Kendallvue Elementary School

Allergic Reactions and Anaphylaxis

Allergic reactions are a concern for students at school. While seasonal allergies can be distracting, they are not life threatening. If your student has seasonal allergies or pet type allergies, please see the page on Medications for further information.

Students with a history of life-threatening allergies should have emergency medication at school. Anaphylaxis is a serious allergic reaction that can be rapid in onset and may cause death. It is the most severe reaction to an allergen. Early recognition and treatment is critical!

The most common cause of an allergic reaction is food. ANY food can cause a reaction, but the most common foods that cause allergic reactions are milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, and soybeans. These are sometimes referred to as The Big-8. Allergic students may accidentally encounter problem foods as several of the Big-8, especially eggs, milk, wheat, and soybeans are often used in processed products and can be "hidden."

Other possible causes of allergic reaction are insect stings or bites, latex, and medications. While students will not be exposed to any medications at school other than those designated for their use by parents and health care providers, it is important that parents notify the school of these allergies. If a student were ever transported to a medical facility by emergency medical responders, information on allergies should be available to medical personnel to keep the student safe.

Prevention and Treatment

Food allergy prevalence is rising, and scientists are working to better understand why. Prevention is the best method of avoiding allergic reactions. While we cannot guarantee allergen free schools or classrooms, there are ways we can support students with allergies.

• Help student to avoid allergens by requesting that parents sign a Medical Statement for Disability - School Meal Modification (SD-1)
• Communicate with all staff about potential allergens and recognition of allergic reaction signs and symptoms
• Notify classroom teachers of allergies related to class parties
• Trains and delegate the use of Epinephrine for severe reactions
• Make stock Epinephrine available to administer for undiagnosed allergic reactions by designated personnel in an emergency
• Hang signs on classroom door or cafeteria: Food Aware or Latex Aware
• Encourage hand washing before AND after meals and snacks

Signs and Symptoms

Mild symptoms involve only ONE body system, but can be any of the following:

• oral – itching or tingling
• skin – itching , hives, or mild swelling
• gut – nausea or discomfort/stomach ache
• nose – runny, stuffy, sneezing

Typically, mild symptoms are treated with an antihistamine if available, such as Benadryl (diphenhydramine). If symptoms are worsening or appear to involve more than one body system, directions for severe reactions will be followed.

Severe allergic reactions involve worsening of mild symptoms, symptoms in more than one body system, or more exaggerated symptoms:

• oral – swollen lips or tongue
• skin – itching, hives, swelling
• gut – nausea, vomiting, diarrhea
• nose – runny nose, cough, wheeze, shortness of breath
• cardiovascular – light-headedness, loss of consciousness, blue or gray around lips
• general – anxiety, sense of doom, may say they feel they are going to die
• NOTE: younger children may describe unusual sensations in their mouths like “my tongue itches.”

Severe allergic reactions will be treated with the student’s Epinephrine, or with stock Epinephrine for previously undiagnosed allergic reactions. Emergency services/911 is always called when symptoms of anaphylaxis are observed. Emergency services/911 is always called when Epinephrine is administered. These calls are Jeffco Public Schools district policy, but are also medically necessary!

While Epinephrine works well to halt progression of allergic reactions, it is a short-acting medication and additional medical attention will be necessary to ensure that symptoms do not begin again when the medication wears off!

Recognize and Respond to Anaphylaxis!

Emergency Medications

In order to store emergency medications in the school health room or for a student to self-carry emergency medications at school (when deemed appropriate by a health care provider), a Colorado Allergy and Anaphylaxis Emergency Care Plan and Medication Orders form must be completed, signed by the health care provider who writes the prescription for the emergency medication and by one parent/guardian, and brought to the school Health Room. This form must also include information about dosing of an antihistamine for allergic reactions, even though most antihistamines are available without a prescription. A blank copy of this form may be downloaded here, or at the bottom of this page.

This standard form is a fillable PDF, which will make it easy to download to your computer and fill in the blue areas, EXCEPT the information in the dosing section, including whether the student my carry and self-administer medication. Dosing and timing often change as students grow. Unless your student has seen a health care provider very recently and you are certain of the current dosing, please allow the health care provider to complete this portion of the form before signing and dating the form.

Dosing must include the amount of the active ingredient in mg, mcg, units, or the like.

Please note: Dosing should not be written as a volume, like 10mL, only because concentrations of liquid medications may vary. All liquid medications must be accompanied by a dosing syringe or cup to ensure accurate dosing.

SAFETY: Some health care providers may have other forms, but this form is standardized by the Colorado Department of Education to make finding information for each student as quick and easy as possible in an emergency. Please discuss this safety concern with your student’s health care provider.

Medical privacy/HIPAA: Some health care providers will not fill out or forward this form without a medical release of information form signed and on file in their office. This has typically been true of providers at Kaiser Permanente, but may be true of other offices as well.

If you prefer, you may request that the health care provider’s office fax or email this completed form to our school health room directly. If you do, please ensure that you sign the form before giving it to the health care provider’s office staff. Our fax number is 303-982-7991 and this form may be sent by email to our Health Aide.

References:

Allergenic Foods and their Allergens, with links to Informall. (2014, March 10). Retrieved April 12, 2019, from https://farrp.unl.edu/informallbig8

Food Allergies | Healthy Schools | CDC. (2018, February 14). Retrieved April 12, 2019, from https://www.cdc.gov/healthyschools/foodallergies/index.htm

Food Allergy. (2019, April 09). Retrieved April 12, 2019, from https://www.niaid.nih.gov/diseases-conditions/food-allergy

Additional resources:

https://www.foodallergy.org/

• Colorado Allergy and Anaphylaxis Emergency Care Plan and Medication Orders (Upload PDF)

• Food Allergy Awareness Poster. Teachers, this is a great classroom resource to put near the sink! (Upload PDF)

• Medical Statement for Disability - School Meal Modification (SD-1) form (Upload PDF)

• Recognize and Respond to Anaphylaxis poster (Upload PDF)

WHEN BRINGING MEDICATIONS TO SCHOOL

•  Any medications or supplies to be used in implementing the school health plan should be provided to the school Health Room at your earliest convenience

•  A completed Colorado Allergy and Anaphylaxis health plan, also serves as the Medication Agreement Form for only the medications stated on the health plan

•  In order for the health plan to be considered complete, both Parent and Health Care Provider sections must be completed and signed as instructed above

•  All medications must be in the original pharmacy labeled container, and/or the manufacturer’s box with prescription label affixed, with the student’s name and the correct dosage identified, and the dosage must match the dosage written on the health plan

•  We cannot accept or administer any medication that is expired or within 30 days of expiration. Please note that there are typically TWO expiration dates on medications: one is the manufacturer expiration date that is usually printed on the bottom or back of the box and the second is the use by or discard by date on the pharmacy label. We use the earlier of the two dates to determine when the medication expires. (Some pharmacies, such as Walmart, do not print an expiration on their pharmacy labels. These medications will be considered expired one year from the date that the prescription was filled, as fill dates are always listed on the prescription label.)

•  The school may not alter or change any medications from their original form, such as cutting pills in half. If pills must be cut according to dosing instructions, parents must cut at home and then bring to school.

There is further information on medications in school at the Medications tab to the left. Please let us know if you have any questions or concerns that are not addressed here or on the Medications page.