Introduction7Overview8Prevention14Planning15IHP16IEP17Student1920Administration21Administrator21Nurse22MedicalDirector23Teachers24Personnel26Volunteers27Personnel28EnvironmentalConcerns29Accommodation ID: 884990
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1 TableofContents Introduction............
TableofContents Introduction.........................................................................................................................7Overview........................................................8Prevention..........................................................................................14Planning.................................................................
2 ...........................15IHP........
...........................15IHP............................................................................16IEP................................................................................17Student..........................................................................................19...............................................................................20Administration.
3 ........................................
............................................................................21Administrator.............................................................................21Nurse............................................................................................................22MedicalDirector.........................................................................................2
4 3Teachers...............................
3Teachers....................................................................................................................24Personnel..........................................................................................26Volunteers...........27Personnel......................................................................................28EnvironmentalConcerns.....................
5 ......................................29
......................................29Accommodations...............................................................................................32Issues..................................................................................................................33EventReaction..........................................................................34Development.................
6 ........................................
...................................................................36 2 2 Pages Regulations........................................................................................................38............................................................................................................................41Policy............................................................
7 ...................................45Let
...................................45Letters.................................................................................................47Plan/EpinephrineSheet........................48ItemChecklist....................................................................50History...........................................................................................51Plan.............
8 ........................................
..................................................................52IndividualizedPlan..............................................................53ManagementAlgorithm.................................................................55 4 Foreword effectiveCommissionerconsultationtheCommissionerStateanaphylacticguidelines(seecompleteLaweachboardadvisabledeveloppolicy,flexibilitythatencom
9 passesconditions,incorporatesnewpolicy,D
passesconditions,incorporatesnewpolicy,DepartmentandNewresponsibilitiesrespondingothermedicalconditions;personnelconditions;guidelinesdevelopmenthealthchildrenconditions;schoolinformationconditions;andotherthecarryingtesting. 5 Foreword consultationassisttheirusedconstitutecare.recommendationsbestdevelopedtheythelawsNeweveryandwasNewStateDepartment Director,NewStateEducation Gingold  Â
10       MSEd           Â
      MSEd                                   NewStatewide SNT,DirectorHospital Professor,DepartmentPediatricsAllergy/ImmunologyDistrict DiLauraDevore,                                      Pediatrician                      School 6 Foreword reviewDirectorServicesStateSchoolBoardAssociatio
11 nMindlinandParentCarolDirectorNutritionA
nMindlinandParentCarolDirectorNutritionAssociationMolloyAssociationNursesAmandaandParentWendyHordandSafetySpecialistStateUnitedAdministratorsAssociationStateNicksonExecutiveDirectorTurnerElementaryPrincipalRushHenriettaSchoolPresidentWilliamKlepackStateAcademyFamilyPhysiciansJoshuaLipsmanHealthHealthMedicalSocietyBrienRN,NursingAssociateExecutiveSecretaryNursingOfficeProfessionsStateEduc
12 ationMarletteGovernmentalRelationsRepres
ationMarletteGovernmentalRelationsRepresentativeStateSchoolBoardsAssociationFrancesO’DonnellNutritionProgramStateEducationAnaphylaxisMunozPacenzaFoodAllergyInitiativeChrisWeissLegislativeRegulationScherrerEducationalProgramsSichererAssociateProfessor,PediatricsSinaiSchoolMedicine Introduction medicalconditions;canthecareallergicstudentallergieshealthrequiresverificationallergymanage
13 menthistory.healthprofessionalpersonnelh
menthistory.healthprofessionalpersonnelhandlelifeincludehealthstaff.schooldepartments;includingguidance,custodialschoolpersonnel,other Allergy Allergies knownthatincidencesetting.Approximatelythepopulationincludecanthereandindividualingestinginhaling,mucousmembranes),causingthatinitialprocessunnoticed.However,thethesereactionhourssymptomsthetheallergicknowncausesAllergies causedhornets.i
14 ncludereactions.timely Allergy follownea
ncludereactions.timely Allergy follownearproperty,coveredinsideAllergies productsproducts,usuallyseriouslatexdegreeshouldavoidedstudentslatexSymptoms bodylimitedshock,waterynoseFaintingSource:PositionStatementAmericanAcademyAsthmaandImmunology)Accessedhttp://www.aaaai.org/media/resources/academy_statements/position_statements/ps34.asp 6/10/08 Allergy respondexperiencemoveallergiesprepara
15 tionsneedaddressneedsexperiencehistoryha
tionsneedaddressneedsexperiencehistoryhavingallergicoccurface“reboundstudentssafety,adolescentshaveallergen verymedical basisAppropriateproviderspotentiallycondition,attention.shoulddiagnosedconditionsfromprogressingEmergencymedicationsanaphylacticdelaymedication.giving Allergy doubttheemergencyimmediatetransportationhavetheirshouldprovider’sdirector’sspecifictelephone kno
16 wnmedicationpractitioner,patientnursepro
wnmedicationpractitioner,patientnurseprofessionaladministerdirectorlegallyprovideregulatorypolicy,commonlybutParent(s)/guardian(s)bringtheautouseunlicensedpersonneladministerauto(trainingtheEpinephrinepotentiallysecond Allergy emergencythatwindowtime,don’tschool*EpiPen®EpiPenJr®.areregisteredtradenamesDEY®registeredtradenameVersusPharmaceuticalscontainslicensedindividuallicensedo
17 rderedstudent,deliveryinformdistrictmayh
rderedstudent,deliveryinformdistrictmayhavinganaphylacticspecificAntihistaminehydrochloridename notthegiveunlicensedstaffmayselfantihistamines.andshould Allergy Epinephrinepersonnel.handledphysicaldelayguidance,localplantheirthehavethem?centrallylocatedlocations Formanek,(2001).FoodWhenFoodBecomestheEnemyAdministration,16,2005tures/2001/401_food.html.Anaphylaxis:SevereAllergicReaction.In
18 dividualizedHealthcareNurse,SunRiseRiver
dividualizedHealthcareNurse,SunRiseRiverPress,2005.NursesAllergy/AnaphylaxisManagemenNationalAssociationSchool2001.AskedQuestionsAnaphylaxis,November30,2005fromhttp://www.foodallergy.org/anaphylaxis/index.html AmericanAcademyAsthma,Allergy,accessed11/6/2007http://www.aaaai.org/media/resources/academy_statements/postion_statements/ps34.asp HA,MendelsonJP.childrenadolescentsEngl1992;327:38
19 0 Importance offendingimportantthestuden
0 Importance offendingimportantthestudent.Allergyinformationstudentandhealthstaffinformationconfidentiality.anaphylaxis,settingingestionfactorsstudents,desks,cafeteria;ingredientssales;curricularshouldallergieswould 15 HealthHistoryandPlanning beginningmayhavestudentneedsmedical,studentssameprocessorderaddressobtainedforms,consultationthehealthhistoryconditiontimefrequency,reactions;hosp
20 italizations;symptoms;accommodationsthes
italizations;symptoms;accommodationstheschool.teamincludes:healthMedicalallthatexposedparent(s)/guardian(s)thereinforceimportancenotifyingthetheircondition.Medicbraceletsallergy. 16 CarePlanConsiderations studentsstudent,individualTheinitiatedschoolnursepersonnelwithconditions.thethatlayuseguidecriticalResourcessampleemergentemergencystudent.forpictureneedsstudenttheprescribedtheplanstaf
21 f/volunteers“needknow”fieldthe
f/volunteers“needknow”fieldthestudent’smedicalprovider. 17 CarePlanConsiderations nursinghealthcarelongeroutlinetheteachingusuallybaseddiscussesinterventionsneed.fromdocumentRehabilitationmajoraccommodationsneeds/disabilities.foodcondition..plan 18 CarePlanConsiderations Specialthedisability.personentitledattendmental,hasdisabilityspecialwhereproblemsparent/guardianthe 19
22 GuidelinesfortheSchoolTeam the threateni
GuidelinesfortheSchoolTeam the threateningconditionbasedrecognizeadultimmediatelysuspectedmuchyouhandsandreadstings:youclosedbees,products;younonothers.successfulmanagementimportanceallergens. 20 GuidelinesfortheSchoolTeam: Parent/GuardianPartnerships approachcommunicatingparent(s)/guardian(s)severestudentsparent/guardian.meetbeforeorderwritten,personneltrainingforparent/guardiantheintro
23 duceopportunityparent/guardianfacilitate
duceopportunityparent/guardianfacilitatefollowingsampleHistory”Resources,necessaryformsDepartment’sdistrictcontainers;plan,theparent(s)/guardian(s)school’sinvolvethemorecomfortable 21 GuidelinesfortheSchoolTeam: SchoolDistrictAdministration managementandhighmodifiedtrainingcommunicationactivities,includingthatallergies.plannursenotificationtrainingteachers,issues,thatthrea
24 teningallergies. SchoolBuildingAdministr
teningallergies. SchoolBuildingAdministrator aspectsthedevelopmentpoliciesinvolvedlatex;reduction 22 GuidelinesfortheSchoolTeam: SchoolNurse detailedhealthhistorydiscussordersproviderEmergencyuseproviderneeded)reviewinformationnecessary.Resources,custodialResources,epinephrinemodifysafetyplaceDevelopmentsampleAssessmentaddress 23 GuidelinesfortheSchoolTeam: SchoolMedicalDirector personne
25 l8NYCRRpractitionerClarificationAnaphyla
l8NYCRRpractitionerClarificationAnaphylacticesny.com/laws_guidelines.cfm forplanningnecessary.Communicateschooland 24 GuidelinesfortheSchoolTeam: Teachers allergy.everytraininginclude:allergies;(Emergencyimmediatelyinitiatetheaccessibleprominentthreateningrequests,thatchild’sconfidentiality.harassing,allergies. Team: Teachers guidelineseventsplanningstudent’stradingsnacksinvolv
26 ementattentionnon 26 GuidelinesfortheSch
ementattentionnon 26 GuidelinesfortheSchoolTeam: FoodServicePersonnel administrationthemfoodrequested;ECPhistory;allergens.protocolswhichcrosscontamination.contaminationandtableschairswithandwaterseparatemanufacturersproductsaresafe.betweenand/orbarrierswithstudentisolatedrequires504needed:symptomssymptoms,takeproperwashing.foodfoodcrosscontamination;allergies.forstudentswithahead 27 Gui
27 delinesfortheSchoolTeam Coaches/Athletic
delinesfortheSchoolTeam Coaches/AthleticDirector AfterSchoolEmployees/Volunteers allafterwithcommunicationandresponsibletheinvolvedactivities 28 GuidelinesfortheSchoolTeam: TransportationPersonnel havetheyallowedattentioncleaning,includinghandrails.mayattendantsemergencycommunicationTransportationthestudents 29 ClassroomandSchoolEnvironmentalConcerns needparent/guardianallergicaccommodat
28 ionsmeetstudentneedenvironmentthatstuden
ionsmeetstudentneedenvironmentthatstudent’spossible.thatchild’sclassroom.student’sconfidentiality.parent/guardianinformencouragedhandsthinknurseseatstudentspeanutaccidentalexposure 30 ClassroomandSchoolEnvironmentalConcerns shouldbowlprogram,thatallergenic.offeredthecontaminationthestudenttheteacherhave.theablesymptomshealthinformationdiscussconfidentialstudentbeenickname.
29 deservesrespectful 31 ClassroomandSchool
deservesrespectful 31 ClassroomandSchoolEnvironmentalConcerns aboutstrategiesMuñozSicherer,nursethestudentspolicypotentialshouldmanagementindependencePatientsignsshouldmeasuresfoodingredients.studentinvolvedemergencythetheircondition.provideralsoinstructed 32 CafeteriaAccommodations shouldlevelexposure.should(ECP)communicationimmediatelyexposureneeds.shouldavoidedestablishedfoods.contai
30 ningtheinformationmanufacturerscontainin
ningtheinformationmanufacturerscontainingshouldcarefullyrechecked.servedallergy.glovesEnvironmentalstudentallergycafeteriaproviderstudentdevelopedsafeincludingtheusedthethose 33 FieldTripIssues thefieldtheschooladministeredtrainedmemberIdeally,planningthestudentingredientsthepersonnelschoolavoidhighriskdestinations;patient“willing”memberstudentthecommunicationparent(s)/guardian
31 (s)theirallergiesbeforewipes. Reaction s
(s)theirallergiesbeforewipes. Reaction studentallergen,immediatelyallergyEmergencyimmediately;Emergencyconsiderations:yoursymptoms,notcalmunattended;attemptthethemthe Ȭ lastsadditionaldoseAmbulancesbroughtmeetlocation.student Reaction factsthemembersinvolvedanaphylacticreactionsupport;anywitnessed 36 PolicyandProtocolDevelopment policiesphysicalmostfollowingnursesconditions;guidelines
32 individualizedriskcommunicationplannurse
individualizedriskcommunicationplannursenursereasonableincludingallergens,opportunitiessuchPolicytheResourcetheattentionmemos Pages Forms and PublicHealthLaw2500H*2–AnaphylacticPolicyforSchoolDistricts commissioner,consultationeducation,schoolguidelinestheSuchdevelopednursesotherexpertisetreatingdirectors,foranaphylacticsubdivisiononethissectionthepreventingindividualizedwithwhichco
33 mmunicationallergyresultreductionanaphyl
mmunicationallergyresultreductionanaphylacticcommissionerthecommissionereducationalpolicy.             and AdditionalRelatedLaws,Regulations,andMemos maypursuantEpinephrineinjectorhttp://public.leginfo.state.ny.us/menugetf.cgi?COMMONQUERY=LAWS administerspecificimmunizationadministeredimmediatelyhttp://www.schoolhealthservicesny.com/laws_guidelines.cfm and AdditionalGuidanc
34 eDocuments Medicationshttp://www.schoolh
eDocuments Medicationshttp://www.schoolhealthservices http://www.schoolhealthservicesny.com/laws_guidelines.cfm NutritionKnowledgeResources:http://portal.nysed.gov/portal/page/pref lableAnnouncement1.ht Networkhttp://www.foodallergy.org/downloads/HTRLsheet.pdf http://www.kidshealth.org/parent/firstaid_safe/sheets/insect_stings_sheet.html EpinephrineAutohttp://www.schoolhealthservicesny.c
35 om/uploads/Use%20of%20Epi pens%20June%20
om/uploads/Use%20of%20Epi pens%20June%202002.pdf 41 Glossary Symptomswhichoccursuddenlyshortcourse.AdrenalineSynonymAllergiesconditionthesystemprotein ȬȬ inhaled,ingested,notallergicAllergicproducesOncehistaminecausestriggerhives,(loweredallergythreateningthatthesuchandhives.Antihistaminesmedicationsbody 42 Glossary disorderbronchoconstriction,mucus,edema.Thesebreathingthe    las
36 tingMajor(usuallyingredientsfoodoils,nur
tingMajor(usuallyingredientsfoodoils,nursebothpersonnel.theandexperiencingpotentiallyusedmeasuredduringanaphylaxis*EpiPen®andJr®.registeredtradenamesDEY®ratealsocontraindicationsallergicFAANeducationSectionActprotectsphysicalPlanusefulneeds. 43 Glossary allergiesthatoccursingested.HistaminenaturallyWheninhaleallergen,membranescausingitchingchangesthethatallergens.tongue,throatHivesdoc
37 umentbasedstudentlanguagetheAlsoallergie
umentbasedstudentlanguagetheAlsoallergiescontactprotocolphysicianmemberknown 44 Glossary him/herselfmaketheand/ordirectedthetheimprovethebefore/after(e.g.,ThisdeliverssymptomsbeforeemergencyTwinjectprovidesmedicationregisteredtradenameVersusPharmaceuticals AnaphylaxisPolicy andOverview)severehascausesincludeaffectvariousbreathingbloodEpinephrineAnithistaminestheeffectsepinephrine.immedia
38 tely.(Importanceanaphylaxis.keystudentma
tely.(Importanceanaphylaxis.keystudentmanagementtheallergiesthreatening Identifyingmembersrolesresponsibilities)MedicalVolunteersadjustmentsgeneraltrainingrecognitionmanagementconditionIndividualizedprotocolsEpiPens,alluselawsspecificconditions;selfhealthhealththeinformationECP)training 47 SampleFormsandLetters AllergyIndividualizedEmergency P age 48 P age 49 Making the difference .
39 . . Life-Threatening Allergies CH
. . Life-Threatening Allergies CHECKLIST healthadministrationhealthcarewrittenemergencymedicationsemergencymedications(EpiPenBenadrylschoolschoolwithcontactnumbers,updatedalternatesnacksneededschool ageappropriateunderstandingallergy,allergens,riskadultschoolexperiencingallergicreactionfeelingswithschoolnurse/parent/guardian/mentalstaffregardingallergyidentifycontainingallergensen
40 vironmentaccommodations(cafeteria,classr
vironmentaccommodations(cafeteria,classroom,Readlabelsvigilantlywatchallergens shouldhavehis/herdeskchairdiscreetlylabelappropriateparent/guardianenvironmentsafe”letterallparent(s)/guardian(s)requestingthatallergensafesnacksallstudentshandsthoroughlyaftersnacksandlunchstudentseparatedisposablecontainersthatexposedallergenspreparationReadlabelsvigilantlywatchallergensPlanaccommodatio
41 ns reviewcareplans(IHP,personnelleasttwi
ns reviewcareplans(IHP,personnelleasttwiceyearappropriatepersonnelregardingemergencystaffrecognizeandallergicstudentreadlabelscarefullyCollaborateadministrationfacultyandsafesignsdoorsneeded)protocolstrainspecificrolesemergencysituation Designatesafe”tableawayfoodserviceareapaperplacematavailableEncourageotherstudentsallergensafeluncheseatDiscreetlylabelseparateallergicpossible,with
42 parent/guardiantablewithclothcleanerSITU
parent/guardiantablewithclothcleanerSITUATION!suchFormulaLysolwipes,bleach,effectivelyallergentabletopsothersurfaces.AntibacterialgelseffectiveandusedSchool P age 50 SAMPLE Allergies Name:   Birth:             PrimaryHealth           SecondaryHealth           Provider’sName:            Diagnosis(note         studenta
43 llergy?       _________ _________
llergy?       _________ ________________________________________________________________________________________________ Whatsymptomsledtothediagnosis?_________________________________________________________ __________________________________________________________________________________________ usual        _________ ____________________________________________________
44 ________________________________________
___________________________________________ Approximatelymanyallergicreactionsexperienced?     washis/herlastallergicreaction?         studenthospitalizedresultallergicreaction?   manytimes?    studentearlyawarenessallergicreaction?     treatmentusuallyrequireallergicreaction?      studentexperiencedallergicreactionschool      pleasedescribelat
45 estincident:Â Â Â Â Â Â Â Â Â _________
estincident:         ________________ studentasthma?:               (Asthmacanincreaseseverityreaction)haveallergicreactionsaffectedhis/herasthma?_________________________________________________ _______________________________________________________________________________________________ studentdirected?                   anythingelsethatthe
46 shouldtakecarecanstudent? schoolinformat
shouldtakecarecanstudent? schoolinformationrespectfulconfidentialmanner.Mayschoolstaffshareinformationwithstaff“needbasis?                    Parent/GuardianSignature           _________ Page51 SERVICESSchoolYear:   SAMPLEPLAN– StudentName:           Grade:    IdentifiedAllergen(s):                 Asthma:Â
47              relevant  Â
             relevant            (H)   (W/C)        Name:     (H)   (W/C)    Contact:     Phone:   (W/C)    Additionalcontactsneeded:          BuildingHealthSchoolNurse:       Phone:    can’treached,call:          ANTHESE General:Dizziness,lossfeelingpanicdoomMouth:Swellingface,
48 throat;reportthatdifficultybreathing,con
throat;reportthatdifficultybreathing,congested,cough,tightnessthroatStomach:nausea,abdominalcramps,diarrheaSkin:swelling,rashyouthesymptoms,importantinitiatethefollowingcare:possible,rinsethemouthwithfollowingmedicationprovider:Benadryl:     Yes         administration:        _______ Epinephrine:     Yes         administration:        epinep
49 hrineemergencyservicesaccessed Reporttha
hrineemergencyservicesaccessed ReportthatthestudentallergicreactionindicaterequireSupportadditionalshouldinitiatedimmediatelyfollowingwithoutwaiting        provider)shouldinitiatedfollowingappearancehealthcareprovider)Provider’sName:           PreferredHospital:             written           Theparentguardiansignatureauthorizesschoolsh
50 areinformationschoolstaff“needknow&
areinformationschoolstaff“needknow”basis.eventemergency,carewillparentscontacted.for the current school year and summer session as needed onlyGuardianSignature:           StPicture Pa g e52 INDIVIDUALIZEDHEALTHCAREPLAN          1/1/98 Grade: HealthAllergy:andPeanut           AnaphylacticdueExposurePeanuts Diagnoses:     regimenmanagemen
51 tallergy00082)Items:medicationsneeded.av
tallergy00082)Items:medicationsneeded.avoidingallergens,medicationsemergentsituation.completehealthdevelopingcareschool.staffenvironmentexposureandpresentationpeanutmanagement.protocolsneeded)thatneeded.(includingordershealthcarestaffthatemergencymayAnticipatedResults:andexperiencedifficultieseventallergicreaction.activemanagementand P age 53 Name:Â Â Â JaneJones Birth:Â Â Â Â Â Â 1/1/98
52 Grade:4 PrimaryHealthAllergy:PeanutsPea
Grade:4 PrimaryHealthAllergy:PeanutsPeanutProducts   SecondaryHealth        withassessprovideteachersyearneeded.presentationfallmeetingaddresssecondImpairment Diagnoses:associatedcausingexchange        intolerancedifficultiesItems:regardingasthmaorderedhealthcaresymptomsasthmaepisode.treatmentneededasthmaepisode.Demonstrateandidentifiedmedicationsandinhalermedicatio
53 nneeded.supportasthma.Jane’sasthmar
nneeded.supportasthma.Jane’sasthmareactionstaffJane’smedicationlimitedasthmaasthmaneedsJane’sAnticipatedResults:participatingasthmamanagementwithmanagementquestionsneededhealthstatus. P age 54 No Registrationbasicinformation(generalform) Parent/guardianindicatesthathistory Yes Parent/guardianschoolallergydiagnosis Parent/guardiangivesschoolprivate allergyprivatehealthca
54 re No Yes nursestudentspecificEmergencyC
re No Yes nursestudentspecificEmergencyCarePlan(ECP)parent/guardiansignforwardprivatehealthcareprovidertrainsstaff“asbasiseadsassistsschoolteamsafestudentbasedindividualneedseviewsplanneeded arent/guardianstudentconfidentstrategiescareplans O administration ferparent/guardianback Parent/guardianstudent nurse/Principal/SchoolReviews“CaringStudentsLifeAllergies”Reviewsschool
55 districtAnaphylaxisPolicywithparent/guar
districtAnaphylaxisPolicywithparent/guardiandiscuss:AnaphylaxisPolicyCareDiscuss:StrategiesavoidallergensCommunicationstaffaccommodationsobtains:Parent/guardianwithknow”basisMedicationanymedicationprescriberParent/guardian priva t e healt h care prov ider as need ed cumulative health re c o r d Parent/guardianneededmedicationordersmedication Yes No carepermission) enrolled Yes No te