The Ministry of Education released Policy Program Memorandum 161: Supporting Students with Prevalent Medical Conditions. School Boards across Ontario are expected to implement PPM161. The HDSB has created several Administrative Procedures to better support students who have Anaphylaxis, Asthma, Diabetes, Epilepsy, and Seizure Disorders. With the revised HDSB procedures, students who have any of the listed prevalent medical conditions must have a Plan of Care in place. Furthermore, the Plan of Care must be co-created by the student, parent, and school staff. In our school, we have several students who are at-risk for potentially life-threatening allergies. Most are allergic to food and some are at risk for insect sting allergies. Anaphylaxis is a severe allergic reaction that involves one or more body systems. It can result from reactions to foods, insect stings, medications, latex, or other substances. While rare, anaphylaxis can lead to death if untreated. Education and awareness are key to keeping students with potentially life-threatening allergies safe.
Our school plan for students with prevalent medical conditions including anaphylaxis is designed to ensure that students at-risk are identified, strategies are in place to minimize the potential for accidental exposure, and staff and key volunteers are trained to respond in an emergency situation.
Identification of Students At Risk:
At the time of registration and through the annual Verification Process, parents (or students age 18 years) are asked about their son or daughter’s medical condition(s), including whether their son or daughter is at risk of anaphylaxis and asthma. With parent/student consent staff is made aware of these students. It is the responsibility of the parent or student who is age 18 years to:
Inform the school administration of a prevalent medical condition.
In a timely manner, co-create the student’s Plan of Care plan which includes a photograph, description of the student’s allergy and/or medical condition, emergency procedures, contact information, and consent to administer medication. With parent/student consent, Plan of Care plans are shared with staff.
Advise the school if their son or daughter has outgrown an allergy and no longer requires an epinephrine auto-injector (letter from allergist is required to support this statement.
Encourage students to wear medical identification, e.g. MedicAlert bracelet. The identification alerts others to the youth’s allergies and indicates that the student carries an epinephrine auto-injector. Information accessed through a special number on the identification jewelry can also assist first-aid responders, such as paramedics, to access important information quickly.
Have their son or daughter at-risk of anaphylaxis carry their auto-injector with them at all times and have a backup available in the school, usually in the main office. All students will carry their own auto-injector, asthma inhaler, and diabetes kit as appropriate, and as outlined in the student’s Plan of Care.
Provide additional auto-injectors if your son or daughter is going on a field trip. If the location is remote, the organizer of the field trip will carry a cell phone and know the location of the closest medical facility.
An individual Plan of Care for Anaphylaxis, Asthma, Diabetes, and Epilepsy/Seizure Disorder must be signed by the student and parent (if the student is under 18). The school cannot assume responsibility for treatment in the absence of such a protocol. A copy of the Plan will be shared and stored according to the consent provided on the Plan of Care (i.e. main office, cafeteria).
Adults will listen to the concerns of the student who usually knows when he/she is having a reaction, even before signs appear. It is not assumed that students will always be able to properly self-administer their auto-injector. To respond effectively during an emergency, a routine has been established and practiced. During an emergency:
One person stays with the student at all times.
One person goes for help or calls for help.
Epinephrine is administered at the first sign of a reaction.
Time of administration is noted. (The use of epinephrine for a potentially life-threatening allergic reaction will not harm a normally healthy child if epinephrine is not required).
911 is called. The student will be transported to an emergency room by paramedics even if symptoms have subsided. Symptoms may recur hours after exposure to an allergen.
The student’s parents will be contacted, and one calm and familiar person will stay with the student until a parent/guardian arrives. The used epi-pen will be given to the paramedics.
Creating a Minimized Allergen School Environment:
Individuals at risk of anaphylaxis must learn to avoid specific triggers. While the key responsibility lies with the individual and his/her family, the school community must also be aware. Special care is taken to avoid exposure to allergy-causing substances. The cafeteria services in our schools operated by Compass Group have Allergy Alert posters in the servery. As well, Compass' serveries have a Gross Nut-Free practice that means that the serveries do not have any product with nuts as an ingredient including peanut oils, chocolate bars that contain nuts and peanut butter. The risk of accidental exposure to a food allergen is significantly diminished by such measures. Given that anaphylaxis can be triggered by minute amounts of an allergen when ingested, students with food allergies must be encouraged to follow certain guidelines including:
Eat only food that they have brought from home unless it is packaged, clearly labeled, and approved by their parents.
Wash hands before eating.
No sharing food, utensils, or containers.
Place food on a napkin or wax paper rather than in direct contact with a table.
Students must take responsibility for asking servery staff for a product’s ingredient list if unsure of the contents.
Each year there will be training for staff which includes an overview of anaphylaxis, asthma, diabetes, and epilepsy/seizure disorders, and emergency procedures for each of these prevalent medical conditions. With parent/student consent, substitute teachers will be advised to review the student’s Plan of Care.
The following are strategies our school uses to keep our families informed:
Our plan will be posted on our school website.
Email reminders sent to parents regarding Plan of Care requirements and medical forms to be submitted to the main office for students having a prevalent medical condition.
Our school-wide plan will be reviewed on an annual basis and updated where needed.
Although we cannot guarantee an allergen-free environment, we can all do our part to minimize the risks.