School Emergency Plan

This plan was designed for milk allergy and asthma management at school but it was put to the test when my son went into anaphylaxis on the school yard to an exposure to some kind of environmental allergen last September. The plan worked perfectly because everyone in the school knew their respective roles and jumped into action when the Emergency Plan was activated. The most important thing which needs emphasis is due to forward planning, all school personnel were properly trained to assess and manage and respond to an episode of anaphylaxis in the school setting.

Lynda Mitchell

RECOMMENDED ACCOMMODATION AND RELATED SERVICE OR AID
(Name of Child)
1997-1998 School Year

General Issues

(Mark date completed next to each item as it done)

____________ 1. A conference will be held with all school personnel that have contact with (Name of child) (Mr. NNNN, Principal; Mrs. NNNN, school nurse, Mrs. NNNN, school nurse, Mr. NNNN, counselor; and Mrs. NNNN, teacher)

____________ 2. As a follow up to the conference, a summary of (name of child)'s health condition and symptoms of allergic reacions, written by (name of parent), will be distributed to all personnel having contact with (Name of child).

____________ 3. The homeroom teacher will place a picture of (name of child) and a brief summary of concerns and procedures in a substitute teacher folder.

____________ 4. The school nurse will keep a care plan, medical orders and (name of child)'s picture readily available in the medication and orders book.

____________ 5. An informational tag will be place at all phones with directions on using 911.

____________ 6. The parent, will contact her child's medical doctor for specific written medical orders and recommendations for the nurse.

____________ 7. The nurse will make known the exact location of medication to the appropriate school personnel.

____________ 8. A photo of (name of child) will be placed in the kitchen ensuring quick identification if the need arises.

____________ 9. The parent, will notify the school nurse when there is a change in (name of child's) health status or medication plan.

____________ 10. (Name of child)'s teacher and the school nurse will work with his class to help them understand and accept (name of child)'s special health needs.


Food Allergy Issues

____________ 11. The school nurse will do an inservice about food allergies with the first grade classes.

____________ 12. A video on food allergies geared for adults will be shown in an inservice for all staff members not previously inserviced who may have contact with (name of child)

____________ 13. (Name of child) will be seated in the cafeteria where the teachers/cafeteria monitors can observe him easily and children sitting next to him will be asked to not drink milk in order to avoid potential milk spills near (name of child). Before being seated, the table will be wiped down in order to ensure that no spilled milk residue is on the table.

____________ 14. (Name of child) will follow the following rules while at school:
a. (Name of child) can only eat foods which are sent from home.
b. (Name of child) is not allowed to trade or accept food from other students
c. (Name of child) is not allowed to eat any foods brought in by parents for birthday celebrations or other school festivities.
d. (Name of child) is not allowed to accept any candy treats or rewards.
e. (Name of child) cannot participate in any art projects which have food components to which he may be allergic (finger paints with puddings, decorating with icings, etc.)

____________ 15. A box of safe snacks will be provided by the parents and kept in (Name of child)'s classroom for parties and in case he forgets his lunch.

____________ 16. Teacher(s) will check with parents when any questionable food products are used for arts & crafts or projects.

____________ 17. Teacher will contact (Name of child)'s mother if special provisions need to be arranged for class parties. If parties will involve food or food projects, (Name of child)'s Mom would like to be able to attend to help prevent any accidents.

____________ 18. For field trips, an emergency medicine kit always accompanies (Name of child) wherever he goes, and this may be best accommodated on field trips by arranging for (Name of child)'s mom to be a chaperone, or a suitable substitute such as (Names of parents who parents are comfortable substituting)

Asthma Issues

____________ 19. (Name of child) will be allowed to go to the Health Room for an asthma treatment whenever he feels the need, or when the teacher thinks he needs to be checked by the nurse. Usual symptoms are wheezing, hacking cough or a "tight chest".

___________ 20. (Name of child) will be given a nebulizer treatment at home before school if he has any symptoms of asthma the prior evening or the morning prior to going to school. If (Name of child) requests an additionalalbuterol treatment before noon, this may indicate an acute worsening of his asthma status, and (Name of child)'s Mom would like to be notified.

____________ 21. (Name of child) has the option of choosing either an albuterol inhaler treatment or a albuterol nebulizer treatment, depending upon how he feels. The nurse may tell (Name of child) he needs a nebulizer if he appears to need one of these rather than an inhaler.

____________ 22. (Name of child) will go to the health room at a designated time daily around the lunch period to have his prescribed Intal inhaler treatments.

____________ 23. (Name of child)'s parents will provide nebulizer sets, and all prescribed medications for any scheduled or p.r.n (as needed) treatments. The school nurse will advise the parent when the supplies or meds are running low.



Symptoms of Anaphylaxis

(Name of child)'s usual first symptom has been retching/vomiting, followed by facial swelling and hives. This all occurred within a couple of minutes of ingesting the food containing a milk product. Wheezing and respiratory distress began shortly thereafter. His most recent reaction also included lethargy. An Epi-pen should be given at the FIRST SIGNS of food allergy reaction (facial swelling and hives). It is best to err on the side of caution and administer the Epi-pen rather than to take a wait and see approach.



Medical Emergency Procedure

1. Alert the school nurse:
   Using the two way signal radio, notify the nurse immediately.
   Nurse will make assessment and administer the Epi-Pen Jr.
   Nurse will make decision whether to call 911 and designate a caller.
   Designated person will make 911 call
2. Begin asthma nebulizer treatment
3. Call (Name of child)'s allergist, NNNNNNN, xxx-xxxx
4. A second dose of Epi-pen Jr. will be given if ambulance doesn't arrive within 20 minutes and symptoms are not abating.
5. Advise paramedics of the number of Epi-pen doses given.
6. Call Parent, XXXXXXXXX
   Home number: xxxxxxxxx
   Work number: xxxxxxxx
   Pager directions:
     Dial xxxxxx
     Leave voicemail message and hang up.
7. If parent cannot be reached, contact:
   NNNNNN xxx-xxxxx (friend's Mom)
   NNNNNN xxx-xxxxx (Grandmom)
   NNNNNN xxx-xxxxx (friend's Mom)

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