Orleans Central Supervisory Union
FOOD ALLERGY POLICY & PROCEDURES
Policy & Procedure: Food Allergy Management in School
Schools in the Orleans Central Supervisory Union recognize the increasing prevalence of life
threatening allergies among school aged children and are committed to providing a safe and
healthy environment for all students. Understanding that the risk of accidental exposure to
allergens can be reduced in the school setting, we will work with parents, students and health
care providers to minimize risks and be prepared to respond appropriately in an emergency.
The focus of allergy management shall be on prevention, education, awareness,
communication, and emergency response.
The goals for allergy management include:
1. A process for reducing allergen exposure risk and developing emergency plans for
students with life-threatening allergies from PreK-12. This process is outlined in the
guidelines that follow.
2. To maintain the health and protect the safety of students with life-threatening allergies
with strategies that are:
a. developmentally appropriate
b. promote self-advocacy and competence in self-care
c. ensure equal educational opportunities.
3. To ensure that Individual Healthcare Plans (IHPs) and Food Allergy Action Plans
(FAAPs) for students with life threatening allergies are based on medically accurate
information and evidence-based practices.
In accordance with applicable law, it is the policy of Orleans Central Supervisory Union to
provide all students, through reasonable accommodations where required, the opportunity to
participate in all school programs and activities. Accordingly, school administrators and staff
will work proactively with parents to assure that the needs of children with life threatening
allergies are taken into consideration in the conduct of education within the supervisory union.
The OCSU coordinator of school health services will ensure the supervisory union’s
management plan is reviewed and updated as needed annually.
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Orleans Central Supervisory Union
FOOD ALLERGY POLICY & PROCEDURES
BACKGROUND
Food allergy reactions can span a wide range of severity of symptoms. The most severe and
potentially life threatening reaction is anaphylaxis. This protocol is to be used for students
who are at risk for anaphylaxis. When a physician assesses that a child’s food allergy will
result in anaphylaxis, the child’s condition meets the definition of “disability” and may be
covered under the Federal Americans with Disability Act (ADA), Section 504 of the
Rehabilitation Act of 1973, if the allergy management affects the student’s ability to access
education.
Anaphylaxis refers to a collection of symptoms affecting multiple systems in the body, the most
dangerous of which include a compromised respiratory system and shock. Foods that most
commonly cause anaphylaxis include, but are not limited to, peanuts, tree nuts, shellfish, milk,
wheat, soy, fish, and eggs. These severe allergic reactions can occur within minutes of
ingestion/exposure or can be delayed for up to two hours. Some reactions are “biphasic” in
nature with an initial period of symptoms, a symptom free period of 2-3 hours followed by
severe shock-like symptoms. At present the only treatments for severe food allergies are:
 Strict avoidance to prevent reactions
 Emergency administration of epinephrine and/or diphenhydramine in the event of
exposure, followed by initiation of the EMS response system. Exposure may occur
by ingestion, inhalation, or dermal contact
MEDICATIONS
The most commonly prescribed medications for the treatment of anaphylaxis are:


diphenhydramine (brand name Benadryl), an antihistamine, which comes in many
oral forms: tablets, liquids, liquid-gel capsules, and rapid-dissolve strips
*epinephrine (brand name EpiPen, EpiPen Jr, and Twinject auto injectors), a form
of adrenalin, in doses of 0.15mg for those 33-65 lbs. and 0.3mg for those > 66 lbs.
to be injected intramuscularly.
Note:
EpiPen is a single dose auto-injector which can be packaged singly or doubly to
provide one or two doses respectively.
Twinject contains two doses of epinephrine, the first dose in an auto-injector and
the second dose in the form of a traditional injection by syringe. Orleans Central
Supervisory Union recommends against the use of the Twinject in the school
setting as the second dose (syringe) is an inappropriate design for use by
unlicensed personnel.
*Current (Nov 2010) guidelines from the National Institute of Health recommend epinephrine
administration immediately, but many health care providers still order the administration of diphenhydramine first.
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Orleans Central Supervisory Union
FOOD ALLERGY POLICY & PROCEDURES
CARE PLAN CONSIDERATIONS/OPTIONS
1. An Individual Healthcare Plan (IHP) is developed by the school nurse, student, parents,
and other school personnel to identify a student’s individual nursing needs and specific
strategies to meet those needs.
2. A Food Allergy Action Plan (FAAP) is developed by the school nurse, and
physician/healthcare provider with input from parents, student, and/or other school
personnel to outline emergency steps to be implemented in the event of exposure or
possible exposure to the food allergen. See sample at the end of this document.
3. Section 504 Plan- The intent of Section 504 of the Rehabilitation Act of 1973 is to provide
students with disabilities equal access to educational programs, services, and activities.
Students with disabilities may not be denied participation in school programs and activities
solely on the basis of disability. Whether students with life-threatening food allergies are
identified under Section 504 as disabled individuals or not, schools within the Orleans
Central Supervisory Union will provide those students with IHPs and FAAPs to address
their health and safety needs.
SPECIFIC RESPONSIBILITIES:
Parent/Guardian
1. Inform the school nurse of your child’s allergies before the student begins attending (or as
soon as possible after diagnosis). All severe food allergies must be verified by the
student’s physician/healthcare provider.
2. Provide your child with a medical alert bracelet/necklace.
3. Teach your child to:
 Recognize the first symptoms of a food allergy/anaphylactic reaction.
 Wash hands before and after handling food.
 Communicate the appearance of anaphylaxis symptoms ASAP to the school
nurse, teacher or other trusted adult
 Carry his/her epinephrine auto-injector (EPIPEN), if appropriate to age, maturity
level, and situation.
 Self-administer epinephrine auto-injector.
 Not share snacks, lunches, drinks or utensils.
 Report teasing and/or bullying that relates to the allergy to a trusted adult.
 Read food labels for ingredients.
 Know of allergy-safe zones and behaviors.
4. Work with the school to develop plans (IHP, FAAP, 504) to provide accommodations and
an appropriate emergency response in the classroom, cafeteria, and at school sponsored
activities.
5. Complete (including obtaining physician input) and submit all required medication, medical
release, and FAAP forms.
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Orleans Central Supervisory Union
FOOD ALLERGY POLICY & PROCEDURES
6. Inform the school of changes in your child’s food allergy status, your home, work and cell
phone numbers, medical information and emergency contact information.
7. Provide emergency medication and replace when it becomes out-of date.
8. Chaperone your child’s field trips when possible/requested.
9. Provide “reserve safe snacks” to be kept in your child’s classroom so there is always
something your child can choose from during an unplanned special event.
Student
1. Ask the school nurse, your teacher, or another trusted adult in the school to help you if
problems arise relating to your food allergy.
2. Use proper hand washing (soap, water, friction) before and after eating and throughout the
school day.
3. Do not share or trade foods or eating utensils with others. Use strategies to avoid food
allergens.
4. Do not eat anything with unknown ingredients.
5. Communicate about your food allergy with others
6. Tell an adult immediately, if you eat or are exposed to (inhaled, or touched) the food
allergen.
7. Tell an adult immediately if you are being bullied or harassed about your food allergy.
8. Make sure you always have access to your emergency medication, whether it is in
the nurse’s office, your classroom, your coach has it; you are carrying it, etc.
9. Work towards greater responsibility and independence in managing your food allergy
including self-administration of your emergency medication.
10. Demonstrate maturity and responsibility when carrying your emergency medication.
11. Be aware of your environment and how it relates to your allergy.
12. Know and understand your responsibilities with regard to your food allergy and safety.
School Administration
1. Ensure that all applicable federal laws (including ADA, Section 504, FERPA, and HIPAA),
all state laws and district policies/guidelines that apply are followed.
2. Ensure that plans (IHP, FAAP and/or 504) are developed to provide a safe learning
environment for each student with life threatening allergies.
3. Ensure that the above plans are implemented
4. Ensure staff training and education for appropriate staff which includes:
 reducing life-threatening allergy risks
 recognizing food allergy symptoms
 emergency procedures and location of emergency medications
5. Respond immediately to reports of students being teased or bullied about their food
allergies.
School Nurse
1. Work with parents, school staff, and student’s physician/health care provider to develop
and implement appropriate IHP, FAAP and/or 504 plan(s).
2. Maintain up-to-date emergency medications
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Orleans Central Supervisory Union
FOOD ALLERGY POLICY & PROCEDURES
3. Act as liaison between the school and student’s physician/health care provider regarding
the IHP, FAAP and 504 plans.
4. Maintain and update the IHP and FAAP. Communicate any changes to staff ASAP.
5. Provide information and training to school staff regarding the IHP, FAAP, and emergency
medication administration as appropriate.
6. Provide necessary information, training and medications as needed for field trips.
7. Respond immediately to reports of students being teased or bullied about their food
allergies
Teachers
1. Participate in the development and implementation of the student’s IHP, FAAP and/or 504
plans.
2. Consider the ramifications of any food use (curriculum, projects or celebrations) within your
classroom.
3. Know the signs and symptoms of anaphylaxis (life-threatening allergic reaction) as
provided in the student’s IHP.
4. Implement the activities and accommodations cited in the students’ IHP and/or 504 plans,
and be prepared to implement the FAAP if needed.
5. Become proficient in emergency medication administration.
6. Communicate with your students and their parents for their cooperation in providing a safe
classroom environment.
7. Reinforce appropriate classroom hygiene practices/hand washing before and after eating,
and no sharing of food or utensils.
8. Respond immediately to reports of students being teased or bullied about their food
allergies.
9. Notify the parents and school nurse in advance of any field trips or other situations that
might impact a student’s IHP, FAAP and/or 504 plan(s).
Food Service
1. Know all foods/ingredients utilized in the kitchen.
2. Know signs & symptoms of anaphylaxis and emergency protocols related to food allergies.
3. Employ strategies and practices to avoid cross contamination of foods:
 Allergen-free prep areas in the kitchen
 Allergen-free tables in the cafeteria
 Frequent and careful hand washing
4. Use non-latex gloves in food preparation and service.
5. Maintain a current list of students with food allergies.
6. Respond appropriately to all concerns related to food allergies.
7. Respond immediately to reports of students being teased or bullied about their food
allergies.
Custodian
Follow current recommendations for the cleaning/maintenance of allergen-free tables and
areas.
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Orleans Central Supervisory Union
FOOD ALLERGY POLICY & PROCEDURES
Bus Driver/Company
1. Enforce “No Eating or Drinking” policy on the bus.
2. Be knowledgeable regarding students’ FAAP plans, and skilled in first aid, CPR and
emergency medication administration.
3. Maintain emergency communication devices (e.g., cell phones, two-way radios,
etc.) on busses.
4. Respond immediately to reports of students being teased or bullied about their food
allergies.
OTHER IMPORTANT POINTS
After School Activities
1. The IHP and/or FAAP will be available for parents to copy and give to others who
assume responsibility for their child.
Field Trips
1. Life threatening food allergy exposure risks will be considered in the planning and
implementation of field trips.
2. Parents will be invited/encouraged to attend or chaperone.
3. Bag lunches of children with food allergies will be stored separately to minimize cross
contamination.
4. Attending staff will ensure that the FAAP and emergency medications are available and
followed if needed.
5. Emergency Medical Services (911) will be called in all instances of anaphylaxis.
Additional Thoughts
1. Educate, Educate, Educate. Severe food allergy management is an ongoing process that
evolves with student needs and staff changes. Food bans do not work because it creates a
false sense of security. Today, processed foods contain trace amounts of food items that
are not always identified on the food label.
2. Special events/Non-routine days. The greatest risk for a life threatening allergic reaction
exists when the normal routine is broken such as classroom parties, field trips, a substitute
teacher, or after school events.
3. Be Prepared. Always have the FAAP and emergency medications available and think
ahead to prevent possible exposure to a food allergen.
4. Symptoms vary greatly. Call 911 when anaphylactic symptoms occur or if ingestion is
strongly suspected. Use emergency medication if needed following the FAAP.
5. Be safe, not sorry! Take all complaints from children with food allergies very, very
seriously.
6. A child with a life threatening food allergy should NEVER eat food of undetermined
ingredients.
7. Cross contamination. It only takes a trace amount of the food protein (allergen) to cause
an allergic reaction. Hand washing and thorough cleaning of all possible surfaces (tables,
desks, chairs, counters, utensils, dishes, mixing bowls, etc.) where an allergen has been
used is absolutely necessary to prevent exposure from cross contamination,
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