\"Commentary\"~ FA precautions in Journal of School Health

Posted on: Sat, 12/02/2006 - 11:19pm
Gail W's picture
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Joined: 12/06/2001 - 09:00

Journal of School Health
November 2006
Vol. 76, No. 9
American School Health Association

Commentary
[i][b]Assuring the Safety of Severely Food Allergic Children in School[/i][/b]
Genevieve H. Hay, Thomas B. Harper III, Taylor G. Moore

pages 479 - 481

I won't transcribe the entire article, but it's a good general overview with multiple references to the American Academy of Pediatrics, AAAAI, and the ADA. I don't think you can obtain the article on line without being a member. I thought I'd post part of one section that might be helpful for parents trying to find resources to share with their schools. This section would be helpful to those trying to implement accommodations:

_______________________________________________
[i][b]Awareness and Inclusion of Students[/b]

Occasions when allergenic foods will be present in the cafeteria, classroom, or on school outings can be stressful for students with food allergies, their families, and school personnel. Avoidance is the key to managing food allergies. Thorough precautions should be taken to ensure that children with allergies do not have reactions or do not feel isolated or stigmatized because of their allergy.

Some fundamental school-wide precautions for students with severe food allergies include the following. First, the school personnel should be aware of offending foods and know how to read food labels. Second, the cafeteria must provide safe substitutions at no extra cost to families. Third, trading of food and utensils must be strictly prohibited. Fourth, since some allergic children react to physical contact with offending foods, including residue on uncleaned tables and materials, the surface areas of tables and toys should be thoroughly cleaned with warm, soapy water followed by a wipe down with a fresh paper towel. Implementing milk-free and peanut-free tables in the cafeteria where allergic students can eat their lunches safely may be considered. Fifth, to prevent physical contact contamination, all students and personnel should practice hand washing after handling food. Finally, foods used in lessons or on class t rips should be free of offending foods and ingredients and should be purchased with complete product labeling. ]When food substitutions are made in a lesson, use the same substitution for the entire class to avoid singling allergic students out as different.[/i]

___________________________________________________

Posted on: Sun, 12/03/2006 - 2:10am
Momcat's picture
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Joined: 03/15/2005 - 09:00

Gail,
This looks like a great article! Thanks for posting it. I just sent in a request for a copy from our county library system.
Cathy

Posted on: Sun, 12/03/2006 - 2:16am
Joanne's picture
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Joined: 02/22/1999 - 09:00

There's also more in this article making it quite clear that there shoudl be an emergency plan in place, and that food allergic children are covered under ADA:
SCHOOL EMERGENCY PLANNING AND RESPONSE
The American Academy of Pediatrics Committee on School Health recommends that schools be equipped to treat anaphylaxis in students. (1,2,6) [b]Public schools must comply with the physician's emergency treatment plan and with the Americans with Disabilities Act (ADA), which mandates accommodations for students with allergies. (1) ADA accommodations include participation of students with allergies in all activities, developing and efficiently implementing a food allergy plan, and making sure medications are always accessible.[/b]
In conjunction with the allergist, the parent of a child with a life-threatening food allergy should contact the teacher and school nurse to explain the condition, answer questions, and develop an emergency plan. At least 2 automatic epinephrine injection devices (Epi-Pen[R], Epi-Pen[R] Jr, or Twinject[TM]) should be supplied by the parents for all children with previous food reactions. (1,2) These devices should accompany the child on class trips or any outings. (1,2,8) [b]An individual child's emergency plan [/b] should delegate who carries and administers the medication; who calls the emergency medical services, parents, and physician; and who will stay with the child having the reaction. A child experiencing an allergic reaction should not be left alone.
The school should develop a procedure for alerting the child's teachers and a prominent notation should be made on the child's health record. Teachers and other school personnel should be prepared to respond to food allergic reactions by being trained to administer cardiopulmonary resuscitation (CPR) and first aid. Phone numbers of the nearest medical facility and the estimated response time of a local emergency medical services (EMS) team should be determined.
When implementing the emergency plan, school personnel should begin with recognition of the symptoms and prompt administration of epinephrine. Additional measures including medication administration should be deferred to EMS personnel or to physicians in an emergency room. In a designated sequence, calls should be made to emergency medical services (911), parents, and the child's physician (if phone number is available). Under no circumstances should the child having the anaphylactic reaction be transported by school personnel to an emergency facility unless no emergency transport services are available in the community. Prompt therapy with epinephrine at the school site and intervention of emergency medical services at the site and during transport are mainstays of therapy to reverse a potentially life-threatening anaphylactic reaction.

Posted on: Sun, 12/03/2006 - 10:52am
TwokidsNJ's picture
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Joined: 05/28/2005 - 09:00

Thank you! This will help as support with a letter I am writing to our Superintendent.
How can I get the entire thing?
edited to add: Emailed you but it didn't work. Can you possibly post it in sections or something? Thanks!!!! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
[This message has been edited by TwokidsNJ (edited December 03, 2006).]
[This message has been edited by TwokidsNJ (edited December 04, 2006).]

Posted on: Mon, 12/11/2006 - 1:06am
beachfan's picture
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Joined: 02/15/2006 - 09:00

Gail, I would love to get the entire article also. The inclusion aspect is helpful and I would be interested to find if there are any recommendations given to notify parents when food is being brought in so the pa student can feel included.
Thanks for the information.

Posted on: Mon, 12/11/2006 - 5:31am
Momcat's picture
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Joined: 03/15/2005 - 09:00

I'm not sure if it's ok to post a copy-righted article, but I was able to get a copy from my county library system. Just call the reference desk with the journal and article title and the date of the issue. Often these services are free or only the cost of making copies.
Cathy

Posted on: Mon, 12/11/2006 - 7:06am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Thanks Cathy.

Posted on: Sun, 12/03/2006 - 2:10am
Momcat's picture
Offline
Joined: 03/15/2005 - 09:00

Gail,
This looks like a great article! Thanks for posting it. I just sent in a request for a copy from our county library system.
Cathy

Posted on: Sun, 12/03/2006 - 2:16am
Joanne's picture
Offline
Joined: 02/22/1999 - 09:00

There's also more in this article making it quite clear that there shoudl be an emergency plan in place, and that food allergic children are covered under ADA:
SCHOOL EMERGENCY PLANNING AND RESPONSE
The American Academy of Pediatrics Committee on School Health recommends that schools be equipped to treat anaphylaxis in students. (1,2,6) [b]Public schools must comply with the physician's emergency treatment plan and with the Americans with Disabilities Act (ADA), which mandates accommodations for students with allergies. (1) ADA accommodations include participation of students with allergies in all activities, developing and efficiently implementing a food allergy plan, and making sure medications are always accessible.[/b]
In conjunction with the allergist, the parent of a child with a life-threatening food allergy should contact the teacher and school nurse to explain the condition, answer questions, and develop an emergency plan. At least 2 automatic epinephrine injection devices (Epi-Pen[R], Epi-Pen[R] Jr, or Twinject[TM]) should be supplied by the parents for all children with previous food reactions. (1,2) These devices should accompany the child on class trips or any outings. (1,2,8) [b]An individual child's emergency plan [/b] should delegate who carries and administers the medication; who calls the emergency medical services, parents, and physician; and who will stay with the child having the reaction. A child experiencing an allergic reaction should not be left alone.
The school should develop a procedure for alerting the child's teachers and a prominent notation should be made on the child's health record. Teachers and other school personnel should be prepared to respond to food allergic reactions by being trained to administer cardiopulmonary resuscitation (CPR) and first aid. Phone numbers of the nearest medical facility and the estimated response time of a local emergency medical services (EMS) team should be determined.
When implementing the emergency plan, school personnel should begin with recognition of the symptoms and prompt administration of epinephrine. Additional measures including medication administration should be deferred to EMS personnel or to physicians in an emergency room. In a designated sequence, calls should be made to emergency medical services (911), parents, and the child's physician (if phone number is available). Under no circumstances should the child having the anaphylactic reaction be transported by school personnel to an emergency facility unless no emergency transport services are available in the community. Prompt therapy with epinephrine at the school site and intervention of emergency medical services at the site and during transport are mainstays of therapy to reverse a potentially life-threatening anaphylactic reaction.

Posted on: Sun, 12/03/2006 - 10:52am
TwokidsNJ's picture
Offline
Joined: 05/28/2005 - 09:00

Thank you! This will help as support with a letter I am writing to our Superintendent.
How can I get the entire thing?
edited to add: Emailed you but it didn't work. Can you possibly post it in sections or something? Thanks!!!! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
[This message has been edited by TwokidsNJ (edited December 03, 2006).]
[This message has been edited by TwokidsNJ (edited December 04, 2006).]

Posted on: Mon, 12/11/2006 - 1:06am
beachfan's picture
Offline
Joined: 02/15/2006 - 09:00

Gail, I would love to get the entire article also. The inclusion aspect is helpful and I would be interested to find if there are any recommendations given to notify parents when food is being brought in so the pa student can feel included.
Thanks for the information.

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