1. Life Threatening Food Allergies
in Schools and Educational
Programs
Why We Need State Mandated
Guidelines
Suzette Cyr, RN, BSN
Jennifer Kelley, RN BSN
Jeremy Beaulieu, RN, BSN

2. What is a Food Allergy?
When the body’s immune system mistakenly
believes a harmless substance is harmful to
the body. It tries to protect the body by
releasing histamines and IgE antibodies to
attack the substance.

3. Food Allergy Response
 Chemical triggers like histamine and IgE
antibodies are released in response to an
allergen and can cause allergic reactions
with a variety of symptoms
 Symptoms may vary from person to person
and not all reactions appear the same

4. Histamine Reaction

5. Symptom Reactions
 Symptoms can range
from mild to severe.
Severe, life-
threatening reactions
are called anaphylaxis.
 40-50% of people
diagnosed with food
allergies are judged to
have a high risk of
anaphylaxis.

6. Symptoms of Anaphylaxis
 Tingling sensation in the
mouth
 Swelling of the tongue and
throat
 Difficulty breathing
 Hives
 Vomiting
 Abdominal cramps
 Diarrhea
 Drop in blood pressure
 Loss of consciousness
 Death (in rare cases)

7. Common Food Allergies
 Peanuts
 Tree nuts
 Wheat
 Soy
 Milk
 Eggs
 Fish
 Shellfish

8. Food Allergy Statistics
 There is no cure for food allergies. Strict avoidance of food
allergens and early recognition and management of allergic
reactions to food are important measures to prevent serious
health consequences.
 More than 12 million Americans have food allergies. That’s
one in 25, or 4 percent of the population.
 Approximately 2 million school-age children (ages 5-17)
have food allergies in the U.S.
 The CDC reported an average of 317,000 food allergy-
related ambulatory care visits per year to emergency and
outpatient departments and physicians offices for children
under the age of 18.

9. Food Allergy Statistics
 In two published studies addressing fatal
food anaphylactic reactions, more than half
(59%) of the individuals were age 19 or
younger.
 In a study of 13 food allergy-induced
anaphylactic reactions in school-age
children, four of the six fatal reactions
occurred in a school-type setting.

10. Why Should Schools and Educational Programs
Be Prepared to Address Food Allergies?
 Schools and educational programs have a
responsibility for the health and safety of children
under their care.
 First food allergy reactions often occur in these
settings.
 Fatalities can result from delaying administration of
epinephrine and providing effective emergency care
 Food allergies could be a complicating factor when
dealing with other conditions (i.e. asthma).
 Children with food allergies have unique social and
emotional challenges.
NSBA’s School Health Programs (2010). Food Allergies and Schools: Keeping students safe and ready
to learn. [Powerpoint Slides]. Retrieved from http://static.cdn.esgn.tv/food_allergy_webcast_slides.pdf.

11. What is Currently in Place for
Maine’s Educational Programs?
Department of Education Manual of Policies:
 Defines the role of school nurse
 Forms for food allergy action plans
 Student assessment form for epi-pen use
 504 plans are implemented in schools for
health/safety/environmental modifications necessary
for students with disabilities
 State policy supports students’ right to carry and self-
administer prescribed asthma/allergy/anaphylaxis
medications in schools

12. Issues That Need to Be
Addressed in Maine Schools
 Quality of training/education provided to
staff caring for children with food allergies
 Assessment of signs and symptoms of reaction
and potential for anaphylaxis
 Assessment of signs and symptoms of children
with asthma and other co-morbidities
 Competency of staff and their knowledge of
food allergies (i.e. safety, prevention, food
handling, recognizing symptoms, and
responding to reactions)

13. Issues That Need to Be
Addressed in Maine Schools
 School’s responsibility toward
understanding social and emotional
challenges of children with food allergies
 Importance of disseminating general
educational information on food allergies to
staff, parents, and children
 Information provided to parents about
prepared food ingredients, food preparation,
and cleaning practices

14. Lack of Consistency in Maine
Schools
A review of several schools found the
following:
 Scarborough: Written regulations regarding students
diagnosed with food allergies/sensitivities (adopted
9/3/09)
 SAD 6: No written policy; verbal guidelines exist
 Auburn: No written policy; follow state department of
education guidelines for school nurses
 Portland: No written policy could be located

15. Problems With Relying Only On
504 Plans
 Plans are individualized, therefore there are
no standardized guidelines for managing
allergic reactions and assisting parents with
developing plans based on child’s needs
 Stigmatization may prevent parents from
making requests for their child’s needs to
schools

16. What Needs to Be Done
 Legislation with mandated guidelines for
managing life threatening food allergy
reactions in school/educational settings.
 A collaborative training approach involving
school staff and services to identify and
monitor students with food allergies,
established health care plans, and
emergency care plans

17. What Needs to Be Done
 Establish written emergency protocols to
prepare for and respond to food allergy
emergencies
 Implement practices that minimize exposure
to allergens

18. Resources Available for Funding
State Mandated Guidelines
 FDA Food Safety Modernization Act
(2010):
 Section 112: Food allergy and anaphylaxis
management
 Establishment of voluntary food allergy and
anaphylaxis guidelines
 Local and state agencies can receive grants for
developing school-based food allergy
management programs