TORONTO WALDORF SCHOOL



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Toronto Waldorf school summer camp

anaphylaxis policy

Revised February 2018

Anaphylaxis is a severe allergic reaction that can lead to rapid death if left untreated. Many Canadians suffer from extreme life-threatening allergies to certain foods, medications, insect stings or non-food materials, such as latex. For them, exposure to even a minute amount of the substance to which they are allergic can trigger an anaphylactic reaction. Although peanuts and peanut products are the most common foods to cause anaphylaxis, fish, eggs, sulphites, milk, sesame seeds or any other food can cause this dangerous condition. In recent years, anaphylaxis has increased dramatically among children and adolescents.

Anaphylactic reactions occur when the body’s sensitized immune system overreacts in response to the presence of a particular allergen. Anaphylaxis affects multiple body systems, including skin, upper and lower respiratory, gastro-intestinal and cardiovascular.

The recommended emergency treatment for a camper suffering an anaphylactic reaction is the administration of epinephrine (adrenaline) by an auto-injector (i.e. Epi-Pen or by an Anakit). The person affected must then be rushed to hospital to receive further medical attention, even if the symptoms decrease with the administration of the epinephrine or by an Anakit.

The greatest risk of exposure is in new situations or when normal daily routines are interrupted, such as birthday parties or camp outings.

The Toronto Waldorf School Summer Camp’s allergy plan has three components:

1. Information and Awareness;

2. Avoidance; and

3. Emergency Response.

INFORMATION AND AWARENESS

ENSURING THE SAFETY OF ANAPHYLACTIC CAMPERS IN A CAMP SETTING DEPENDS ON THE CO-OPERATION OF THE ENTIRE CAMP COMMUNITY. TO MINIMIZE RISK OF EXPOSURE, AND TO ENSURE RAPID RESPONSE TO AN EMERGENCY, PARENTS, CAMPERS AND CAMP PERSONNEL SHOULD ALL UNDERSTAND AND FULFILL THEIR RESPONSIBILITIES.

CAMP REGISTRAR

• Works closely with the parents of an anaphylactic camper;

• Makes contact with parents of an anaphylactic camper and the camp lead each summer to gather or update medical information related to the condition including: causal factors, severity of allergy, past incidents of anaphylactic reactions and other health considerations.

• Prepares and maintains a camper file including consent forms, waiver, physician’s instructions and alert sheets with an updated photograph for each anaphylactic camper.

• Ensures the Alert sheets with updated photographs are posted in the child’s classroom, front office, extended care program areas and in the faculty room in a prominent location.

• Ensures parents provide two auto-injector kits to the receptionist by the first day of camp. At least two auto-injectors are suggested, one located with the Camp Lead or the child, if age appropriate, and one located in the Front office in a known accessible location.

• Notifies all appropriate camp personnel of medical alert concern and of established policy.

• Reviews procedures with entire staff each summer.

• Develops and maintains an emergency plan that is consistent with the camp’s anaphylaxis policy.

• Arranges for staff training sessions for all camp personnel on how to recognize and treat anaphylactic reaction, on camp procedures to protect anaphylactic campers from exposure, and on camp protocol for responding to emergencies. This session should also include training in the emergency administration of the auto-injector. Training should take into consideration the age, maturity and responsibility-level of anaphylactic campers.

CAMP STAFF

• Ensures that alert sheets are posted in the child’s classroom, faculty room, Front Office and extended care program, in a prominent location.

• Encourages campers not to share lunches or trade snacks.

• Reinforces with all campers the importance of hand washing before and after eating.

• Facilitates communication with other parents.

• Leaves information in an organized, prominent and accessible format for substitute staff.

• Ensure the camp assistants and volunteers working with an anaphylaxis child is aware of the child’s needs and of the camp’s policy. If the assistants are to be on their own, they need to have reviewed this policy and have practiced with an Epi-pen practice kit (see the Receptionist).

PARENTS OF AN ANAPHYLACTIC CAMPER

• Inform the camp of their child’s allergies.

• Provide a Medic Alert bracelet for their child.

• Provide the camp with two up-to-date auto-injection kits, clearly labelled with the child’s name and prescription details. Provide camper with a body pouch or fanny pack for carrying at least one auto-injector at all times on their body, if age appropriate.

• Review the camp prevention plan with camp personnel and provide in-service support and information as requested.

• Teach their child:

i) about their allergen and the substances that trigger it;

ii) to recognize the first symptoms of an anaphylactic reaction;

iii) to know where medication is kept, and who can inject it;

iv) to communicate clearly when he or she feels that a reaction is starting;

v) to carry his/her own auto-injector in a body pouch or fanny pack when age appropriate;

vi) not to share snacks, lunches or drinks and to politely explain why he/she is not sharing;

vii) to understand the importance of hand-washing;

viii) to cope with teasing and being left out; and

ix) to take as much responsibility as possible for his/her own safety.

ANAPHYLACTIC CAMPER

• Has an age appropriate understanding of his/her allergy and its triggers.

• Complies with taking medication as arranged and approved by camp administration.

• Takes as much responsibility as possible for avoiding allergens.

• Washes hands before and after eating.

• Learns to recognize symptoms of an anaphylactic reaction.

• Promptly informs an adult, as soon as accidental exposure occurs or symptoms appear.

• Keeps an auto-injector on his/her person at all times when age appropriate.

Avoidance

The camp will adopt a policy whereby the camp environment will be adapted to accommodate anaphylactic campers. The camp cannot assume responsibility for providing a completely allergen-free environment.

• Anaphylactic campers must learn to avoid specific triggers. While the key responsibility lies with anaphylactic individuals and their family, in the case of an anaphylactic camper, the camp community must also be aware.

• Safe eating area procedures will be established, including cleaning and hand-washing procedures.

• An anaphylactic child will be encouraged to take precautions, such as placing food on a napkin or waxed paper rather than in direct contact with the lunch table.

RECOGNITION

An anaphylactic reaction can begin within seconds of exposure or after several hours. Any combination of the following symptoms may signal the onset of a reaction.

• Hives*

• Itching (on any part of the body)

• Swelling (of any body part, especially eyes, lips, face tongue)

• Red watery eyes

• Runny nose

• Vomiting

• Diarrhea

• Stomach cramps

• Change of voice

• Coughing

• Wheezing

• Throat tightness or closing

• Difficulty swallowing

• Difficulty breathing

• Sense of doom

• Dizziness

• Fainting or loss or consciousness

• Change of colour

*Hives may be entirely absent, especially in severe or near fatal cases of anaphylaxis.

Symptoms do not always occur in the same order, even in the same individuals. The time from onset of first symptoms to death can be as little as a few minutes if reaction is not treated.

Anaphylactic children usually know when a reaction is taking place. Camp personnel should be encouraged to listen to the child. If he or she complains of any symptoms that could signal the onset of a reaction, staff should not hesitate to implement the emergency response steps.

THERE IS NO DANGER OF REACTING TOO QUICKLY AND POTENTIAL DANGER IN REACTING TOO SLOWLY!

EMERGENCY RESPONSE STEPS

1. Keep the child calm.

2. Administer Epi-Pen immediately if the child displays any of the symptoms. The Epi-Pen gives you 15 minutes to seek medical attention. If you are with someone else, have them call 911. If not, administer the Epi-Pen first and then call 911.

• Pull off grey safety cap.

• Grip with a tight fist and firmly jab/press black tip into outer thigh. Keep pressed against thigh and hold for count of 10. Do not place thumb at end of Epi-Pen. Listen for “click” and check to see if the needle is exposed when it is pulled out of the thigh. If so, it has worked. If there is no exposed needle, administer the 2nd pen right away.

3. Call 911. Advise dispatcher that the child is having an anaphylactic reaction.

4. Treat with second dose of epinephrine (Epi-Pen) if necessary in 10 to 15 minutes if an ambulance has not arrived and the symptoms have reappeared.

5. Advise the Front Office of the situation, including the need to call the parents asap.

6. Follow through in transporting the child to hospital immediately even if symptoms subside.

7. Remain in the emergency room for four to six hours for observation.

*Note: Used Epi-Pen needs to be discarded in a needle-proof container to minimize any chance of injury.

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