The Smithfield School Department is committed to the safety and health of all students and employees. In accordance with this and pursuant to Rhode Island General Laws §§16-21-31 and 16-21-32, the purpose of this policy is to:
- Provide a safe and healthy learning environment for students with food allergies
- Reduce the likelihood of severe or potentially life-threatening allergic reactions
- Ensure a rapid and effective response in the case of severe or potentially life-threatening allergic reaction
- Protect the rights of food allergic students to participate in all school activities.
Nearly every school has students who have severe, sometimes life-threatening allergies, some of them undiagnosed. Schools are considered high-risk areas for students with food allergies. While schools may not be able to totally prevent allergic reactions, they can dramatically reduce both the likelihood of such reactions occurring and the severity of consequences if they do occur. Effective prevention and treatment plans, proper procedures, well-trained staff and clear communication can save lives.
The level of sensitivity and the types and severity of reactions vary considerably among individuals with food allergies. Therefore the school’s approach to preventing and treating food allergies must be tailored to those individual’s needs. At the same time, an undiagnosed student may experience an allergic reaction to food the first time while at school and any allergic reaction can turn life-threatening. Therefore the school’s approach must also be comprehensive.
Definitions and Background Information
Anaphylaxis is an acute allergic reaction that affects more than one system of the body. It is a life-threatening event. If someone exhibits difficulty breathing, a drop in blood pressure, or symptoms in more than one body system (cutaneous, respiratory, gastrointestinal, or cardiovascular) after possible exposure to an allergen, it should be considered anaphylaxis. Medical attention and treatment should be sought immediately.
Emergency Health Care Plan (EHCP) (the doctor’s orders) means a set of procedural guidelines that provide specific directions about what to do in a particular emergency situation.
Epinephrine (also known as adrenaline) is the treatment of choice to prevent or treat anaphylaxis. It can help reverse the symptoms and prevent progression to other symptoms. It should be given immediately. A delay in treatment with epinephrine can be fatal.
Epinephrine auto-injector (sometimes called EpiPen) is a device that is used for the automatic injection of epinephrine into the human body.
Food allergy is an abnormal, adverse reaction to a food that is triggered by the body’s immune system. The immune system responds to an otherwise harmless food as if it was harmful, resulting in the release of various chemicals, including histamines. The most common food allergies are to peanuts, tree nuts, milk, soy, eggs, fish, crustacean shellfish, and wheat.
Food allergy symptoms are manifestations of the allergic reaction in various parts of the body.
Symptoms may affect:
- the cutaneous system (skin inflammation, tingling, itching, hives, rash, swelling of the tongue or throat);
- the respiratory system (runny or stuffy nose, sneezing, coughing, wheezing, difficulty breathing);
- the gastrointestinal tract (abdominal cramps, vomiting, diarrhea); and
- the cardiovascular system (drop in blood pressure, dizziness, lightheadedness, heartbeat irregularities, fainting, shock).
Symptoms can begin immediately upon, or hours after, exposure to an allergen. Some individuals exhibit initial symptoms followed by a second phase of symptoms hours later.
Individual Health Care Plan (IHCP) (other accommodations the school provides) means a comprehensive plan for the care of children with special medical needs, including food allergies. IHCPs may include both preventive measures and treatment options.
An Individual Health Care Plan/Emergency Health Care Plan shall be developed for each student identified with any food allergy with potentially serious health consequences. The school nurse teacher will develop the IHCP/EHCP in collaboration with the student’s health care provider, the parents/guardians of the student, and the student (if appropriate). This shall be done prior to the entry into school or immediately thereafter for students previously diagnosed with an allergy; it should be done after the diagnosis for students already enrolled who are newly diagnosed with an allergy. In both instances, a directive from the child’s physician and signed by the parent must be supplied to the school in order to formulate the plans. These plans should include emergency measures in case of exposure.
Smithfield Schools comply with the RI State General Law 16-21-30.
The principal, in coordination with the school nurse teacher, shall implement protocols consistent with this policy and with the IHCPs / EHCPs, providing food allergic students with protections while they are attending school. These protocols should include:
- All Smithfield public schools have a designated peanut/tree nut free table in the cafeteria. For the elementary level, annual completion of the Smithfield Public Schools Food Allergy Waiver Form (Revised May 2016)
- No foods containing peanuts/tree nuts, or peanut/tree nuts based products shall be sold/distributed in the school.
- All elementary schools are peanut/tree nut free snack schools. No snacks may be sent to the school that contain any peanut/tree nut products to be eaten in the classroom. Lunches sent from home are not affected by this policy. Students bringing in lunches that may contain peanut/tree nut products will not be seated the the nut free tables in the cafeteria.
Posting of Signs
Signs shall be posted at all entrances to the schools and cafeterias advising that there are students with allergies to peanuts/tree-nuts.
Training shall be provided for personnel on the signs and symptoms of anaphylactic shock, proper epinephrine auto-injector administration, adverse reactions, accessing the “911” emergency medical system, and preparation for movement and transport of the student. At all times during normal school hours, at least one person other than the certified school nurse teacher must be trained and responsible for the administration of the epinephrine auto-injector, subject to Good Samaritan provisions. These personnel shall review emergency protocols on an annual basis. If trained school personnel are not available, any willing person may administer the epinephrine auto-injector. Good Samaritan provisions apply. School bus drivers and monitors shall receive training in the administration of epinephrine.
The principal shall ensure that other school employees - including, but not limited to, school nurse teachers, classroom teachers, specialty teachers, aides, student teachers, substitute teachers, food service staff, custodial staff, playground monitors, coaches - who may be involved in the care of a student diagnosed with a peanut/tree-nut allergy shall be informed of the IHCP/EHCP, as appropriate. These individuals should understand and consistently follow plans and protocols, be able to recognize symptoms of an allergic reaction, know what to do in an emergency, and work with other school staff to eliminate the use of food allergens in the allergic student’s snacks and meals, educational tools, arts and crafts projects, or incentives.
If a student has been authorized to carry his/her own epinephrine auto-injector, at least one additional epinephrine auto-injector should be made available to the school staff for access. Refer to Smithfield school Dept policy 31-40 revision date 6/15/15.
Emergency Protocols and Standing Orders
The child’s physician shall review at least annually the procedures for addressing incidents of anaphylaxis and the use of the epinephrine auto-injector. The student’s parents/guardian are responsible for providing this annually updated directive from the child’s physician, and their written authorization, to the school. They are responsible for supplying and replacing when necessary all prescription medication that is authorized pursuant to this section. The IHCP will be developed as soon as the physician’s directive is received by the school.
The school physician shall issue a standing order for the administration of an epinephrine auto-injector by the school nurse for a student who has not been previously medically identified for the prevention or treatment of anaphylaxis. (Each school building has one designated for this purpose.)
In the event of an episode of anaphylaxis, the principal/school administrator shall verbally notify the student’s parents/guardians as soon as possible or delegate someone to notify them. Following the episode, the school nurse teacher shall complete a written report and file it in the student health record.
All threats or harassment of students with food allergies will be taken very seriously and will be dealt with in accordance with the Smithfield bullying and discipline policies and pursuant to Rhode Island General Laws §16-21-34.
Pursuant to Section 504 of the Rehabilitation Act of 1973 (Section 504), the Family Educational Rights and Privacy Act (FERPA), the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Rules and Regulations for School Health Programs (R 16-21-SCHO), and other statutes and regulations, the confidentiality of students with food allergies shall be maintained, to the extent appropriate.
Evaluation and Review
This policy shall be reviewed and updated on a regular basis, particularly after a serious allergic reaction has occurred at a school or at a school-sponsored activity.