KeeneIndependent School District

School Health Services Guidelines

Food Allergies/ Epi-Pen IITraining

Level II Food Allergy TrainingWhy am I taking another course?

You have a student with a history of severe food allergy⦿ You are a cafeteria monitor who has a student with

a history of severe food allergy⦿ You are assigned to cover the clinic when a nurse

is absent⦿ You are a before or after school program sponsor

and have a student with a history of severe food allergy

Level II Food Allergy TrainingAllergy Review:⦿ Food intolerance – an unpleasant reaction to a

food, that unlike a food allergy DOES NOT involve the immune system or the release of histamine

⦿ Food Allergy – a group of disorders characterized by immunological responses to specific food proteins

⦿ Anaphylaxis – a serious allergic reaction that is rapid in onset and may cause DEATH

What happens to the body during a severe food allergy attack?

https://youtu.be/AKVjKC3u9hk

Highlight link. Right click. Select “Open Link” to view video.

Level II Food Allergy TrainingSigns and Symptoms of an allergic reaction:

Body System Sign or Symptom

Mouth Tingling, itching, swelling of the tongue, lips or mouth: blue/grey color of the lips

Throat Tightening of the throat; tickling feeling in back of throat; hoarseness or change in voice

Nose/Eyes/Ears Runny, itchy nose; redness and/or swelling of eyes; throbbing in ears

Lung Shortness of breath; repetitive shallow cough; wheezing

Stomach Nausea; vomiting; diarrhea; abdominal cramps

Skin Itchy rash; hives; swelling of face or extremities; facial flushing

Heart Thin weak pulse; rapid pulse; palpitations; fainting; blueness of lips, face or nail beds; paleness

In the case of a life-threatening reaction, more than one system of the body is involved. The mouth, throat, nose, eyes, ears, lungs, stomach, skin, heart and brain can all be affected.

Level II Food Allergy TrainingEpinephrine⦿ First-line treatment in the case of

anaphylaxis

⦿ It works by relaxing the muscles in the airways and tightening the blood vessels

⦿ A repeat injection may be needed as ordered by physician

Level II Food Allergy TrainingEpinephrine auto-injectors-prescribed by physician

› EpiPen®⚫ Junior for students 33-66 lbs (green label)⚫ Regular for students (yellow label) 66 lbs and over

RegularJunior

Level II Food Allergy TrainingAdministration of Epinephrine⦿ Medication Authorization – must be on

file in the nurses office⦿ Name on authorization must match

name on prescription label⦿ Epinephrine is stored in a breakeable-

sealed yellow box mounted in the office. ⦿ Some students may carry the

epinephrine with them to class and school activities with proper paperwork completed

Level II Food Allergy Training5 Rights of Medication Administration

1. Right student

2. Right medication

3. Right dose

4. Right route

5. Right time

Level II Food Allergy TrainingHow to Administer Epinephrine⦿ Epi-pen

http://www.youtube.com/watch?v=tjILFYPE3Uw

⦿ Twin-jet http://www.twinject.com/

Highlight website, right click on mouse and click on open hyperlink to watch video.

Level II Food Allergy TrainingPost Epinephrine Injection⦿ 911 must be called if epinephrine has been

given (call 911 before parents, you don’t want to delay the arrival of EMS)

⦿ Notify the parents

Documentation⦿ The student’s reaction to the allergen

⦿ Medication administration

⦿ The student’s reaction to the epinephrine

Level II Food Allergy TrainingSelf-Administration of Epinephrine⦿ Per Federal law, students may carry their

epinephrine with them in the classroom and on school activities with proper paperwork completed

⦿ If a student uses their epinephrine in your classroom:› Immediately contact the nurse (if nurse is not

available, notify the front office)› Designate someone to call 911› Monitor the student’s respiratory status› Note the student’s reaction to the allergen and

the time the epinephrine was administered

Level II Food Allergy TrainingNotification of a student with disclosed food allergies:⦿ Once notification is received by the school

nurse appropriate school personnel will be notified.

Every student with a disclosed food allergy:⦿ Should be considered for possible 504

accommodations

⦿ Will have an Allergy Individual Health Care Plan (AIHP) which includes an emergency plan

Level II Food Allergy TrainingAllergy Individual Health Care Plan (AIHP)

⦿ Provides directions on what to do if a student with a disclosed food allergy is having a reaction in your classroom

⦿ AIHP should be taken on field trips

⦿ A copy should be placed in your sub folder

Level II Food Allergy TrainingSampleEAP

Level II Food Allergy TrainingSampleEAP cont.

Level II Food Allergy Training

Individual Healthcare Plan (IHP)-a plan written by the school nurse (RN) that details accommodations and/or nursing services to be provided to a student because of the student’s medical condition based on medical orders written by a health care provider in the student’s medical home. The EAP is a part of the IHP.

Level II Food Allergy Training

No Epinephrine?

⦿ If a student does not have epinephrine at school – CALL 911!

* Advise the 911 operator that the student appears to be having an anaphylactic event* Each office on KISD’s campuses has an EpiPen® and EpiPen Jr® available for use in the event of Anaphylaxis Do not use another student’s epinephrine auto-injector

Level II Food Allergy TrainingExposure Reduction at School⦿ Campus Wide

• Allergy aware : Students with food allergies attend school at that campus

• Allergy Free Tables: Students without the allergen in their lunches may sit at the allergy free table (i.e. peanuts)

⦿ Classrooms: • Food: Limit use of foods as rewards or manipulation• Parties: Avoid foods that contain the allergen• Hand washing: Wash hands before and after meals or

use hand wipes. Alcohol based hand gel is not effective in eliminating the allergen

Level II Food Allergy TrainingExposure Reduction at School⦿ Field Trips:

o Notify school nurse at least 2 weeks prior to field trip

o Don’t leave for field trip without the epinephrine

o Be aware of foods offered on field trip (may need to contact facility in advance)

⦿ Transportation:o Notify the transportation department that a student

with food allergies who is at risk for anaphylaxis will be riding the bus

o Prohibit food and drink on buses

Level II Food Allergy TrainingBullying

⦿ Be aware of how the student with food allergies is being treated

⦿ Classmates avoid endangering, isolating, stigmatizing or harassing students with food allergies

⦿ Enforce school rules on bullying and threats

Level II Food Allergy TrainingNext Steps⦿ See the school nurse to:

› Review and demonstrate proper epinephrine administration

› Pick up AIHP

› Determine where medication is kept⚫ In clinic⚫With student⚫ Both

Post Anaphylaxis ReviewIn the event of an anaphylactic event, a post exposure conference will be held on the campus. The following will be addressed in the debriefing:

⦿ Identification of the source of the allergen exposure⦿ Steps to prevent future exposure⦿ Interview of the student and witnesses regarding events

leading up to incident⦿ Work with Child Nutrition if allergen was due to food served

by the school⦿ Review AIHP/504 plan(s)⦿ Replacement of epinephrine if used at school

In the rare event of a fatal reaction, the district’s crisis plan will be activated.

Level II Food Allergy TrainingQuestions?

Please see the school nurse!

THANK YOU!

⦿ Developed by Grapevine-Colleyville ISD

⦿ Edited by Keene ISD

⦿ Used by permission

⦿ Updated 2017Food Allergy II

Printable Food Allergy II Quiz