Medication in Schools for Pupils at risk of Allergic Reaction.
Name and date of birth of pupil
PROTOCOL FOR THE MANAGEMENT OF ALLERGIC EMERGENCIES IS
ON PAGE 3
Double-click on the text above to edit the header, then complete as appropriate
Health Care Plan for a Pupil with Medical Needs Date
Name of Pupil
Date of Birth
Condition Allergic reaction to
Class School
Contact Information
Family Contact 1
Name
Phone No: (home)
Mobile No
Relationship
Family Contact 2
Name
Phone No: (home)
Mobile No
Relationship
GP
Name
Phone No
Clinic/Hospital Contact
Name
Phone No
Plan Prepared By:
Name
Designation
Distribution
School DoctorSchool
Parent
(work)
(work) signature date
Nurse
Other (
HV/SN/Comm. Paed
)
Template version 24/7/2008; G Farmer/ J Austin Page 1

Medication in Schools for Pupils at risk of Allergic Reaction.
Name and date of birth of pupil
PROTOCOL FOR THE MANAGEMENT OF ALLERGIC EMERGENCIES IS
ON PAGE 3
Describe condition and give details of pupil’s individual symptoms/signs
Complete as appropriate
Condition Allergic reaction to
Document any chronic allergic disorders to prevent confusion
Please note that _ _ _ _ _ _ also has asthma and eczema.
– for example:
Emergency Situation. Symptoms and signs will appear after accidental exposure.
Describe the usual time course of the reaction – for example:
The onset is usually sudden (within seconds/minutes) but occasionally symptoms take a few hours to develop after contact with the offending item.
Causative Factors. Accidental contact with an item to which the child is allergic.
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Medication in Schools for Pupils at risk of Allergic Reaction.
Name and date of birth of pupil
PROTOCOL FOR THE MANAGEMENT OF ALLERGIC EMERGENCIES IS
ON PAGE 3
MILD REACTIONS
If in doubt
– give treatment
Symptoms Displayed; One or more of the following may occur

Itchiness even if no rash

Rash or blotchiness

Swelling around the eyes
Use the spaces to document any other reactions that the child may have experienced

Swelling around the mouth, with no difficulty breathing or swallowing


 If a child is unable to speak, or otherwise causing alarm, seek medical help and use the “severe reactions” protocol.
Indications for treatment; Any of the above symptoms or signs.
(For known asthmatics, if wheezy, give their usual asthma treatment in addition to the medication below.)
Medication Give generic and trade names of the antihistamine used, Delete if not applicable
Details of Dose State the dose in mg and mls
Method and time of administration By mouth, at the onset of symptoms.
NB
After administering medication;

Telephone and advise parents –(contact number on page 1). An agreement should be reached on ongoing supervision.

If symptoms are more severe after 10 minutes, or if there is no improvement after 20 minutes, repeat the dose. If this is required- seek medical help, as a period of clinical observation will be required.

Do not leave child alone

Observe in case he/she goes on to develop a serious reaction

If serious reaction develops follow protocol for Epipen administration (on next page)

Seek medical help if concerned, or a if a severe reaction develops
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Medication in Schools for Pupils at risk of Allergic Reaction.
Name and date of birth of pupil
PROTOCOL FOR THE MANAGEMENT OF ALLERGIC EMERGENCIES IS
ON PAGE 3
SEVERE REACTIONS (also known as “Anaphylaxis” or “Anaphylactic Shock”)
If in doubt
– give treatment
Symptoms Displayed One or more of the following may occur

Severe swelling of lips or face

Tongue becomes swollen

Difficulty breathing

Unable to speak

Wheeze*

Difficulty in swallowing

Neck feels funny

Feel weak or faint

Feeling of impending doom

May become unconscious

Use the spaces to document any other severe reactions that the child may have experienced.
Indications for treatment Any of the above symptoms or signs. (*Mild to moderate wheeze in the absence of other symptoms or signs indicates an asthma attack. This should be treated with the patient’s usual asthma medication, rather than Epinephrine. For known asthmatics, if wheezy, give their usual asthma treatment in addition to the medication below.
Delete if not asthmatic
Medication Epinephrine
Supplied as a preloaded pen device (Epipen)
..edit in Epipen Junior, if appropriate
Details of Dose Administer the pen device into the muscle on the outside of the thigh.
1. GIVE EPIPEN straight away – minutes count. It can be administered through light clothing.

2. PHONE 999 stating severe allergy and anaphylaxis

3. IF THE CHILD IS PALE OR FAINTING – keep them lying flat.

4. TELEPHONE GP if in a remote area where the response of the emergency services may be delayed
– (contact number on page 1)

5. Contact parents
– (contact number on page 1)

6. If no reaction 5 minutes after the Epipen injection, repeat the dose.

Delete this line if only only epipen has been
7. Do not leave the child alone - place in recovery position if unconscious
 provided
8. Observe breathing and pulse
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Medication in Schools for Pupils at risk of Allergic Reaction.
Name and date of birth of pupil
PROTOCOL FOR THE MANAGEMENT OF ALLERGIC EMERGENCIES IS
ON PAGE 3
Daily care requirements (e.g. before sport, dietary, therapy, nursing needs)
.
Children with this allergy should avoid eating, or even skin contact with the offending item and anything to which they are know to be allergic. The child should spit out any offending food if accidentally ingested.
Delete if not applicable (eg, allergy to insect stings)
The medication above should be carried on any school trips.
Action to be taken in an emergency Give medication and seek help as indicated above
Follow up care The child should not be left alone while symptoms persist.
Members of staff ( more than 1 in each school
) trained to administer medication for this child
(state if different for off-site activities)
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
I agree that the medical information contained in this form may be shared with individuals involved in the care and education of
………………………………………………………………………………………………………………..
Signed …………………………………………………………Date ……………………………………...
Parent or Guardian (or pupil if above the age of legal capacity)
Review date……………………………………………………
This document should be reviewed at annual intervals
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Medication in Schools for Pupils at risk of Allergic Reaction.
Name and date of birth of pupil
PROTOCOL FOR THE MANAGEMENT OF ALLERGIC EMERGENCIES IS
ON PAGE 3
Appendix to Protocol for Allergic Reactions
(including anaphylaxis)
A/ Important points about administration of medication:
1. If Epipen is given a phone call MUST simultaneously be made to 999, paramedics and the GP.
2. The child should go to hospital even if they appear to be recovered.
3. Epipen should be given to the outside of the thigh ( not in the buttock ).
4. The child must not be left alone.
5. Procedures must be in place in school for staff to seek help in emergency.
6. It is parents responsibility to ensure that the medication is kept within the expiry date.
7. A spoon should be provided for children who have liquid antihistamine.
B/ Schools’ Responsibilities:
1. To identify those children for whom an “allergic reaction” protocol has been provided.
2. Ensure that each affected child has a recent written protocol – ask parent to contact GP for update if the current version of the protocol is more than 1 year old
3. Ensure that a supply of antihistamine, for mild and non specific reactions, is available
4. Ensure that, for children with more severe reactions, a supply of adrenaline is available (Epipen, 2 syringes where appropriate)
5. Medication should only be given to the named child for whom the medication is intended.
6. Instructions and training on when and how to use medication

School Staff should volunteer to administer Epipen/Antihistamine.

It is recommended that all staff attend the training session and are then invited to volunteer.

School ancillary and auxiliary staff should be included in the training session.

The names of staff volunteers should be noted by the school on the protocol. The Head
Teacher is responsible for ensuring school staff are indemnified.

It is recommended that training takes place on an annual basis as school staff change with each school year. The Head Teacher should arrange this with the school nurse.

Schools may wish to send staff on training in CPR
7. To ensure that all staff, including non-teaching and playground staff, caring for these children are aware of the protocol, and of how to seek help in case of emergency. This must be reviewed when staff change, or when a child changes class. Catering staff need to be aware of children requiring special diets.
8. It is important that schools ensure information is transferred to a child’s new teacher at the start of each new school session. It is also important that any supply teachers are made aware of children with life threatening reactions.
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Medication in Schools for Pupils at risk of Allergic Reaction.
Name and date of birth of pupil
PROTOCOL FOR THE MANAGEMENT OF ALLERGIC EMERGENCIES IS
ON PAGE 3
9. Ensure staff are aware of when to seek medical assistance – for example, if a severe attack occurs, and if Epipen is given. In isolated areas, a GP may be able to attend more quickly than the ambulance.
10. Administrative procedures:
 ensure parents have completed written consent (sample letters in Scottish Office document)

Ensure all teachers are aware of how to send for help. The child should not be left alone. A
Red Card system with classroom number may by suitable.

A log book should be kept to note the date, reasons and medication given and signed by the member of staff giving it.

Be aware that it is the parents responsibility to keep medication up to date.

It is recommended that schools should return all medication to parents at the end of the school year for renewal the following session.

Advice on storage: ensure that Epipen and oral antihistamine is kept in a safe but accessible place known to all staff including the janitor, office and playground staff. Medication should be kept in a dark place at room temperature. Avoid extreme areas of heat.

A system to optimise ambulance access should be devised.

Useful websites include www.allergyinschool.co.uk
. and The Anaphylaxis Campaign
( www.anaphylaxis.org.uk
)
11. Schoo l staff should be familiar with the content of the Scottish Office document entitled “The
Administration of Medication in Schools”. This can be obtained from The Stationery Office Bookshop,
71 Lothian Rd, Edinburgh EH3 9AZ, tel 08706065566, www.scotland.gov.uk
.
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