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Dealing with anaphylaxis in schools

Anaphylaxis in schools
If your child suffers from a severe food allergy, sending them to school every day can be a daily battle of trust. Jo Willacy takes a look at policy, action plans and training for parents and school staff to help tackle allergy management concerns.

Dealing with allergies can be incredibly stressful for both children and parents, but it can help to know that your child is well cared for during those hours spent at school. Although some people are clued up when it comes to dealing with an allergic reaction, many are not and allergies are still often misunderstood.

Luckily, through policy changes, campaigning and training, sending your child out into the world doesn't have to be anxiety-inducing. The more information about anaphylaxis everyone has, the better.  

Why it's important for schools to be involved in anaphylaxis care

"Every school is likely to have at least one child who is severely food allergic and nut allergy is particularly common, with one in 50 children nationwide thought to be affected," explains Mandy East, National Coordinator at the Anaphylaxis Campaign.

"In severe cases of anaphylaxis the reaction will include nettle rash anywhere on the body, swelling of the throat and mouth, severe asthma, nausea and vomiting. In very severe cases there may be collapse and unconsciousness, although this is rare," says Mandy.

This reaction can, in some children, be caused simply by breathing in the food particles that someone else has eaten or touching a surface that had the food item on it and putting their hand to their mouth.

The seriousness of the symptoms need a very quick reaction using an injection of adrenaline (also called epinephrine) delivered into the muscle in the side of the thigh. It is vital that it is administered as soon as symptoms of a severe reaction appear because if treatment is delayed the consequences can be fatal.

This is why it is essential for schools to have several members of staff on hand who know exactly what is required in this situation and can react quickly.

Primary schools' legal responsibility for children with allergies

Public attitude and policy has drasticallly changed in the past few years when it comes to anaphylaxis awareness and guidance. Since 2014, under the Children and Family Act, schools have a legal duty to make arrangements for those with allergies. The guidance for this legislation states:

  • Children with medical conditions should be properly supported so that they have full access to education, including school trips and physical education.
  • Governing bodies must ensure that arrangements are in place in schools to support pupils at school with medical conditions.
  • Governing bodies should ensure that school leaders consult health and social care professionals, pupils and parents to ensure that the needs of children with medical conditions are properly understood and effectively supported.

Since 2017, under the Human Medicines (Amendment) Regulations, schools have been allowed to obtain spare AAI devices (adrenaline auto-injectors) for emergencies. These are in addition to any AAIs a child may already bring to school. The school needs parental permission and medical approval to use the spare AAI device on a specific child. 

For those children who have allergies and are at risk of anaphylaxis but have not been prescribed an AAI, the school can administer a spare one if:

  • There is a care plan in place confirming the risk of anaphylaxis.
  • A healthcare professional has authorised its use. 
  • There is parental consent. 

Severe food allergy: the primary-school parent's action plan

If your child suffers from a severe food allergy the Anaphylaxis Campaign suggests the following:

  • Notify the school and make sure there is clear communication about your child’s particular food issue
  • Work with the school to develop a plan throughout the school including in the classroom and the dining areas and any extra clubs or activities your child attends at the school
  • Make sure your child’s medication is in date (check it regularly)
  • Educate your child in how to manage the allergy themselves, including what are safe and unsafe foods for them, avoiding allergens, how to spot the symptoms of an allergy and how and when to tell an adult of a reaction 

Training and support for parents and teachers

The Anaphylaxis Campaign offer free primary and secondary resources as part of its Making Schools Safer Project, which include lesson plans and assembly presentations.

There is an online 45-minute training Allergywise course for parents and school staff – completely free.

Doctor Doyle YouTube videos also provide plenty of helpful tips and information about using AAIs and advice on what can trigger an allergy. 

'A piece of toast with peanut butter on it felt like a loaded gun to me'

Tamsin Schwab, 41, is mum to Jack, 11 and Sam, five and they live in London with dad John, 41. Jack was diagnosed with a cashew nut allergy when he had a near fatal allergic reaction when he was aged three, while they were on holiday in Menorca.

‘Jack had been eating peanuts since he was 18 months – John is American so we often fed him peanut butter and jelly sandwiches. When he had the anaphylactic reaction from eating cashew nuts – when we literally thought we were going to lose him – it was a total shock to us and it changed everything. It is life-threatening, and although it's not like other diseases, there is a constant reminder of how careful you have to be.

'When it first happened Jack had just started nursery and I had this sense that I just wanted to take him away. I cried every time I dropped him off. At primary school it became a case of us learning along with the school, who had never had a pupil with this issue before. I found it hard to tell other parents not to bring in nuts to school in the beginning, but when I saw a child carrying a piece of toast with peanut butter on it, it felt like a loaded gun to me. Luckily one of the staff at the school took it upon herself to take the issue on board and was brilliant – we couldn't have done it without her. I was on the phone to her most weeks and she would write letters to parents to tell them not to send their child in with nut-laden muesli bars.

'It still took me to when Jack was in the last year of primary at aged 11 – years of being a dramatic mother and making a big issue of it – to relax and trust the school to deal with it. Now he is at secondary school, he is much more in control of it himself.

'If your child has been recently diagnosed, make sure you talk to the school nurse or the member of staff who is first aid qualified, as well as the class teacher. You need to stress the potential seriousness of the situation and not worry about being an annoying mother. It is possible to relax about it, but you do need to have your strategy in place and trust not only your child but school staff as well.'

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