Melanie Lundheim shares insights into how to create a safer learning environment for students with peanut allergies, tree nut allergies and anaphylaxis. A book for kids that accompanies this presentation is available in SlideShare and on YouTube: https://www.youtube.com/watch?v=weqKg5yeVwg

1. Kids’ Allergies: Peanuts and Tree Nuts
Create a Safer Learning Environment
© 2012 Melanie Lundheim.Any reproduction of these materials requires prior written consent.

2. Welcome.You’re about to discover some
ways to prevent, recognize and respond to
peanut and tree nut exposures in school.
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3. Exposures to these common foods can trigger a
life-threatening condition known as “anaphylaxis.”
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4. • Hives, itching
• Flushed or pale skin
• A feeling of impending doom
• Hoarseness, difficulty breathing
• Lip, tongue or throat swelling
• Airway constriction, wheezing
• Nausea, vomiting or diarrhea
• A weak and rapid pulse
• Dizziness, fainting, loss of consciousness
• Death
Anaphylaxis is a serious allergic reaction that is rapid in onset
and may cause one or more of the following symptoms:
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5. Food allergies and associated anaphylaxis are
on the rise. Prevalence of peanut and tree nut
allergies alone has tripled between 1997 and 2008.
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6. Many anaphylactic reactions occur at school —
sometimes to students whose allergies
were unknown at the time of the reaction.
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7. In fact, our own — otherwise incident-free —
daughter has had peanut-triggered anaphylaxis
three times within just eleven months at school.
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8. We know from experience: the steps you
take to prevent, recognize and respond to
exposures and anaphylaxis could be life saving.
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9. So let’s get started on our discussion about
how to create a safer learning environment for
students with peanut and tree nut allergies.
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10. You may already be aware that peanuts and
tree nuts are two of the top eight food allergens,
along with milk, eggs, wheat, soy, fish and shellfish.
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11. In general, allergies to milk, egg, wheat and soy
resolve in childhood, whereas allergies to
peanuts, tree nuts, fish and shellfish are lifelong.
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12. So what exactly are peanuts and tree nuts?
And what’s the difference between them?
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Peanuts Tree Nuts

13. Peanuts are legumes and they grow in the ground.
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14. Tree nuts, like these, grow on trees.Tree nuts are commonly
processed, and thereby “cross contaminated,” with peanuts.
Almond Brazil Nut Chestnut
Hazelnut Hickory Nut Pecan
Pine Nut Pistachio Walnut
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15. The cause of peanut and tree nut allergies is unknown.
Currently, the only treatment is:
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• Strict avoidance of the
allergens
• Early recognition of
symptoms
• Proper management of
allergic reactions

16. Until there’s a cure for food allergies, students
of all ages need your help and vigilance to stay safe.
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17. As a rule of thumb, remember that
students must not smell, touch, taste or eat
peanuts and tree nuts if they’re allergic to them.
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18. But, we realize: they can’t live in a bubble!
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19. This is why many children with peanut and tree nut
allergies learn early on to advocate for their own safety.
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20. Yet, despite their best efforts, it’s a challenge
for them to stay safe in school with so many
kids, contaminants, shared surfaces and supplies.
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21. As a result, exposures to these potent food allergens
happen in school more often than other public places.
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22. Seem far fetched? Consider that even the most minute
traces of peanut or tree nut can trigger anaphylaxis.
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23. Impossible to see with the naked eye, peanut and tree
nut proteins can spread like a virus onto surfaces,
pencils, dispensers, floors, keyboards and more.
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24. So strive to keep shoe soles, hands, surfaces and
other areas free of peanut and tree nut proteins.
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25. Enforce peanut and tree nut free classrooms.This
includes activities before, during and after school.
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26. Establish a fail-safe system to ensure all subs, staff members
and volunteers are pre-trained and aware of students’ peanut
and tree nut allergies before entrusting children in their care.
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27. Always read package labels. Foods, as well as science and art
materials, should not contain peanuts or tree nuts or be
made on equipment that processes peanuts or tree nuts.
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28. Beware of cross contamination in foods, as well as on
utensils, wind instruments, masks and other supplies.
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29. Also note that hand sanitizer doesn’t kill peanut or tree nut
proteins. So encourage washing with soap and water before
and after eating, and at other times during the day.
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30. Discontinue preparing and serving peanuts and tree
nuts in the school kitchen to avoid cross contamination.
Make menu ingredient lists available at school and online.
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31. Create peanut and tree nut free desks and cafeteria tables.
Always wash surfaces, edges and seats with dedicated
cleaning equipment, warm, soapy water and spray.
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32. Ensure anaphylactic students have access to their life-saving medication
at all times in class, at recess, and on field trips and busses.
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33. Develop two-way communication systems on and away from
school grounds to rapidly respond to exposures and call 911.
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34. Learn how and when to administer epinephrine;
anaphylactic students can’t always do it themselves.
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35. Review students’ food allergy action plans. Depending on
symptoms, they may need epinephrine, a call to 911,
and their prescribed antihistamine and inhaler doses.
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36. To administer epinephrine, refer to your
training and the medication label for instructions.
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37. • Hives, itching
• Flushed or pale skin
• A feeling of impending doom
• Hoarseness, difficulty breathing
• Lip, tongue or throat swelling
• Airway constriction, wheezing
• Nausea, vomiting or diarrhea
• A weak and rapid pulse
• Dizziness, fainting, loss of consciousness
• Death
Remember, students may require their medications when one
or more of these anaphylactic symptoms are present:
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38. Escort and observe anaphylactic students
at all times when they exhibit symptoms.
Seemingly mild reactions can progress within seconds.
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39. • Teachers and subs
• Health workers
• Food service workers
• Administrators
• Paras, aides and support staff
• Volunteers and chaperones
• Custodians
• Drivers, coaches and others
Ensure all adults who care for students are trained on how
to prevent, recognize, and respond to peanut and tree nut
exposures and anaphylaxis, including:
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40. Be mindful: foods containing peanuts or
tree nuts as a primary ingredient can easily
spread contaminants throughout the school.
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41. To reduce risk, remove peanut/nut-containing items from
vending machines, and don’t serve or share such items at
student and faculty potlucks, field trips and other events.
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42. Create, post and enforce your food-allergy management
policy. On a regular basis, communicate it to everyone so
you’ll remain transparent and consistent, district wide.
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43. Allergic or not, peanut and tree nut allergies
affect us all. Remember: we’re on the same team!
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44. So strive to create a culture of
awareness, understanding and compassion
among students, families and staff.
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45. Never joke with, tease or bully food-allergic students
or their teachers and caregivers about food allergies.
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46. After all, food-allergic students are protected
under the Americans with Disabilities Act.
Federal laws give them rights to safe schools.
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47. They need your understanding, vigilance
and help to stay safer in school.
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48. Classrooms, before, during and after
school, and on special occasions
Kitchens, where kids’ food is prepared,
to avoid cross contamination
Student and staff potlucks, special
events, and vending machines, where
people may carry and spread allergens
throughout the schools
Shared wind instruments, masks,
supplies and art/science materials
Home economics food ingredients
Surfaces, in classrooms and at a
dedicated lunchroom table
Please provide peanut/nut-free:
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49. All staff, subs and chaperones are
trained to prevent, recognize and
respond to peanut/nut exposures
Teachers have a system for informing
pre-trained subs of kids’ health issues
Systems and communications are in
place on school grounds and at field
trips to rapidly respond to exposures,
administer medications and call 911
Anaphylactic kids are never unescorted
by an adult when symptoms are
present; reactions can progress rapidly
Your food allergy management policy is
posted, communicated and enforced
Before adults take charge of students, please ensure:
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50. By making these potentially life-saving adjustments,
all students can feel and stay safer in school.
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51. About the presenters:
Soren and Tessa have life-threatening peanut
and tree nut allergies.Together with their
parents, friends and photographers, they
created this presentation to help adults
prevent, recognize and respond to exposures
and anaphylaxis at school.
Disclaimer:
The materials and other information provided
by this presentation are for educational,
communication and information purposes only
and are not intended to replace or constitute
medical advice or treatments.
For more information, visit:
linkedin.com/in/melanielundheim Soren,Andy, Melanie and Tessa
© 2012 Melanie Lundheim.Any reproduction of these materials requires prior written consent.
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