- Rationale of Policy
- Definitions and Background Information
- Individual Health Care Plan with an Emergency Health Care Plan
- School Procedures
- Posting of Signs
- Prevention of Cross-Contamination
- Staff Training
- Emergency Protocols
The Montessori School is committed to the safety and health of all students and employees. In accordance with this, the purpose of this policy is to:
- Provide a safe and healthy school 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 a severe or potentially life-threatening allergic reaction
- Enable food allergic students to participate in all school activities
The prevalence of food allergies may be increasing, affecting many children nationwide. Schools are considered higher risk areas for students with food allergies, with many incidents of accidental exposure occurring in schools. While the application of a school policy cannot totally prevent allergic reactions form occurring, an effective policy can substantially reduce the likelihood of allergic reactions occurring and the severity of consequences if they do occur.
The level of sensitivity and the types and severity of reactions vary significantly among individuals with food allergies. The Montessori School’s approach to preventing situations in which food allergies may occur and in treating food allergies is specific to individual student’s needs. The Montessori School recognizes that a student without a diagnosed food allergy may experience an allergic reaction to food for the first time while at school and that any allergic reaction can become life-threatening. Therefore, The Montessori School’s approach is also comprehensive.
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) means a set of procedural guidelines that provides specific directions about what to do in a particular emergency situation. An emergency health care plan that is specific to a student shall be included in the individual health care plan for that student.
Epinephrine 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 were 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:
- Mucous membranes: swelling of the lips, tongue eyes; red, watery eyes
- Skin: skin inflammation, tingling, itching, hives, rash, flushing
- Upper respiratory: sneezing, coughing, nasal congestion, numbness around mouth
- Lower respiratory: wheezing, deep cough, difficulty breathing, shortness of breath, chest tightness
- Stomach: cramps, nausea, vomiting, diarrhea, acid reflux
- Heart: pale or blue skin, drop in blood pressure, dizziness, lightheadedness, heartbeat irregularities, fainting, shock)
- Mental, emotional states: “sense of impending doom”, irritability, change in alertness, mood change, confusion
Symptoms can begin immediately upon, or up to two hours after, exposure to an allergen. Some individuals exhibit initial symptoms followed by a second phase of symptoms two to four hours later. If more than one system is affected, it is considered anaphylaxis.
Individual Health Care Plan (IHCP) means a comprehensive plan for the care of children with special health care needs, including food allergies. An individual health care plan may include both preventive measures and treatment options. An individual health care plan that is specific to a student shall include an emergency health care plan.
In The Montessori, an Individual Health Care Plan with an Emergency Health Care Plan shall be developed for each student identified with any food allergy with potentially serious health consequences. The Head of School will develop the IHCP with an EHCP in collaboration with the student’s health care provider, the parents/guardians of the student, and the student (if appropriate). The Montessori School must rely on parents/guardians to supply timely and accurate information regarding a student with any food allergy with potentially serious health consequences. Parents/guardians are strongly encouraged to promptly provide accurate information to The Montessori School so that the needed IHCP and EHCP can be created, revised and/or implemented. This plan development will be done, as permitted, prior to entry into school or immediately thereafter for students previously diagnosed with a food allergy. This plan development will be done promptly following the reporting of the diagnosis to the school for students already enrolled who are newly diagnosed with a food allergy. An IHCP should include both preventative measures to help avoid accidental exposure to allergens and to ensure the existence of appropriate responsive measures in case of a serious allergic reaction and/or emergency situation at school.
Depending on the nature and extent of the student’s allergy, the measures listed in the IHCP may include, but are not limited to:
- Posting additional signs (e.g. in classroom doorways and in classrooms)
- Prohibiting the sale of particular food items in the school
- Designating special tables in the cafeteria and in other eating areas
- Prohibiting particular food items from certain classrooms and/or the cafeteria
- Completely prohibiting particular food items from the school or school grounds
- Educating school personnel, students, and families about food allergies and responsive measures when an allergic reaction occurs
- Implementing particular procedures related to cleaning surfaces touched by food products, and washing of hands after eating and storing containers which contain food products
In The Montessori School, the Head of School, in coordination with a consulting nurse, shall implement a protocol, consistent with this policy and with the IHCP, providing food allergic students with protections while they are attending school or participating in school-sponsored activities. The procedures shall be reviewed and updated at least annually, as well as after any serious allergic reaction has occurred at school or at a school-sponsored activity.
In The Montessori School, the Head of School shall post appropriate signs in a conspicuous place at entry for each classroom and the gymnasium and in others school locations as determined by the Head of School, advising that there are students with allergies to peanuts/tree-nuts and/or other specific food allergies. The exact wording on the sign may vary, in accordance with the contents of a student’s IHCPs and school procedures.
The Montessori School will take reasonable care to prevent cross-contamination in areas where snacks and lunch are eaten. Cross-contamination happens when allergens are transferred from one food item to another. Such actions will include:
- Separate lunch tables provided for children with food allergies and for children with lunches containing food allergens in the classroom
- All tables will be cleaned prior to and after use with a mild soap solution and water
- Students are encouraged to wash hands thoroughly under adult supervision before eating their snacks/lunch
- Students are taught to neither share nor exchange each other’s lunches/tableware
- Students with allergies should bring a safe snack at the beginning of the school year that teachers can hand out at school events
In The Montessori School, the Head of School shall identify school personnel who might be involved in managing an emergency in a school, including anaphylaxis. Training shall be provided for these personnel on the signs and symptoms of anaphylactic shock, proper epinephrine auto-injector administration, adverse reactions, accessing the 9-1-1 emergency medical system, and preparation for movement and transport of the student. At all times during normal school hours and at on-site school-sponsored activities, at least one person must have been trained in the administration of the epinephrine auto-injector. These trained staff shall review emergency procedures on an annual basis.
In The Montessori School, the Head of School shall ensure that all school employees and other adults – including, but not limited to teachers, classroom teachers, specialty teachers, aides, student teachers, substitute teachers, food service staff, custodial staff, playground monitors, coaches, and after school providers – who may be involved in the care of a student diagnosed with a peanut/tree-nut allergy and/or other food allergies shall be informed of the IHCP and EHCP. These individuals should understand and consistently follow plans and procedures, be able to recognize symptoms of an allergic reaction and be able to reasonably respond in the event of an emergency.
Parents/caregivers will be informed by the school about their rights and responsibilities regarding IHCPs and EHCPs for food allergic students. They will be given guidance to help them follow the measures stipulated in these plans (e.g. avoiding peanut/tree-nut-based products in snacks or lunches). Parents/caregivers will provide accurate, complete and timely information to The Montessori School about student food allergies. Prior to starting the school year, parents of students with food allergies will supply the school with documentation to verify the allergy, signed by the student’s pediatrician. Parents of students with a food allergies will also present an allergy action plan for each individual student completed by the child’s allergist with current phone numbers as emergency contact information. Parents are also encouraged to communicate with those persons and/or entities transporting a food allergic student so as to ensure that drivers are properly trained to recognize symptoms of allergic reactions and know how to respond in case of an emergency.
If self-management and use of and epinephrine auto-injector by a student is requested by parents, that request shall be considered by The Montessori School and discussed with the parents. The Montessori School shall consider any applicable factors in determining whether self-management and administration of an epinephrine auto-injector by a student is warranted, including but not limited to the student’s age, capabilities, severity of medical need, supporting medical information supplied by the parents or any other source specific to the student, the risk if any to other students and reasonable alternatives and/or precautions that may exist. If self-management and use of an epinephrine auto-injector by a student is authorized, such authorization shall be included in the student’s IHCP.
In the event of an episode of anaphylaxis, the Head of School or other designated school representative will verbally notify the student’s parents/guardians as soon as possible. If the parent or guardian cannot be reached the Head of School or her designate will call 911 and accompany the child to the emergency room until the parent or guardian arrives. Following the episode, the Head of School will write a detailed report of the incident and file it in the student’s health record.
Pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and other statutes and regulations, the confidentiality of students with food allergies shall be maintained, to the extent appropriate and as requested by the student’s parents/caregivers.