MANAGEMENT OF SEVERE ALLERGIES IN THE SCHOOL SETTING

Allergy symptoms depend on the substance involved and can involve the airways, sinuses and nasal passages, skin, and digestive system. Allergic reactions can range from mild to severe. In some severe cases, allergies can trigger a life-threatening reaction known as anaphylaxis (Mayo Clinic, 2015).  In order for the child with severe allergies to receive appropriate medical care at school the parent must provide:

1. Severe Allergy Emergency Action Plan- completed by the parent

2. Physician Authorization for Medication Form- completed by the physician, signed by the parent

3. Diet Order if your child has a food allergy-completed by the parent and physician

4. Allergy medication as recommended by the physician

A FOOD ALLERGY is an immune system reaction that occurs soon after eating a certain food. Even a tiny amount of the allergy-causing food can trigger signs and symptoms such as digestive problems, hives or swollen airways. In some people, a food allergy can cause severe symptoms or even a life-threatening reaction known as anaphylaxis. Food allergies may cause:

• Tingling mouth

• Swelling of the lips, tongue, face or throat

• Hives

• Anaphylaxis

An INSECT ALLERGY is caused by the injection of venom or substances into the skin from the insect.  The venom causes pain and sometimes triggers an allergic reaction. The severity of the reaction depends on the sensitivity to the insect venom or substance and whether the child has been stung or bitten more than once.  Signs and symptoms include:

•  A large area of swelling (edema) at the sting site

• Itching or hives all over your body

• Cough, chest tightness, wheezing or shortness of breath

• Anaphylaxis

Most reactions to insect bites are mild, causing little more than an annoying itching or stinging sensation and mild swelling that disappear within a day or so. A delayed reaction may cause fever, hives, painful joints and swollen glands. You might experience both the immediate and the delayed reactions from the same insect bite or sting. Only a small percentage of people develop severe reactions (anaphylaxis) to insect venom. Signs and symptoms of a severe reaction include:

• Nausea

• Facial swelling

• Difficulty breathing

• Abdominal pain

• Deterioration of blood pressure and circulation (shock)

ANAPHYLAXIS is a severe allergic reaction.  Some types of allergies, including allergies to foods and insect stings, have the potential to trigger anaphylaxis. A life-threatening medical emergency, this reaction can cause you to go into shock.  Children who have the potential to experience an anaphylactic reaction to an allergen should have an epi pen available for school personnel to administer when needed. Signs and symptoms of anaphylaxis include:

• Loss of consciousness

• Deterioration of blood pressure and circulation (shock)

• Severe shortness of breath

• Skin rash

• Lightheadedness

• Nausea and vomiting

• Facial swelling

• Difficulty breathing

• Abdominal pain

REFERENCES

Mayo Clinic.  (2015). Disease and Conditions:  Food Allergy. http://www.mayoclinic.org/diseases-conditions/food-allergy/basics/definition/con-20019293

Mayo Clinic.  (2015). Disease and Conditions:  Insect Allergy. http://www.mayoclinic.org/first-aid/first-aid-insect-bites/basics/art-20056593