Students spend about half of their waking hours at school. Every teacher wants to make their classroom a safe environment for all students, and being aware of food allergies is an important way to do that. Show
Of all the most common allergies, food allergies pose the biggest risk at school due to social activities and cafeterias. Food allergies in children are on the rise, and 40% of those affected report a severe reaction. While some people might erroneously use the word “allergy” to describe an intolerance or diet preference, a true allergic reaction is an involuntary immune response to certain foods and can be very dangerous. The most common food allergens are:
With any food allergy, the severity can’t be predicted, so every educator needs to have the tools to prevent students from coming in contact with common allergens and act quickly when life-threatening reactions occur. Mild reactions vs anaphylaxisMany people experience seasonal allergies throughout the year that cause annoying symptoms like itchy eyes and runny noses, but it’s important to understand that a severe allergic reaction, called anaphylaxis, is different. Mild allergic reactions to food can include things like itching, hives, and mild nausea, but anaphylaxis causes difficulty breathing and can be life-threatening. While prevention is hugely important, teachers can’t stop there, since allergens also hide in foods that you may not be aware of. It may be easy to spot an allergen when a student brings a bag of trail mix with peanuts in it to lunch, but you may not realize that another student’s lunch contains a sauce made with peanuts. Since allergens can be tricky to spot, educators should assume that they will encounter an allergic reaction at some point and prepare for it. A well-prepared teacher could make the difference between life and death when you know the signs and symptoms of anaphylaxis and what steps to take when a student has a severe reaction. Be prepared to actIf one of your students had an anaphylactic reaction tomorrow, would you know what to do? We created our course “Precautions for Anaphylaxis” to help educators understand how common food allergens might affect their classrooms. In this 30-minute course presented by our team at Responsive Learning, teachers will discover more about topics like:
When you’re finished with this course, you’ll have peace of mind knowing everything you need to confidently handle different allergen situations you may face. Whether you’re a new teacher who’s just starting out or have been in education for years, this course will help you know how to take precautions to prevent allergic reactions, recognize the signs and symptoms of anaphylaxis, and how to take action in an emergency. Don’t wait for an emergency before you learn how to take precautions for anaphylaxis. Discover more about this course and view a demo today. About anaphylaxisAnaphylaxis is a severe, potentially life-threatening allergic reaction that can develop rapidly. It is also known as anaphylactic shock. Signs of anaphylaxis include:
What to doAnaphylaxis should always be treated as a medical emergency. If available, an injection of a medicine called adrenaline should be given as soon as possible. Some people with a previous history of anaphylaxis will have an auto-injector of adrenaline. This should be injected into their outer thigh muscle and held in place for 5 to 10 seconds. Instructions for how to use these auto-injectors can be found on the side of each device. You should call 999 for an ambulance whether adrenaline has been given or not. If after 5 to 10 minutes the person still feels unwell, a second injection should be given. This should be given in the opposite thigh. A second dose may also be needed if the person improves and then becomes unwell again. The person should lie flat, with their legs raised on a chair or a low table. If they are having difficulty breathing, they should sit up to make breathing easier. If the person is unconscious, you should move them to the recovery position – on their side, supported by one leg and one arm, with the head tilted back and the chin lifted. If the person's breathing or heart stops, cardiopulmonary resuscitation (CPR) should be performed. Further treatment will be carried out in hospital. Read more about treating anaphylaxis. Causes and triggersAnaphylaxis is the result of your body's immune system overreacting to a harmless substance, such as food. Substances that trigger allergic reactions are known as allergens. Anaphylaxis usually develops within minutes of contact with an allergen, but sometimes the reaction can happen up to 4 hours later. The most widely reported triggers of anaphylaxis are:
Read more about the causes of anaphylaxis. Preventing further episodesIf you know what has triggered anaphylaxis, it's important to take steps to avoid exposure to similar triggers. You should be referred to a specialist allergy clinic to either find out your allergy triggers or, if you already know what causes it, for further assessment and advice about how to avoid allergens in the future. You may be given two adrenaline auto-injectors to use during any future episodes of anaphylaxis. Read more about preventing anaphylaxis. Who is affected?Anaphylaxis is not common, but people of all ages can be affected. People with other allergic conditions, such as asthma or the allergic skin condition atopic eczema, are most at risk of developing anaphylaxis. Although the condition is life threatening, deaths are rare. There are around 20 deaths in the UK each year. With prompt and proper treatment, most people make a full recovery. Causes of anaphylaxisAnaphylaxis is caused by a problem with the immune system, which is the body's natural defence against illness and infection. In the case of anaphylaxis, your immune system overreacts to a harmless substance and releases a number of different chemicals, such as histamine, to deal with the mistaken threat. TriggersSome of the more common triggers for anaphylaxis are shown below. Insect stingsMost cases of anaphylaxis are caused by wasp and bee stings, although potentially any insect bite or sting can cause anaphylaxis. It's estimated around 1 in 100 people will experience an allergic reaction after a wasp or bee sting, but only a small number of these people will go on to develop severe anaphylaxis. FoodsMore than half of all cases of food-related anaphylaxis are caused by peanuts. Other foods known to trigger anaphylaxis include:
MedicinesMedicines known to trigger anaphylaxis in a small amount of people include:
People sensitive to these types of medicines will usually develop anaphylaxis as soon as they begin a course of treatment, although they may have safely received them in the past. The risk of anaphylaxis using these types of medicines is very small, so in most cases the benefits of treatment outweigh the potential risk. For example, the risk of developing anaphylaxis is around:
Contrast agentsContrast agents are a group of special dyes used in some medical tests to help certain areas of your body show up better on scans such as X-rays. For example, a contrast agent injected into a blood vessel will help show up any problems in the vessel, such as a blockage, on the X-ray. This is known as angiography. The risk of developing anaphylaxis after being injected with a contrast agent is thought to be less than 1 in 10,000. Rubber latexLess than 1 in 100 people in the population has a natural rubber latex allergy. Healthcare, hair, beauty, catering and motor industry workers are more likely to have a latex allergy. Those with a history of hayfever, asthma, eczema, and certain medical conditions, like spina bifida, are more likely to be affected. Idiopathic anaphylaxisSometimes, despite extensive testing, no trigger can be found for anaphylaxis, and the cause remains unknown. This is known as idiopathic anaphylaxis. Treating anaphylaxisIf you think somebody is experiencing symptoms of anaphylaxis, you should use an adrenaline injector if one is available. Dial 999 immediately afterwards. Call 999 straight away if an adrenaline injector is not available. If you can see a potential trigger, such as a wasp or bee sting stuck in their skin, carefully remove it. Adrenaline injectionsAdrenaline causes the blood vessels to become narrower, which raises your blood pressure and reduces swelling. It also causes the airways to open, relieving breathing difficulties. An adrenaline injection should be given as soon as a serious reaction is suspected. The signs of suspected anaphylaxis are:
The injection can be done by the person with anaphylaxis, but sometimes – if it's a young child or someone who is unconscious, for example – another person may need to do it. Before attempting the injection, make sure you know what to do. You should read all of the instructions carefully when you, or the person you are responsible for, are first prescribed the injector. After injecting, the syringe should be held in place for 5 to 10 seconds. Injections can be given through clothing. After injecting the adrenaline, you should immediately dial 999 for an ambulance, even if the person is starting to feel better. Most people should experience a rapid improvement in symptoms once the adrenaline has been used. If there's no improvement after 5 to 10 minutes, you should inject a second dose of adrenaline, if one is available. This should be injected into the opposite thigh. Read Medicines and Healthcare products Regulatory Agency (MHRA) 2014 guidelines on how to use an adrenaline auto-injector (PDF, 188kb). Positioning and resuscitationIn most cases, the person should lie flat, with their legs raised on a chair or a low table, to help maintain bloodflow to the head and heart. Pregnant women should lie down on their left side to avoid putting too much pressure on the large vein that leads to the heart. If the person is conscious but having trouble breathing, they should sit up to make breathing easier. If the person is unconscious, check that their airways are open and clear, and also check their breathing. Then put them in the recovery position to make sure they don't choke on their vomit. Place the person on their side, making sure they are supported by one leg and one arm. Open the airway by tilting the head and lifting the chin. If the person's breathing or heart stops, cardiopulmonary resuscitation (CPR) should be performed. Admission to hospitalEven if adrenaline is given, the person will need to go to hospital for observation – usually for 6 to 12 hours – as symptoms can occasionally return during this period. While in hospital, an oxygen mask can be used to help breathing, and fluids given by an intravenous drip directly into a vein can help increase blood pressure. As well as adrenaline, additional medications such as antihistamines and corticosteroids can be used to help relieve symptoms. Blood tests may also be carried out while you're in hospital to confirm anaphylaxis. You should be able to leave hospital when the symptoms are under control and it's thought they will not return quickly. This may be after a few hours, but you may have to stay in hospital for a few days if the symptoms were severe. You may be asked to take antihistamines and corticosteroid tablets 2 to 3 days after leaving hospital to help stop your symptoms returning. You will probably be asked to attend a follow-up appointment so you can be given advice about how you can avoid further episodes of anaphylaxis. An adrenaline auto-injector may be given to you for emergency use between leaving hospital and attending the follow-up appointment. Read more about preventing anaphylaxis. Preventing anaphylaxisIf you have anaphylaxis, you should be offered advice and medication to help prevent further episodes. Allergy clinicYou should be referred to a specialist allergy clinic for tests to find out what caused the anaphylaxis. Knowing what allergen triggered the allergic reaction can help you avoid further episodes of anaphylaxis. Some of the tests commonly used to determine allergies include:
Read more about diagnosing allergies. Adrenaline auto-injectorsYou may be prescribed an adrenaline auto-injector if you've had a previous episode of anaphylaxis and there's a risk of you having another episode in the future. There are 3 types of auto-injector:
Each type is slightly different, and you should make sure you know how to use your auto-injector correctly. You can also ask for a "trainer" kit so you can practise giving yourself or your child injections. The following points are important:
Avoid triggersIf a trigger has been identified as causing your episode of anaphylaxis, you will need to take steps to avoid it in the future. FoodYou can reduce the chances of being exposed to a food allergen by:
See our page on living with a food allergy for more information. Insect stingsYou can reduce your risk of being stung by an insect by taking basic precautions, such as:
Some specialist allergy centres also offer special treatment to help desensitise you to insect stings if you are at a particularly high risk of a further sting – for example, if you are a beekeeper or gardener. Read more about preventing insect stings. MedicinesIf you're allergic to certain types of medicines, there are normally alternatives that can be safely used. For example, if you're allergic to:
Always tell any healthcare professional about medicine allergies you have, as they may not be aware of them. Contrast agentsThere may be times when it's necessary to use contrast agents – for example, if you had bleeding inside your brain – even if this places you at risk of anaphylaxis. In such circumstances, you can be given injections of antihistamines and corticosteroids before the contrast agents, which may help prevent symptoms occurring or at least make them less severe. What is the first thing you should do when a patient is having an anaphylactic reaction?Call 999 for an ambulance immediately (even if they start to feel better) – mention that you think the person has anaphylaxis. Remove any trigger if possible – for example, carefully remove any stinger stuck in the skin.
Which one is the most important in the management of anaphylactic shock?Epinephrine — Epinephrine is the first and most important treatment for anaphylaxis, and it should be administered as soon as anaphylaxis is recognized to prevent the progression to life-threatening symptoms as described in the rapid overviews of the emergency management of anaphylaxis in adults (table 1) and children ...
What is the most important action a nurse can take to prevent anaphylactic shock in a patient?The FIRST step the nurse should take is to immediately remove the allergen. This would be stopping the medication, and then call a rapid response. The nurse should maintain the airway and start CPR (if needed) until help arrives.
What are the appropriate steps to manage an anaphylactic reaction?If anaphylaxis is suspected, take the following steps: Rapidly assess airway, breathing, circulation, and mentation (mental activity). Call for emergency medical services (EMS). Place the patient in a supine position (face up), with feet elevated, unless upper airway obstruction is present, or the patient is vomiting.
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