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Food Allergies at School

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Updated September 10, 2013

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A Tragic Story of Food Allergy at School

In January 2012, 7-year-old Ammaria Johnson died at her school as a result of anaphylaxis from peanut allergy. Students had just returned from winter break, and while on the playground, another student gave Ammaria an unknown food containing peanuts. Ammaria experienced shortness of breath and hives as a result of her peanut allergy, and sought help at the school office. Unfortunately, despite the school's knowing about Ammaria’s peanut allergy, no life-saving medications were given: the school didn’t have injectable epinephrine available specifically for Ammaria, and although injectable epinephrine was available, it was prescribed for other students. Emergency medical services were summoned, but Ammaria still died from anaphylaxis and cardiac failure.

Why Current School Policies Toward Food Allergies Must Change

Studies have shown that there are many shortcomings to how allergic reactions are dealt with at school. For example, injectable epinephrine is underused in the treatment of allergic reactions, even when it is available for use. Most allergic reactions at school don’t just occur in the lunchroom — they also occur in the classroom and on the playground, and therefore schools must be prepared to treat allergic reactions anywhere on school grounds. Nearly 25% of allergic reactions at school requiring the administration of epinephrine occur in children who were not known to have a history of food allergies. Therefore, there is a desperate need for standardized treatment protocols for allergic reactions to be in place in public school systems.

Proposals to Make Schools Safer For Children with Food Allergies

In order to create a safer environment at schools for children with food allergies, the following steps are recommended by a group of allergists from Michigan:
  • First, schools need to establish a standardized treatment protocol for the management of food allergy reactions. Such plans are available from the Food Allergy and Anaphylaxis Network, and replace the customized plans that were previously used. Standardized plans allow for quicker and more effective treatment of allergic reactions, since school staff could be familiar with a standard protocol, as opposed to a “custom treatment plan” that would vary from student to student. A “default plan” could also be used for a student with a food allergy reaction that was not previously known to be allergic to a particular food.

  • Second, emergency medications, especially injectable epinephrine, should be available at schools for any student requiring it — not just students that have been specifically prescribed these medications. Injectable epinephrine is the treatment of choice — and the only truly life-saving medication — for anaphylaxis, and therefore schools should have epinephrine available for those students without the ability to obtain their own medication, as well as for those without a previous diagnosis of food allergies.

  • Third, each school needs to have at least one, and preferably more than one, staff member who has appropriate training in the evaluation and treatment of allergic reactions. Ideally this person would be a healthcare professional, such as a nurse or emergency medical technician, but given budget cuts, could be a person with at least CPR training with additional training to deal with allergic reactions.

  • Lastly, schools should limit food to the lunchroom and prevent food from being eaten in the classroom or on the playground. Allergic reactions to foods commonly occur outside of the lunchroom, and most commonly in the classroom — where it may be more difficult to identify and treat allergic reactions.

    If schools were to follow the above steps, children with food allergies would be much safer, and hopefully there wouldn’t be any more tragic stories about children dying as a result of food allergies at school.

    Share your thoughts: Should peanuts be banned from schools?

    Source:

    Greenhawt MJ, Weiss CC. We Must Create a National Policy to Protect and Manage Food Allergic Students at School. Ann Allergy Asthma Immunol. 2012;109:292-4.

    DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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