101 Spruce St. N. Timmins, ON P4N 6M9 Phone: (705) 268-7443 Fax: (705) 267-3590 Toll Free : (877) 422-9322 www.ncdsb.on.ca NORTHEASTERN CATHOLIC DISTRICT SCHOOL BOARD ANAPHYLAXIS Administrative Procedure #: APE015 The Northeastern Catholic District School Board believes that all students and staff are entitled to safe and healthy learning and working environments. To this end, the NCDSB will be diligent in its efforts to reduce the risks of anaphylactic shock as much as it is possible to do so. The NCDSB further supports the notion that students and staff with a life-threatening allergy (anaphylaxis) develop independence with regard to advocating for their personal situation within their school community. REFERENCES Bill 3: Sabrina’s Law – An Act to Protect Anaphylactic Pupils, 2005 NCDSB Policy E-22: Anaphylaxis NCDSB Policy E-6: Provisions of Health Support Services in Schools NCDSB Administrative Procedure APE012: Provisions of Health Support Services in Schools North East Tri-Board Transportation Policy and Procedures Mayo Clinic (online resources) DEFINITIONS ANAPHYLAXIS Anaphylaxis means a severe allergic reaction, which can result in systemic shock that is often severe and sometimes fatal. EPINEPHRINE AUTO-INJECTOR An epinephrine auto-injector is a medical device for injecting a measured dose or doses of epinephrine (adrenaline), by means of auto-injector technology. For the purposes of this procedure, an epinephrine auto-injector would be used in response to anaphylaxis. EPI-PEN An Epi-Pen® is a frequently used epinephrine injector that contains one dose of epinephrine in one pen which is administered with an auto-injector. TWINJECT A Twinject® is a frequently used epinephrine injector that contains two doses of epinephrine in one pen. The first dose is administered with an auto-injector. The second is administered by manual injection. ALLERJECT Allerject® is an epinephrine auto-injector for the emergency treatment of severe allergic reactions. NORTHEASTERN CATHOLIC DISTRICT SCHOOL BOARD MORE APE015 - ANAPHYLAXIS PAGE 2 PROCEDURES A. SYMPTOMS OF ANAPHYLAXIS REACTIONS All staff shall be made aware of the possible symptoms of anaphylaxis reactions. Anaphylaxis symptoms usually occur within minutes of exposure to an allergen. Sometimes however, anaphylaxis can occur a half-hour or longer after exposure. Anaphylaxis symptoms include: Skin reactions, including hives along with itching, and flushed or pale skin (almost always present with anaphylaxis) A feeling of warmth The sensation of a lump in your throat Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing A weak and/or rapid pulse Nausea, vomiting or diarrhea Dizziness or fainting B. RESPONSIBILITIES AND ACTIONS Principals 1. Upon registration, the principal will present this policy to parents or guardians of students with anaphylaxis and ensure that they become familiar with it. The principal will discuss with them the severity of the student’s allergies. The principal is required to have parents complete the requisite forms consistent with these procedures. 2. The principal shall prepare an intervention plan for each anaphylactic student in order to ensure that the school is a safe environment for the anaphylactic student. The individual intervention plan shall include: 2.1 details informing employees and others who are in direct contact with the student on a regular basis of the type of allergy, monitoring and avoidance strategies and appropriate treatment; 2.2 a readily accessible emergency procedure for the pupil, including emergency contact information; and 2.3 storage for epinephrine auto-injectors, where necessary. 3. The principal shall maintain a file for each anaphylactic student of current treatment and other information, including a copy of any prescriptions and instructions from the pupil’s physician or nurse and a current emergency contact list. APE015 - ANAPHYLAXIS PAGE 3 Parent/Guardian Responsibilities 1. At the beginning of each year, parents or guardians of those students identified as being at risk of anaphylactic reactions shall complete the following forms in a clear and precise manner: Emergency Intervention for Allergic Reactions - Student Information Sheet Life Threatening Situation for High Risk Students - Parental Consent Form 2. It is the responsibility of the parent or guardian to advise the school in writing of any changes occurring in the student’s medical condition during the school year. 3. It is imperative that every anaphylactic student provide his or her own properly identified and dated EpiPen Auto-Injector to the school to be stored in an appropriate location in the school. It is advisable that anaphylactic students should carry a second EpiPen on their persons at all times. When it is necessary to proceed with a self-injection, a staff member will be available to provide assistance. 4. Each anaphylactic student should wear a MEDIC-ALERT bracelet. C. COMMUNICATION STRATEGIES AND EXPECTED ACTIONS 1. School principals, with the assistance of parents or guardians, shall make all members of the school staff aware of the information supplied by the parents upon registration. 2. In accordance to the individual case, the teacher will explain the situation to the other students in class and ask for their cooperation. 3. Correspondence will be sent home from the school advising parents of the nature of anaphylaxis and request cooperation to reduce the risk of anaphylaxis. 4. The form Emergency Intervention for Allergic Reactions - Student Information Sheet and the information sheet any detailed information sheets on how to use the epinephrine auto-injector are to be posted in easily accessible areas of the school (such as but not limited to: the administration office, staff lounge, classrooms) and, with the consent of parents or guardians, shared with all persons having to interact with the student. 5. Copies of the documentation shall be brought along on field trips. 6. The school principal shall work with the parents or guardians of an anaphylactic student and the public health nurse in informing the school staff, including the custodian, the supply teachers, the persons providing supervision at lunch and in the school yard, the parents or guardians of classmates, the members of the Catholic school council, volunteers, other students, and other individuals who are in direct contact with the student on a regular basis about the following: 6.1 any food allergies and their severity; APE015 - ANAPHYLAXIS PAGE 4 6.2 how to recognize the symptoms of an allergic reaction; 6.3 how to administer the appropriate medications in emergencies. D. STRATEGY CONSIDERATIONS Greater School Community When an anaphylactic child is in attendance in the school, the school shall 1. discourage the exchange or sharing of food, utensils or food containers; 2. suggest that anaphylactic children eat only those foods prepared at home; 3. ensure that, according to each case, no identified allergens be used in family studies, arts, special events; 4. limit exposure to any identified allergens in school lunches, special events, or other related activities. 5. not allow students with an anaphylaxis to participate in the removal of garbage. Classroom Setting When an anaphylactic child is in attendance in a classroom, the teacher shall ensure: 1. that the students wash their hands before and after eating; 2. that the desks and other surfaces used for eating are cleaned before and after the meal; 3. that those students have access to an area where the risk of contact with allergens is at a minimum for snacks and meals. Allergies to Insect Stings When an anaphylactic child, allergic to insect stings, is in attendance, the principal shall: 1. take precautions to ensure that insect nests and/or hives in the vicinity of the school are removed periodically; 2. ensure that garbage and garbage cans are stored in closed containers. Extracurricular Activities/Educational Excursions For extracurricular activities and/or educational excursions, the supervisor shall: 1. ensure that the pertinent information included in the support document accompany the student during the activity in question; 2. ensure that all monitors, staff members, parents, etc... are aware, of the identity of the anaphylactic student as well as the forbidden food items or other anaphylactic triggers, of the symptoms and the emergency steps to take; 3. ensure that the person responsible for the anaphylactic student is informed about the procedure to follow in using the EpiPen Auto-Injector; APE015 - ANAPHYLAXIS PAGE 5 4. if possible, have access to a cellular phone; 5. suggest that the parent or guardian supply several EpiPen Auto-Injectors; 6. not allow the student from partaking in the activity if the risks are too great. This decision is to be made in consultation with the parents or guardians. E. TRANSPORTATION SERVICES The principal shall work in collaboration with the Manager of Transportation Services (North East Tri-Board Transportation Consortium) and parents/guardians of a student with anaphylaxis to ensure that bus drivers have the required information relating to the student’s condition. The school principal will follow the policies and procedures specific to the Tri-Board Transportation Consortium. Director of Education: Glenn Sheculski Date: August 2015