Anaphylaxis

Purpose

To explain to Leongatha Secondary College parents, carers, staff and students the processes and procedures in place to support students diagnosed as being at risk of suffering from anaphylaxis. This policy also ensures that Leongatha Secondary College is compliant with Ministerial Order 706 and the department’s guidelines for anaphylaxis management.

Scope

This policy applies to:

all staff, including casual relief staff, canteen operators and volunteers
all students who have been diagnosed with anaphylaxis, or who may require emergency treatment for an anaphylactic reaction, and their parents and carers.

Policy

School Statement

Leongatha Secondary College fully complies with Ministerial Order 706 and the associated guidelines published by the department.

Anaphylaxis

Anaphylaxis is a severe allergic reaction that occurs after exposure to an allergen. The most common allergens for school-aged children are nuts, eggs, cow’s milk, fish, shellfish, wheat, soy, sesame, latex, certain insect stings and medication.

Symptoms

Signs and symptoms of a mild to moderate allergic reaction can include:

swelling of the lips, face and eyes

hives or welts

tingling in the mouth.

Signs and symptoms of anaphylaxis, a severe allergic reaction, can include:

difficult/noisy breathing
swelling of tongue
difficulty talking and/or hoarse voice
wheeze or persistent cough
persistent dizziness or collapse
student appears pale or floppy
abdominal pain and/or vomiting.

Symptoms usually develop within ten minutes and up to two hours after exposure to an allergen, but can appear within a few minutes.

Treatment

Adrenaline given as an injection into the muscle of the outer mid-thigh or inhaled through the nose is the first aid treatment for anaphylaxis.

Individuals diagnosed as being at risk of anaphylaxis are prescribed an adrenaline device for use in an emergency. These adrenaline devices are designed so that anyone can use them in an emergency.

Individual Anaphylaxis Management Plans

All students at Leongatha Secondary College who are diagnosed by a medical practitioner as being at risk of suffering from an anaphylactic reaction must have an Individual Anaphylaxis Management Plan. When notified of an anaphylaxis diagnosis, the principal of Leongatha Secondary College is responsible for developing a plan in consultation with the student’s parents/carers.

Where necessary, an Individual Anaphylaxis Management Plan will be in place as soon as practicable after a student enrols at Leongatha Secondary College and where possible, before the student’s first day.

Parents and carers must:

obtain an ASCIA Action Plan for Anaphylaxis (RED) from the student’s medical practitioner and provide a copy to the school as soon as practicable
immediately inform the school in writing if there is a relevant change in the student’s medical condition and obtain an updated ASCIA Action Plan for Anaphylaxis (RED)
provide an up-to-date photo of the student for the ASCIA Action Plan for Anaphylaxis (RED) and provide it to the school each time it is updated
provide the school with a current adrenaline device for the student that has not expired
participate in annual reviews of the student’s Individual Anaphylaxis Management Plan that is prepared by the school.

Each student’s Individual Anaphylaxis Management Plan must include:

information about the student’s allergies and the potential for anaphylactic reaction, including the type of allergies the student has
information about the signs or symptoms the student might exhibit in the event of an allergic reaction based on a written diagnosis from a medical practitioner
strategies to minimise the risk of exposure to known allergens while the student is under the care or supervision of school staff, including in the school yard, at camps and excursions, or at special events conducted, organised or attended by the school
the name of the person(s) responsible for implementing the risk minimisation strategies, which have been identified in the Individual Anaphylaxis Management Plan
information about where the student’s medication is stored
the student’s emergency contact details
an up-to-date ASCIA Action Plan for Anaphylaxis (RED) completed by the student’s medical practitioner.

Review and updates to Individual Anaphylaxis Management Plans:

A student’s Individual Anaphylaxis Management Plan is reviewed and updated on an annual basis in consultation with the student’s parents/carers. The plan will also be reviewed and, where necessary, updated in the following circumstances:

as soon as practicable after the student has an anaphylactic reaction at school
if the student’s medical condition, insofar as it relates to allergy and the potential for anaphylactic reaction, changes
when the student is participating in an off-site activity, including camps and excursions, or at special events including fetes and concerts.

Our school may also consider updating a student’s Individual Anaphylaxis Management Plan if there is an identified and significant increase in the student’s potential risk of exposure to allergens at school.

Location of plans and adrenaline devices

A copy of each student’s Individual Anaphylaxis Management Plan will be stored with their ASCIA Action Plan for Anaphylaxis at the Front Office. Whilst some students keep their adrenaline autoinjector on their person, medication for those that do not will be stored and labelled with their name at the Front Office, together with adrenaline autoinjectors for general use found in the medications drawer in the Front Office.

Risk Minimisation Strategies

Please consider strategies for all school activities, including:

during classroom activities (including class rotations, specialist and elective classes)
between classes and other breaks
in canteens
during recess and lunchtimes
before and after school
camps and excursions, or at special events conducted, organised or attended by the school (eg. class parties, elective subjects and work experience, cultural days, fetes, concerts, events at other schools, competitions or incursions).

To reduce the risk of a student suffering from an anaphylactic reaction at Leongatha Secondary College, we have put in place the following strategies:

staff are provided with a detailed list of students suffering from anaphylactic reactions
students are discouraged from sharing food and drinks
gloves must be worn when picking up papers or rubbish in the playground and the use of nabber grabbers is available
school canteen staff are trained in appropriate food handling to reduce the risk of cross-contamination
keeping the lawns well mown, ensuring children always wear shoes and not allowing drink cans in the school yard
year groups will be informed of allergens that must be avoided in advance of class parties, events or birthdays
Planning for off-site activities will include risk minimisation strategies for students at risk of anaphylaxis including supervision requirements, appropriate number of trained staff, emergency response procedures and other risk controls appropriate to the activity and students attending.

Adrenaline autoinjectors for general use

Leongatha Secondary College maintains a supply of adrenaline autoinjector(s) for general use, as a back-up to those provided by parents and carers for specific students, and also for students who may suffer from a first time reaction at school.

There are currently 4 adrenaline devices approved by the Therapeutic Goods Administration for use in Australia: the EpiPen®, the Anapen®, Jext® and Neffy®. All devices can be used when provided by families for students, however, the principal or allocated staff member can only use Epipen®, Anapen® or Jext® adrenaline autoinjector for general use. For more information about which autoinjector to purchase for general use, refer to Adrenaline autoinjectors for general use.

Adrenaline autoinjectors for general use are stored at the Front Office and labelled “general use”.

The principal is responsible for arranging the purchase of adrenaline autoinjectors for general use, and considers:

the number of students enrolled at Leongatha Secondary College at risk of anaphylaxis
the accessibility of adrenaline autoinjectors supplied by parents/carers
the availability of a sufficient supply of autoinjectors for general use in different locations at the school, as well as at camps, excursions and events
the limited life span of adrenaline autoinjectors, and the need for general use adrenaline autoinjectors to be replaced when used or prior to expiry
the weight of the students at risk of anaphylaxis to determine the correct dosage of adrenaline autoinjector/s to purchase.

Emergency Response

In the event of an anaphylactic reaction, the emergency response procedures in this policy must be followed, together with the school’s general first aid procedures, emergency response procedures and the student’s Individual Anaphylaxis Management Plan.

A complete and up-to-date list of students identified as being at risk of anaphylaxis is maintained by the Front Office and stored in the First Aid room in the Front Office. For camps, excursions and special events, a designated staff member will be responsible for maintaining a list of participating students who are at risk of anaphylaxis , together with their Individual Anaphylaxis Management Plans and adrenaline devices, where appropriate.

If a student experiences an anaphylactic reaction at school or during a school activity, school staff must:

Step	Action
	Lay the person flat Do not allow them to stand or walk If breathing is difficult, allow them to sit with legs outstretched Be calm and reassuring Do not leave them alone Seek assistance from another staff member or reliable student to locate the student’s adrenaline device or the school’s general use autoinjector, and the student’s Individual Anaphylaxis Management Plan, stored at the Front Office. if the student’s plan is not immediately available, or they appear to be experiencing a first-time reaction, continue with steps 2 to 5 and refer to the ASCIA First Aid Plan for Anaphylaxis (Orange), stored with the school’s adrenaline autoinjector for general use at the Front Office, if immediately accessible.
	Administer an EpiPen or EpiPen Jr Remove from plastic container Form a fist around the EpiPen and pull off the blue safety release (cap) Hold leg still and place orange end against the student’s outer mid-thigh (with or without clothing) Push down hard until a click is heard or felt and hold in place for 3 seconds Remove EpiPen Note the time the EpiPen is administered Retain the used EpiPen to be handed to ambulance paramedics along with the time of administration. OR Administer an Anapen® 500 Pull off the black needle shield Pull off grey safety cap (from the red button) Place needle end firmly against the student’s outer mid-thigh at 90 degrees (with or without clothing) Press red button so it clicks and hold for 3 seconds Remove Anapen® Note the time the Anapen is administered Retain the used Anapen to be handed to ambulance paramedics along with the time of administration. OR Administer Jext 150 or 300 Form fist around Jext and pull off yellow cap Place black injector tip against outer-mid thigh (with or without clothing) Push black tip firmly until a click is heard and hold in place for 3 seconds. Remove Jext Note the time the Jext device is administered. The used adrenaline device must be handed to the ambulance paramedics along with the time of administration OR Administer Neffy® 1mg or 2mg Hold the nasal spray with your thumb on the bottom of the plunger and a finger on either side of the nozzle.  Do not pull or push on the plunger. Do not test or prime (pre-spray). Each Neffy nasal spray contains only one spray.  Place the nozzle of the nasal spray into a nostril until fingers touch the nose.  For smaller nostrils, aim for the fingers to touch the nose. Keep the nozzle pointed towards the forehead. Do not angle the nozzle of the nasal spray to the inner or outer walls of the nose.  Press the plunger up firmly until the dose is administered and it sprays into the nostril.  Note the time the Neffy device is administered. The used adrenaline device must be handed to the ambulance paramedics along with the time of administration
	Call an ambulance (000)
	If there is no improvement or severe symptoms progress (as described in the ASCIA Action Plan for Anaphylaxis (RED)), further adrenaline doses may be administered every 5 minutes, if other adrenaline devices are available.
	Contact the student’s emergency contacts.
	The principal or a staff member allocated to do so must contact the Incident Support and Operations Centre (ISOC) on 1800 126 126 to report ‘High’ or Extreme’ severity incidents to report the incident. Incidents assessed as ‘Low’ or ‘Medium’ can be reported directly into EduSafe Plus by the principal or their allocated staff member.

If a student appears to be having a severe allergic reaction but has not been previously diagnosed with an allergy or being at risk of anaphylaxis, school staff should follow steps 2 – 5 as above.

For first time anaphylactic reactions, the school’s general use adrenaline autoinjector device must be used. If the general use device is not immediately available in an anaphylaxis emergency, staff may use another student’s adrenaline device, including the Epipen®, Anapen®, Jext® or Neffy® device. This may save a life. If another student’s adrenaline device is used in an anaphylaxis emergency, the school must notify the parents of the student whose device was used and immediately replace the device.

Where possible, schools should consider using the correctly dosed adrenaline device depending on the weight of the student. However, in an emergency if there is no other option available, any device should be administered to the student.

Communication

This policy will be available on Leongatha Secondary College’s website so that parents and other members of the school community can easily access information about Leongatha Secondary College’s anaphylaxis management procedures. The parents and carers of students who are enrolled at Leongatha Secondary College and are identified as being at risk of anaphylaxis will also be provided with a copy of this policy.

The Principal is responsible for ensuring that all relevant staff, including casual relief staff, canteen staff and volunteers are aware of this policy and Leongatha Secondary College’s procedures for anaphylaxis management. Casual relief staff and volunteers who are responsible for the care and/or supervision of students who are identified as being at risk of anaphylaxis will also receive a copy of this policy.

The principal is also responsible for ensuring relevant staff are trained and briefed in anaphylaxis management, consistent with the department’s Anaphylaxis Guidelines.

Staff training

The principal ensures that the following school staff are appropriately trained in anaphylaxis management:

First Aid Officer
School staff who conduct classes attended by students who are at risk of anaphylaxis

Staff who are required to undertake training must have completed:

an approved face-to-face anaphylaxis management training course in the last three years, or
an approved online anaphylaxis management training course in the last two years.

Leongatha Secondary College uses ASCIA anaphylaxis e-training for Victorian Schools with 22579VIC, or 22578VIC followed by a competency check by the school anaphylaxis supervisor.

Staff are also required to attend a briefing on anaphylaxis management and this policy at least twice per year (with the first briefing to be held at the beginning of the school year), facilitated by a staff member who has successfully completed an anaphylaxis management course within the last 2. Each briefing should address:

the school’s anaphylaxis management policy
the causes, symptoms and treatment of anaphylaxis
the identities of students diagnosed as being at risk of anaphylaxis, their allergens and the location of their Individual Anaphylaxis Management Plans and their medication/s
discussion on staff anaphylaxis training and renewal
how to use an adrenaline device, including hands-on practice with an adrenaline device trainer device (which does not contain adrenaline)
the school’s general first aid and emergency procedures
the location of adrenaline devices prescribed for individual students that have been purchased by their family
the location of adrenaline devices that the school has purchased for general use
how to access on-going support and training.

When a new student enrols at Leongatha Secondary College who is at risk of anaphylaxis, the principal will develop an interim plan in consultation with the student’s parents/carers and ensure that appropriate staff are trained and briefed as soon as possible.

A record of staff training courses and briefings is maintained and stored in a shared google drive.

The principal ensures that while students at risk of anaphylaxis are under the care or supervision of the school outside of normal class activities, including in the school yard, at camps and excursions, or at special event days, there is a sufficient number of school staff present who have been trained in anaphylaxis management.

COMMUNICATION

This policy will be communicated to our school community in the following ways:

Available publicly on our school’s website
Included in staff induction processes and staff training
Discussed at staff briefings/meetings as required
Included in staff handbook/manual
Hard copy available from school administration upon request

Further information and resources

The department’s Policy and Advisory Library (PAL):
ASCIA Guidelines: Schooling and childcare
Hero HQ Anaphylaxis Management Training
https://allergyfacts.org.au/__interest/anaphylaxis/
Royal Children’s Hospital: Allergy and immunology

Leongatha Secondary College policies: