle, they may be <strong>in</strong> denial<br />
that they are hav<strong>in</strong>g a reaction, or they may not be able to self-adm<strong>in</strong>ister due to the severity of the<br />
reaction.) When giv<strong>in</strong>g ep<strong>in</strong>ephr<strong>in</strong>e, it is recommended to have the person sit or lie down. When<br />
adm<strong>in</strong>ister<strong>in</strong>g to a child, it may be helpful to support or brace their leg to reduce movement.<br />
• To respond effectively dur<strong>in</strong>g an emergency, a rout<strong>in</strong>e has been established and practiced, similar to<br />
a fire drill. Dur<strong>in</strong>g an emergency:<br />
1. Give ep<strong>in</strong>ephr<strong>in</strong>e auto-<strong>in</strong>jector (e.g. EpiPen ® or Allerject) at the first sign of a known or<br />
suspected anaphylactic reaction.<br />
2. Call 9-1-1 or local emergency medical services. Tell them someone is hav<strong>in</strong>g a life-threaten<strong>in</strong>g<br />
allergic reaction.<br />
3. Give a second dose of ep<strong>in</strong>ephr<strong>in</strong>e <strong>in</strong> 5 to 15 m<strong>in</strong>utes IF the reaction cont<strong>in</strong>ues or worsens.<br />
4. Go to the nearest hospital immediately (ideally by ambulance), even if symptoms are mild or<br />
have stopped. The reaction could worsen or come back, even after proper treatment. Stay <strong>in</strong><br />
the hospital for an appropriate period of observation as decided by the emergency department<br />
physician (generally about 4-6 hours).<br />
5. Call emergency contact person (e.g. parent, guardian).<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<br />
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