Anaphylaxis Prevention and Response (Procedure)

PROCEDURE:

For students with a medically diagnosed life-threatening allergy (anaphylaxis), WSSB will take appropriate steps for the student’s safety, including implementing an Emergency Care Plan. WSSB will utilize the Guidelines for the Care of Students with Anaphylaxis published by the Office of the Superintendent of Public Instruction.

I. Parent/Guardian Responsibility

Upon enrollment of a student, the parent/guardian will inform the school in writing of the medically diagnosed allergy(ies) and risk of anaphylaxis. This information should be reported directly to the school nurses. In the situation in which it is reported to another staff member, the informed staff member should immediately communicate the information with the school nurses. Upon receiving the diagnosis, school nurses will contact the parent/guardian for further information or clarification if need and develop and Emergency Care Plan. An Emergency Care Plan will be developed for each student with a medically diagnosed life-threatening allergy.

II. Emergency Care Plan

1. The school nurses (registered nurses) will develop a written plan that identifies the student allergies, symptoms to exposure, practical strategies to minimize risks, and how to respond in an emergency.
2. The school nurses may arrange for consultation with the parent/guardian prior to the first day of attendance to develop and discuss the Emergency Care Plan. The plan will be developed by the school nurses in collaboration with the parent/guardian, licensed health care provider and appropriate school staff.  If the treatment plan includes self-administration of medications, the parent/guardian, student, and staff will comply with the policy and procedure of the Self-Administration of Asthma and Anaphylaxis Medication.
3. Annually and prior to the first day of attendance, the student health file will contain:
   1. A current and completed Emergency Care Plan;
   2. A written description of the treatment order, signed by the licensed health care provider; and
   3. An adequate and current supply of auto-injectors (and other medications if needed.)  The school will also recommend to the parent/guardian that the student wear a medical alert bracelet at all times. The parent/guardian are responsible for notifying the school if the student’s condition changes and for providing the medical treatment order, appropriate auto-injectors and other medications as ordered by the licensed health care provider.
4. WSSB will exclude from school those students who have a medically diagnosed life-threatening allergy and no medication or treatment order presented to the school, to the extent the school can do so consistent with federal requirements for students with disabilities under the Individuals with Disabilities Act and Section 504 of the Rehabilitation Act of 1973, and pursuant to the following process requirements:
   1. Written notice to the parents, guardians or person in loco parentis is delivered in person or by mail;
   2. Notice of applicable laws, including a copy of the laws and rules; and
   3. The order that the student will be excluded from school immediately and until medications and a treatment order are presented.

III. Communications Plan and Responsibility of Staff

After the Emergency Care Plan is developed, the school nurse or designee will inform appropriate staff regarding the affected student.  The school nurse (registered nurse) will train appropriate staff regarding the affected student and the Emergency Care Plan. The Emergency Care Plan will be distributed to appropriate staff and placed in appropriate locations. With the permission of parents/guardians of the students, if appropriate, other students, parents and volunteers may be given information about anaphylaxis to support the student’s safety and control to exposure of allergens.

IV. All Staff Training

1. Annually, WSSB will provide training on how to minimize exposure and how to respond to an anaphylaxis emergency. The training will include a review of avoidance strategies, recognition of symptoms, the emergency protocols to respond to an anaphylaxis episode (calling 911 when symptoms of anaphylaxis are first observed) and hands-on training in the use of an auto-injector. 
2. Annually, before the start of the school year and/or before the student attends school for the first time, the school nurse will provide student-specific training and additional information will be provided by the school nurse to teachers, teacher’s assistants, residential staff, clerical staff, and food service workers who will have known contact with a student diagnosed with a known allergen and may implement the Emergency Care Plan.

V. Controlling the Exposure to Allergens

1. Controlling the exposure to allergens requires the cooperation of parents, students, the health care community, and all WSSB staff.  Parents, staff, and volunteers will be asked to cooperate and limit the allergen in food on campus.  WSSB may take other precautions, when needed, such as avoiding the use of party balloons or latex gloves.
2. WSSB will identify low-risk and high-risk areas of allergen exposure, such as foods and beverages brought to the school for seasonal events and implement appropriate accommodations,
3. During school-sponsored activities, appropriate supervisors, staff, parents and volunteers will be made aware of the identity of the student with life-threatening allergies, the allergens, symptoms and treatment. The lead staff member will ensure the appropriate medications are brought with the student during off campus activities.

VI. Employee Opt-Out

School employees (except licensed nurses) who have not previously agreed in writing to the use of epinephrine auto-injectors as part of their job description may file a written letter of refusal to administer epinephrine auto-injectors with WSSB administration.

VII. No Liability

If the school employee or nurse who administers epinephrine by auto-injector to a student substantially complies with the student’s prescription (that has been prescribed by a licensed health care provider within the scope of the professional’s prescriptive authority) and WSSB’s policy on anaphylaxis prevention and response, the employee, school nurse, WSSB, and superintendent are not liable for any criminal action or civil damages that result from administration.

Legal References: RCW 28A.210.383, WAC 392-380                                            

Other References:          Guidelines for the Care of Students with Anaphylaxis – OSPI 2009

Attachments:    Standing Order for the Administration of School Supplied Stock Epinephrine Auto-Injectors for Potentially Life-Threatening Allergic Reactions (Anaphylaxis) in Individuals Pursuant to RCW 28A.210.383