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ACAAI: Schools Earn Poor Grade on Food Allergy Action Plans 11-11-08
Many schools do not have anaphylaxis action plans for their students with
food allergies, researchers said here.
More than 40% of elementary and middle school nurses in and around Greenville,
S.C. -- where every school has its own nurse -- said they had no action plan on
file for at least half their food-allergic students, reported John M. Pulcini,
M.D., of the University of Mississippi in Jackson.
Pediatricians should make sure their food-allergic patients have a written
action plan to give to their schools, said Dr. Pulcini during a poster
presentation here at the American College of Allergy, Asthma, and Immunology
annual meeting.
In addition, he suggested that physicians advocate in their communities for more
effective anaphylaxis action-plan policies in local schools.
Dr. Pulcini and colleagues sent electronic and paper surveys to 67 school nurses
in Greenville County, S.C., where Dr. Pulcini was formerly located. There were
43 respondents.
Topics covered in the survey included whether the school had allergic students,
types of allergies, frequency of allergic episodes in the past year, and whether
there were action plans for allergic students.
Every respondent reported having at least one allergic student at school. The
mean number of allergic students per school was nine (range one to 37).
All but two respondents said they were aware of peanut-allergic students in
their schools. Other common allergies included tree nuts (reported by 60% of
nurses), milk (53%), shellfish (49%), and egg (47%).
Only 44% of respondents said they had allergy action plans available for every
allergic student in their school.
A nearly equal percentage, 42%, said they had action plans for less than half of
students.
Action plans were missing for at least three-fourths of allergic students in 28%
of schools.
About 30% of respondents said they had seen at least one food allergy reaction
in school during the preceding year, with 7% reporting multiple episodes.
Nurses at 70% of schools reported that the school had made at least one
accommodation for students with food allergies and 23% said the school had made
multiple accommodations.
Most schools, 86%, had at least three other adults on staff besides the nurse
who were trained in administering rescue medications.
Two respondents, however, said they were the only personnel at their schools
trained to treat acute reactions.
At 40% of schools, rescue medications may have been stored somewhere other than
in the nurse's office.
Dr. Pulcini acknowledged that Greenville County may not be entirely
representative of schools nationally. On the other hand, he said, similar
studies have been performed in other localities, with presence of action plans
ranging from less than 20% to 60%.
"Greenville is right in that same area," he said.
He said the chief barrier to complete action-plan coverage is time and interest
on the part of school nurses.
"Some nurses in their specific school make it an emphasis and some school nurses
don't," he said.
"It probably has to come from the state level down to the districts to say, this
is something that, as a state, we want to make an emphasis," he said.
"If we leave it to the nurses, they have so many things they have to deal with
-- dietary issues, child abuse, and other things. [Allergy plans] may not be
something they feel is important."
John J. Oppenheimer, M.D., of the University of Medicine and Dentistry of New
Jersey in New Brunswick, commented that the study "is a good example of the
weakest link" -- in this case, the missing action plan.
"If somebody doesn't have an action plan and they begin to [go into
anaphylaxis], there will be no therapy whatsoever beyond possibly an
antihistamine, which we know from lots of studies is not going to be
lifesaving," said Dr. Oppenheimer, who was a discussant for the study.
He said every school district and individual school "needs to be more vigilant
in making sure every one of their food-allergic children has a plan if, God
forbid, something happens."
Comments:
If your child has allergies don't wait for something to happen: be prepared. If your child has ever had an anaphylactic reaction to anything, even a non food issue; you need to ask you doctor for a prescription for a n Epipen 2 pack (it's cheaper this way). You need to have one kept at the school or with your child (if they are old enough) and once kept at home, at all times. You also need to have liquid Benedryl available too. It works best to have your child immediately take the Benedryl as soon as they receive the shot. This will lessen the effects of the allergen. If your child has more than 2 in one week you need to contact your doctor. Sometimes steroids are needed for a couple of days.
There are no natural or alternative cures for this situation; it is life threatening! You can use natural means to lesson the occurrence of these reactions. Also, just because you have never had one doesn't mean you wont. The age of my first one: 30, my brother: 27, my husband: 34, my son: 13!
Here are are the symptoms to look for:
- Increased trouble breathing, coughing, chest tightness or wheezing
- Dizziness, fainting, rapid or weak heartbeat
- Swelling or itching in the mouth or gums and throat or trouble swallowing, constant feeling of something stuck in the throat or esophagus,
- Flushing, itching, hives or a feeling of warmth
- Vomiting, diarrhea or stomach cramping.
- Ear itching
If your child has had more than 1 of these reactions; allergy testing is in order. Blood testing for food and indoor pollutants will be the most effective. If your child does have food allergies, it is best to have him or her bring lunch. You will never keep allergens away in a school cafeteria setting. I told my son's school he couldn't have wheat or milk and they gave him macaroni and cheese. When questioned they said that it didn't have bread or milk in it! You need to also notify their teachers they cannot have any classroom snacks. On days my kids had class parties I gave them something to bring for themselves.
There is a lot you can do to lesson allergies and asthma, search below:
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