Allergies at Allergies at schoolschool

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Natasha, Fiona and MarkNatasha, Fiona and Mark

AllergiesAllergies

OutlineOutline Description of health conditionDescription of health condition Must know information for a Must know information for a

classroom teacherclassroom teacher Sabrina’s LawSabrina’s Law Supporting the child at schoolSupporting the child at school ResourcesResources

Inclusive SettingInclusive Setting ““I’ve found people fall into three I’ve found people fall into three

categories: those who don’t care or are categories: those who don’t care or are downright rude about the inconvenience downright rude about the inconvenience factor; those who are so scared they are factor; those who are so scared they are afraid to treat your child normally; and afraid to treat your child normally; and those who genuinely want to understand those who genuinely want to understand and help,” says Pluta. “The classroom and help,” says Pluta. “The classroom teacher needs to be in that last category teacher needs to be in that last category and needs to help deal with those in the and needs to help deal with those in the first two.” first two.” mother of an 11 year boy with mother of an 11 year boy with a severe milk-protein allergya severe milk-protein allergy

Students with Students with allergies, environmental sensitivities, asthma and allergies, environmental sensitivities, asthma and anaphylaxis do not need the curriculum modified; they need to be anaphylaxis do not need the curriculum modified; they need to be accommodated by having their environment modified. The special accommodated by having their environment modified. The special needs of these students can be life threatening and need to be needs of these students can be life threatening and need to be taken seriously by the entire school community.taken seriously by the entire school community.Students who suffer from severe allergies are entitlted to the same Students who suffer from severe allergies are entitlted to the same education as any other student, however, their special needs education as any other student, however, their special needs become the responsibility of the entire school community.become the responsibility of the entire school community.In order to provide an inclusive classroom where students with In order to provide an inclusive classroom where students with severe allergies are safe teachers need to:severe allergies are safe teachers need to:

Keep the school community informedKeep the school community informed Letters need to be sent home and parents need to be informed and Letters need to be sent home and parents need to be informed and

continuously reminded of any special requirementscontinuously reminded of any special requirements Focus on alternative foods that classmates can bringFocus on alternative foods that classmates can bring Keep positiveKeep positive Have a safe eating area designated so students can eat togetherHave a safe eating area designated so students can eat together Observe what foods are in the student’s lunch boxes Observe what foods are in the student’s lunch boxes Be a good mediator and communicate the special needs of the Be a good mediator and communicate the special needs of the

student with compassion and respect to the other familiesstudent with compassion and respect to the other families Students should not be excluded as a result of their food allergyStudents should not be excluded as a result of their food allergy Extra care should be taken when cleaning the classroom and Extra care should be taken when cleaning the classroom and

schoolschool

Most Common Allergies Most Common Allergies Found in SchoolsFound in Schools

Food AllergiesFood Allergies• Lactose IntoleranceLactose Intolerance• Cow's Milk ProteinCow's Milk Protein• Wheat AllergyWheat Allergy• SoybeansSoybeans• PeanutsPeanuts Anaphylactic Anaphylactic AsthmaAsthma

Lactose IntoleranceLactose Intolerance

Lactose intolerance means the body Lactose intolerance means the body cannot easily digest lactose, a type cannot easily digest lactose, a type of natural sugar found in milk and of natural sugar found in milk and dairy products which cause dairy products which cause uncomfortable symptoms such as uncomfortable symptoms such as gas, belly pain, and bloating. gas, belly pain, and bloating.

Cow's Milk ProteinCow's Milk Protein Cow's milk allergy is the most common food allergy Cow's milk allergy is the most common food allergy

in young children. Milk contains many protein in young children. Milk contains many protein fractions (allergens) that cause allergic reactions. fractions (allergens) that cause allergic reactions. The two main components are whey and casein, and The two main components are whey and casein, and an individual may be allergic to either or both. The an individual may be allergic to either or both. The casein is the curd that forms when milk is left to casein is the curd that forms when milk is left to sour, and the whey is the watery fraction which is sour, and the whey is the watery fraction which is left after the curd is removed. left after the curd is removed.

Common symptoms are: Common symptoms are: eczema or skin rash eczema or skin rash abdominal pain or cramps abdominal pain or cramps vomiting vomiting diarrhea diarrhea

Wheat AllergyWheat Allergy

A wheat allergy is an abnormal A wheat allergy is an abnormal response of the body to the protein response of the body to the protein found in wheat. found in wheat.

Common symptoms include: Common symptoms include: • Skin reactions such as eczema, hives, Skin reactions such as eczema, hives,

swelling (typically eyelids and mouth) swelling (typically eyelids and mouth) • Abdominal cramps, nausea, vomiting Abdominal cramps, nausea, vomiting • Asthma, hay fever (runny or stuffy nose, Asthma, hay fever (runny or stuffy nose,

itching eyes, sneezing). itching eyes, sneezing).

SoybeansSoybeans A soy allergy is an abnormal response of the body to the A soy allergy is an abnormal response of the body to the

proteins found in soy. Soybeans are classified as a legume. proteins found in soy. Soybeans are classified as a legume. Other foods in the legume family are navy, kidney, string, Other foods in the legume family are navy, kidney, string, black, and pinto beans, chickpeas (garbanzo beans), black, and pinto beans, chickpeas (garbanzo beans), lentils, carob, licorice, and peanuts. lentils, carob, licorice, and peanuts.

Symptoms of soy allergy include:Symptoms of soy allergy include:• AnaphylaxisAnaphylaxis• AsthmaAsthma• CankersCankers• DiarrheaDiarrhea• EczemaEczema• FeverFever• VomitingVomiting• Wheezing Wheezing

PeanutsPeanuts Peanut allergy is an abnormal immune system response. Peanut allergy is an abnormal immune system response.

The body decides that the proteinsThe body decides that the proteins peanuts contain cause peanuts contain cause an immunological threat, and it generates antibodies, to an immunological threat, and it generates antibodies, to fight peanuts the next time they appear in the body. fight peanuts the next time they appear in the body.

Symptoms include: Symptoms include: • runny noserunny nose• skin rash skin rash • tingly tonguetingly tongue• difficulty breathingdifficulty breathing• swelling of the throat swelling of the throat • dizziness dizziness • hiveshives• vomitingvomiting• abdominal crampsabdominal cramps• diarrheadiarrhea

Anaphylactic ShockAnaphylactic Shock

Anaphylactic shock, is a sudden allergic Anaphylactic shock, is a sudden allergic reaction involving the whole body. Immediate reaction involving the whole body. Immediate medical treatment is essential - without it medical treatment is essential - without it your heart and circulation may fail and could your heart and circulation may fail and could be life threatening.be life threatening.

An anaphylactic reaction is the swelling of An anaphylactic reaction is the swelling of the face, mouth and tongue leading to the face, mouth and tongue leading to difficulty breathing. Hives, itchy rash and difficulty breathing. Hives, itchy rash and severe vomiting may also occur.severe vomiting may also occur.

The most common cause is eating a food to The most common cause is eating a food to which you're allergic. which you're allergic.

Anaphylactic Shock Anaphylactic Shock (cont.)(cont.)

Peanuts and tree nuts (such as almonds, Brazil Peanuts and tree nuts (such as almonds, Brazil nuts, hazelnuts and walnuts) are the foods nuts, hazelnuts and walnuts) are the foods most likely to provoke a reaction. Anaphylaxis most likely to provoke a reaction. Anaphylaxis can also be triggered by fish, shellfish, eggs can also be triggered by fish, shellfish, eggs and cow's milk. and cow's milk.

Allergy to venom from bee and wasp stings can Allergy to venom from bee and wasp stings can cause anaphylaxis too, as can allergy to latex cause anaphylaxis too, as can allergy to latex rubber and drugs such as antibiotics.rubber and drugs such as antibiotics.

Anaphylaxis requires emergency treatment Anaphylaxis requires emergency treatment because the symptoms of respiratory because the symptoms of respiratory obstruction and shock develop so quickly. An obstruction and shock develop so quickly. An injection of adrenaline (auto-injector [EpiPen]) injection of adrenaline (auto-injector [EpiPen]) must be given to raise blood pressure, relieve must be given to raise blood pressure, relieve breathing difficulties and reduce swelling. breathing difficulties and reduce swelling.

AsthmaAsthma Asthma affects the small airways that carry air in and out of the Asthma affects the small airways that carry air in and out of the

lungs. These airways can become inflamed, swollen and contract.lungs. These airways can become inflamed, swollen and contract. The main symptoms are coughing, wheezing, shortness of breath The main symptoms are coughing, wheezing, shortness of breath

and a tight feeling in the chest.and a tight feeling in the chest. The main causes are:The main causes are: House dust House dust Mould spores Mould spores Pollen Pollen Pets Pets Viral infections, such as colds and flu Viral infections, such as colds and flu Cigarette smoke Cigarette smoke Certain forms of exercise, such as running Certain forms of exercise, such as running Exposure to cold, dry air Exposure to cold, dry air Medication containing aspirin Medication containing aspirin

Sabrina’s LawSabrina’s Law

The law, which took effect January 1, 2006, requires The law, which took effect January 1, 2006, requires school boards to have all principals implement school boards to have all principals implement anaphylaxis plans that include: strategies to reduce anaphylaxis plans that include: strategies to reduce exposure to allergens, procedures to communicate to exposure to allergens, procedures to communicate to parents, students and employees about life-threatening parents, students and employees about life-threatening allergies, and regular training on dealing with life-allergies, and regular training on dealing with life-threatening allergies for teachers and staff. In addition, threatening allergies for teachers and staff. In addition, principals are required to: develop an individual plan principals are required to: develop an individual plan for each student at risk of anaphylaxis, maintain a file for each student at risk of anaphylaxis, maintain a file that lists that student's prescriptions and emergency that lists that student's prescriptions and emergency contacts and ensure that parents enrolling pupils contacts and ensure that parents enrolling pupils supply information on a child's allergies.supply information on a child's allergies.

Full story of SabrinaFull story of SabrinaCTV Toronto: Alicia Kay-CTV Toronto: Alicia Kay-MarkinsonMarkinson

on Sabrina’s Law 1:26 on Sabrina’s Law 1:26

Allergies (teacher Allergies (teacher preparedness)preparedness)

Identify students at riskIdentify students at risk Create an anaphylaxis planCreate an anaphylaxis plan Clarify responsibilitiesClarify responsibilities

Allergies (identify students Allergies (identify students at risk)at risk)

All school staff, including supply or All school staff, including supply or substitute teachers and volunteers, must:substitute teachers and volunteers, must:

Be aware of students with severe Be aware of students with severe allergiesallergies

Have access to their informationHave access to their information Be instructed in proper management Be instructed in proper management

strategies, including the correct use of strategies, including the correct use of an epinephrine auto-injectoran epinephrine auto-injector

A process should be in place to ensure all A process should be in place to ensure all staff receives regular training. staff receives regular training.

Allergies (Create a plan)Allergies (Create a plan)

A comprehensive A comprehensive written written school anaphylaxis plan school anaphylaxis plan should be prepared that:should be prepared that:

Defines roles and responsibilitiesDefines roles and responsibilities Includes information about avoidance strategies, Includes information about avoidance strategies,

staff training, and emergency protocol.staff training, and emergency protocol.A school anaphylaxis plan serves to reduce the risk A school anaphylaxis plan serves to reduce the risk

of exposure to allergenic substances and helps of exposure to allergenic substances and helps schools prepare for an emergency situation. schools prepare for an emergency situation.

It should not imply a guarantee (e.g. peanut-It should not imply a guarantee (e.g. peanut-free environment) or that there is zero risk. free environment) or that there is zero risk. Schools should strive to create an “allergy-Schools should strive to create an “allergy-safe” vs. “allergen-free environment. safe” vs. “allergen-free environment.

The plan should be updated on a regular basis. The plan should be updated on a regular basis.

Allergies (School Allergies (School anaphylaxis plan) anaphylaxis plan)

Should include:Should include: Respect for othersRespect for others Sound medical informationSound medical information Realistic expectations of what the Realistic expectations of what the

school community can do to help school community can do to help safeguard students at risk of safeguard students at risk of anaphylaxis. anaphylaxis.

Allergies (teacher and Allergies (teacher and school initiatives)school initiatives)

““no sharing” policy for food allergic children no sharing” policy for food allergic children should be enforced. should be enforced.

Lunch supervisors must ensure that procedures Lunch supervisors must ensure that procedures for proper hand washing and clean up are for proper hand washing and clean up are being followed. being followed.

appeal to the community to keep peanut butter appeal to the community to keep peanut butter and other peanut/nut products out of the schooland other peanut/nut products out of the school

Require that children who bring peanuts/nut Require that children who bring peanuts/nut products to school eat lunch at a designated products to school eat lunch at a designated tabletable

Ask food allergic children to sit at a table that Ask food allergic children to sit at a table that has been designated “allergy-safe”.has been designated “allergy-safe”.

Allergies (Emergency Allergies (Emergency Plan)Plan)

Each child at risk should have a plan. Two page plan:Each child at risk should have a plan. Two page plan:Page 1- a form with:Page 1- a form with: The person’s photo and allergy informationThe person’s photo and allergy information The signs and symptoms of anaphylaxisThe signs and symptoms of anaphylaxis Instructions on what to do in an emergencyInstructions on what to do in an emergency Emergency contact informationEmergency contact information Consent to administer informationConsent to administer information The signature of the child’s physicianThe signature of the child’s physicianPage 1 – an epinephrine auto-injector instruction Page 1 – an epinephrine auto-injector instruction

sheet:sheet: Epipen instruction sheetEpipen instruction sheet Twinject instruction sheetTwinject instruction sheet emergencyplan_eng[1].pdfemergencyplan_eng[1].pdf

Allergies (Resources)Allergies (Resources) Allergy Safe CommunitiesAllergy Safe Communities Allergy Asthma information associationAllergy Asthma information association Canadian Society of Allergy and Clinical ImmunolCanadian Society of Allergy and Clinical Immunol

ogyogy Anaphylaxis CanadaAnaphylaxis Canada Canadian Allergy, Asthma and Immunology FounCanadian Allergy, Asthma and Immunology Foun

dationdation Association québécoise des allergies alimentairesAssociation québécoise des allergies alimentaires Allergic Living and Sabrina’s LawAllergic Living and Sabrina’s Law Food Allergy InitiativeFood Allergy Initiative The Hospital for Sick Children – Food Allergy The Hospital for Sick Children – Food Allergy

ResourcesResources Kids With Food Allergies: Food Allergy Kids With Food Allergies: Food Allergy

Support and Allergy Free RecipesSupport and Allergy Free Recipes Anaphylaxis - A Handbook for Anaphylaxis - A Handbook for SchoolSchool Boards Boards