Most schools require all staff to receive training for anaphylactic reactions, including preventative strategies and emergency plans. For example, Montgomery County Public School teachers and support staff receive mandatory refresher courses each year to make sure that preventative measures and emergency protocols are in place. School-wide procedures ensure that emergencies related to anaphylactic reactions are handled swiftly and properly. However, in addition to standard trainings and school-wide response plans, teachers can implement classroom strategies to optimize student safety as well.
- Severe, life-threatening allergic reactions in children are most commonly caused by food. Thus, a simple treat given out for honor roll or positive behavior could pose a serious threat to students with severe food allergies. Instead of rewarding students with treats, teachers should consider non-food items for classroom celebrations and milestones. Items such as tokens for the school store, free homework passes, fidget toys, mechanical pencils, or positive handwritten notes home can be just as motivating, if not more so, than candy. If teachers do end up going the “treat” route, avoid food items that contain any of the Big 8, which are the top known allergens. These include milk, soy, wheat, peanuts, tree nuts, eggs, fish, and shellfish. Also, just because a food item does not contain that ingredient, does not necessarily mean that the manufacturer accounts for cross contamination. Food items that are processed or packaged alongside these allergens can be just as dangerous.
- While food is the typical culprit when it comes to anaphylaxis, reactions to insect stings, latex, and medications can be just as dangerous to students. Before teachers plan a field trip, lesson outdoors, or art project, they must consider how students with severe allergies could be impacted by a potential bee sting or latex reaction.
- Similarly, teachers and administrators should work with parents and the school nurse when planning excursions outside of the school building. Events such as Field Day, Outdoor Education, educational trips, and International Night should be carefully planned to include lists of students with severe allergies, as well as their medications and emergency plans should a reaction occur during the event. Teachers should also be informed of which students carry their own Epi-pens, and which are authorized to use the school’s auto injectors.
- Simple preventative measures work to reduce the number of anaphylactic-related emergencies in schools. For instance, when teachers have students working in the classroom during lunch to complete make-up work, ask questions, retake an assessment, etc., they should be sure to wipe down tables and desks after students have finished eating. A simple peanut butter smear, for a student with a severe peanut allergy, could result in an anaphylactic emergency.
- While it is more common to see an immediate reaction after ingestion or contact with an allergen, teachers should be aware of reactions that can potentially occur an hour or more after contact. If students with known allergies exhibit symptoms of anaphylaxis at random, even if they have not eaten recently, they should be seen by a medical professional immediately. When in doubt, teachers should call the nurse for assistance.
Prevention is always the best method; however, teachers know that emergencies happen all too often. Because of this, it is critical that teachers have an action plan in place to know exactly how to deal with an anaphylactic emergency:
- Call for help immediately. Many classrooms are equipped with emergency buttons that automatically call down to the office when triggered. Tell a student to hit the button if possible. If not, send a student next door to ask another classroom teacher to call for help immediately.
- Notify the office staff of the allergic reaction and ask that they bring an Epi-pen immediately. DO NOT leave the child to retrieve the Epi-pen yourself. Even if the health room is directly next door, the student should not be left alone at any point during his/her reaction; another adult should retrieve the Epi-pen.
- Clear the classroom for the student’s privacy and to ensure that medical staff, when they arrive, have swift, unobstructed access to the child.
- If possible, note the onset of symptoms and track the time before and after epinephrine has been administered, in case a second injection is needed.
- Remember, Epi-pens should be injected firmly into the outer thigh and can pierce directly through clothing.
- Do not throw the injector away; paramedics will need to know which medication and dosage was administered.