To hear that a staggering 20% of anaphylactic reactions take place while your child is in the care of their school makes worrying reading.
My two favourite charities are working together to do what they can to raise awareness about the importance of checking expiry dates, getting staff trained and storing adrenaline correctly. Read on to find out more…
Allergy charities combine forces and urge schools to check it, don’t chance it when it comes to stored allergy medications
Most classrooms can expect at least one child to have a food allergy with 20% of severe food allergic reactions occurring while a child is at school. Anaphylaxis Campaign and Allergy UK have joined forced to raise awareness of the need for the treatment of such allergies, AAI (auto adrenaline injector) pens to be checked to ensure they are safe for administration.
After a six month break due to the Covid-19 pandemic many schools are facing a potential risk of AAI medication being void due to expiry dates, storage conditions and more importantly a lack of up to date training of key staff. Covid-19, whilst a life-threatening virus for many, data[1] shows that only two (0.005%) of the 38,156 deaths from coronavirus during March and April in the UK were children aged 14 or under. By comparison, research of children with allergies by Anaphylaxis Campaign discovered that 80% of school aged children had experienced anaphylaxis and 61% had been admitted to hospital when they last experienced a severe allergic reaction[2].
Peanuts, tree nuts, milk and eggs are some of the most common allergens responsible for adverse reactions in children. A very severe allergic reaction can cause anaphylaxis which affects more than one body system such as the airways, heart, circulation, gut and skin. Anaphylaxis is a potentially life-threatening reaction and always requires an immediate emergency response.
Amena Warner, Head of Clinical Services at Allergy UK said: “For parents of children with food allergies their anxiety will be particularly acute with very specific worries about the care and safety of their child in the ’new normal’ school environment. Schools have implemented many changes to keep pupils and staff safe during the pandemic including social distancing bubbles, regular hand washing and cleaning of shared spaces. A ‘no sharing of food’ policy will be one additional protective measure for the food allergic child who should always be aware that they should not share or accept food from others.
“All schools must also ensure measures are in place and they are adhering to the strict guidance governing the health care and safeguarding needs of children in schools which includes the administration of allergy medication and adrenaline auto-injectors (AAIs).”
The treatment for anaphylaxis is an injection of adrenaline and children at risk of anaphylaxis are often prescribed adrenaline auto-injectors (AAIs) to use in an emergency. Children prescribed adrenaline should have two AAIs available to use at all times. Parents and schools are being encouraged to ‘Check It, Don’t Chance It’ to ensure the safeguarding of children with allergies:
- Expiry Dates: With schools having been closed for six months or more it is important that schools holding either the child’s own AAIs or ‘spare’ AAIs check that they are still in date. AAIs are typically dispensed with a shelf life of 12-18 months so many held in schools are likely to have expired and will need replacing. When replacing expired AAIs schools can register their new devices on the manufacturer’s website to receive future timely text and email alerts when the expiry date approaches.
- Storage: Adrenaline must also be stored correctly. Pens (AAIs) should be kept in their original containers to prevent light exposure, must not be stored above 25c and must not be refrigerated or frozen. Given the hot spring and summer this year it is paramount these are checked. All AAIs have a small window that allows the adrenaline inside to be checked. The liquid should be clear and colourless. Any AAIs where the liquid appears discoloured or contains particles should be replaced. AAIs should be stored in a safe, but easily accessible place where they are no more than five minutes away from the child at any time.
- The child’s weight and dose of adrenaline: AAI pens are available in two doses 150mcg and 300mcgs. Children grow fast so parents are urged to keep an eye on their child’s weight and ask their GP to prescribe the higher dose AAI once they have reached the appropriate weight as instructed by the adrenaline manufacturer.
- Allergy Action Plan: Every child with severe allergies needs to have an allergy action plan which should be kept with their AAIs. Check that this plan is up to date at all times.
- Training: Check that all school staff are fully aware of the signs and symptoms of anaphylaxis, how to provide emergency treatment and the implications for management of severely allergic children in school. Free training is available at www.allergywise.org.uk and the SAAG (School Allergy Action Group) free online toolkit for the development of a whole school management policy is available at www.allergyuk.org
Lynne Regent, Chief Executive Officer at Anaphylaxis Campaign said: “Allergic reactions can happen at home, school or when out and about, so correct use when it is needed may save a life. It is important for schools to be aware that 20% of serious food allergic reactions occur in school and that in children, serious allergic reactions may occur for the first time while they are at school. It is therefore essential that staff are educated to recognise the signs and symptoms of severe food allergy and initiate treatment.
“Since a change in the law in 2017, schools have also been allowed to purchase additional AAIs without a prescription to keep in school. They are not intended to replace the child’s own prescribed AAIs but for use as emergency back-ups if the child’s own pens are not available for any reason.”
Oliver Greene, aged 11, from Edgware, North London was born with a range of food allergies however as he grew, his allergies slowly changed and by the age of 6, his only known allergy was to nuts. However, in 2018 Ollie suffered an unexpected anaphylactic shock, at school after he ate a vegi-salami lunch.
Keren, Oliver’s Mum said: “The school reacted really well, they called the ambulance and followed advice. They then checked all the ingredients in the kitchen that day to ensure there had been no traces of nut. However, upon taking Oliver to an allergy consultant for further tests it was discovered that his allergy to soya, which was in the vegi-salami, had returned.”
For Keren, Oliver and his school this was their first experience with anaphylaxis. The school invested in adrenaline auto-injectors (AAIs) and trained staff in the steps to follow if someone has symptoms of anaphylaxis. Oliver recovered but suffered further anaphylaxis, in January 2019, on the first night of a weekend away with his school year group and again spent a night in hospital. Further tests revealed it was possible that he was allergic to celery:
“The second time, school gave Oliver the adrenaline pen and called the ambulance straight away. They had an adult with him all the time and checked the kitchen and ingredients but again it was an undiscovered allergy. The school also bought spare adrenaline pens to keep in case this happens to a child again and offered a first aid programme to the children to teach them how to administer AAI’s. Anaphylaxis can come with no warning, so it is vital to be prepared.”
A brand of AAI called Emerade has recently been withdrawn from the market and even if it is in date it should be replaced. Speak to your GP about this and to get a prescription for a different brand such as EpiPen or Jext that can still be prescribed.
[1] Office for National Statistics (ONS) show that only two (0.005%) of the 38,156 deaths from coronavirus during March and April in the UK were children aged 14 or under, and eight (0.02%) recorded in the 15-19 age range.
[2] Study conducted by Anaphylaxis Campaign, 1217 people responded (562 adults and 655 parents/carers on behalf of their child)
About Allergy UK
We are the leading national patient charity for people living with all types of allergy. We work with government, professional bodies, healthcare professionals and corporates to bring about change and help improve the lives of the millions of people living with allergic disease.
It is estimated that 21 million people in the UK live with allergy, but there remains a gap in healthcare services for those affected by this disease. Our mission is to raise the profile of allergy at all levels, with a vision for everyone affected by allergy to receive the best possible care and support.
Our dedicated Helpline is there for people who need our help and support. Our free Factsheets and wide range of resources provide information to explain the symptoms and triggers that impact on the quality of life of those with allergy
About Anaphylaxis Campaign
The Anaphylaxis Campaign is the only UK wide charity focused on supporting those at risk of severe allergies. We have been providing information and support to patients and their families for over 25 years.
Our ultimate aim is to create a safe environment for all people with allergies by working with and educating the food industry, schools, pre-schools, colleges, health professionals and other key audiences. Our focus is on medical facts, food labelling, risk reduction and allergen management.
References and further reading
[1] Office for National Statistics (ONS) show that only two (0.005%) of the 38,156 deaths from coronavirus during March and April in the UK were children aged 14 or under, and eight (0.02%) recorded in the 15-19 age range.
[2] Study conducted by Anaphylaxis Campaign, 1217 people responded (562 adults and 655 parents/carers on behalf of their child)
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