ANAPHYLAXIS
Anaphylaxis is a sudden and severe allergic reaction, which can be fatal, requiring immediate medical emergency measures be taken.
Play Together Creche recognises that it has a duty of care to children who are at risk from life-threatening allergic reactions while under Play Together Creche supervision.
The purpose of this policy is to minimise the risk to children with severe allergies to potentially life-threatening allergens without depriving the severely allergic child of normal peer interactions or placing unreasonable restrictions on the activities of other children in the service.
This policy is designed to ensure that children at risk are identified, strategies are in place to minimize the potential for accidental exposure, and staff and key volunteers are trained to Play Together Creche in an emergency situation
Play Together Creche management and staff will take reasonable steps to provide an allergy-safe and allergy- aware environment for a child with life-threatening allergies.
Play Together Creche will implement the following steps:
• A process for identifying an anaphylactic child;
• Keeping a record with information relating to the specific allergies for each identified anaphylactic child to form part of the Child Record;
• A process for establishing an emergency procedure plan, to be reviewed annually, for each identified anaphylactic child to form part of the child’s child record;
• Procedures for storage and administering medications, including procedures for obtaining preauthorization for employees to administer medication to an anaphylactic child;
• All incidents will be recorded and the process reviewed Anaphylaxis Procedures Description of Anaphylaxis
Signs and symptoms of a severe allergic reaction can occur within minutes of exposure to an offending substance. Reactions usually occur within two hours of exposure, but in rare cases can develop hours later. Specific warning signs as well as the severity and intensity of symptoms can vary from person to person and sometimes from reaction to reaction in the same persons.
An anaphylactic reaction can involve any of the following symptoms, which may appear alone or in any combination, regardless of the triggering allergen:
• Skin: hives, swelling, itching, warmth, redness, rash
• Respiratory (breathing): wheezing, shortness of breath, throat tightness, cough, hoarse voice, chest pain/tightness, nasal congestion or hay fever-like symptoms (runny itchy nose and watery eyes, sneezing), trouble swallowing
• Gastrointestinal (stomach): nausea, pain/cramps, vomiting, diarrhoea
• Cardiovascular (heart): pale/blue colour, weak pulse, passing out, dizzy/light-headed, shock
• Other: anxiety, feeling of “impending doom”, headache, uterine cramps in females
Because of the unpredictability of reactions, early symptoms should never be ignored, especially if the person has suffered an anaphylactic reaction in the past.
It is important to note that anaphylaxis can occur without hives.
If an allergic child expresses any concern that a reaction might be starting, the child should always be taken seriously. When a reaction begins, it is important to respond immediately, following instructions in the child’s Child Emergency Procedure Plan. The cause of the reaction can be investigated later.
The following symptoms may lead to death if untreated:
• Breathing difficulties caused by swelling of the airways; and/or
• A drop in blood pressure indicated by dizziness, light-headedness or feeling faint/weak.
Identifying Individuals at Risk
At the time of registration, parents are asked to report on their child’s medical conditions, including whether their child has a medical diagnosis of anaphylaxis. Information on a child’s life threatening conditions will be recorded in Child’s Record and to all the staff at the staff meeting.
It is the responsibility of the parent/guardian to:
• Inform the owner/manager/teacher when their child is diagnosed as being at risk for anaphylaxis.
• In a timely manner, complete medical forms and the Child Emergency Procedure Plan which includes a photograph, description of the child’s allergy, emergency procedures, contact information, and consent to administer medication. The Child Emergency Procedure Plan should be posted in key areas such as in the child’s playroom, the office, the feedback notebook etc, Parental permission is required to post or distribute the plan.
• Provide the service with updated medical information.
Record Keeping - Monitoring and Reporting
For each identified child we will keep a Child Emergency Procedure Plan on file. These plans will contain the following information:
• Child-Level Information
o Name
o Contact information o Diagnosis o Symptoms
o Emergency Response Plan
• Service-Level Information
o Emergency procedures/treatment
• GP section including the child’s diagnosis, medication and GP signature.
Ø Child Level
The Manager must ensure that the parents and child (where appropriate), are provided with an opportunity to meet with designated staff, prior to the beginning of each year or as soon as possible to develop/update an individual Child Emergency Procedure Plan. The Child Emergency Procedure Plan must be signed by the child’s parents and the child’s GP. A copy of the plan will be placed in readily accessible, designated areas such as the playroom and office.
The Child Emergency Procedure Plan will include at minimum:
• The diagnosis;
• The current treatment regime;
• Current emergency contact information for the child’s parents/guardian;
• A requirement for those exposed to the plan to maintain the confidentiality of the child’s personal health information;
• Information regarding the child, is parent’s responsibility to advise the service about any change/s in the child’s condition; and
• It is the service’s responsibility for updating the child’s records.
Management will consult with parent’s staff and the insurance company to decide on an appropriate emergency plan on a case by case basis to ensure that an appropriate course of action is taken for the child. Parents will be required to sign a declaration that they are happy for the staff to follow the decided emergency plan. In the event of an emergency designated staff will follow the plans as decided by parents and management.
Emergency Procedure Plan for child using auto-injector:
Play Together Creche will use the following emergency procedure:
1. Administer the child’s auto-injector (single dose) at the first sign of a reaction. The use of epinephrine for a potentially life-threatening allergic reaction will not harm a normally healthy child, if epinephrine was not required. Note time of administration.
2. Call emergency medical care 999, 112 or 911
3. Contact the child’s parent/guardian.
4. A second auto-injector may be administered within 10 to 15 minutes or sooner, after the first dose is given IF symptoms have not improved (i.e. the reaction is continuing, getting worse, or has recurred).
5. If an auto-injector has been administered, the child must be transported to a hospital (the effects of the auto-injector may not last, and the child may have another anaphylactic reaction).
6. One person stays with the child at all times.
7. One person goes for help or calls for help.
The Manager, or designated staff, must ensure that emergency plan measures are in place for scenarios where the child is off-site (e.g. bringing additional single dose auto-injectors on outings).
Provision and Storage of Medication
The location(s) of child auto-injectors must be known to all staff members
Parents will be informed that it is the parents’ responsibility:
• To provide the appropriate medication (e.g. single dose epinephrine auto- injectors) for their anaphylactic child;
• To inform the staff where the anaphylactic child’s medication will be kept (i.e. with the child, in the child’s playroom, and/or other locations);
• To inform the staff when they deem the child competent to carry their own medication/s), and it is their duty to ensure their child understands they must carry their medication on their person at all times;
• To provide a second auto-injector to be stored in a central, accessible, safe but unlocked location;
• To ensure anaphylaxis medications have not expired; and
• To ensure that they replace expired medications.
Allergy Awareness, Prevention and Avoidance Strategies
The Manager should ensure:
• That all Play Together Creche staff and persons reasonably expected to have supervisory responsibility of children receive training, in the recognition of a severe allergic reaction and the use of single dose auto-injectors and standard emergency procedure plans.
• That all members of staff including substitute employees, employees on call, and volunteers have appropriate information about severe allergies including background information on allergies, anaphylaxis and safety procedures.
• With the consent of the parent, the Manager and the staff must ensure that the child’s playmates are provided with information on severe allergies in a manner that is appropriate for the age and maturity level of the child, and that strategies to reduce teasing and bullying are incorporated into this information.
Posters which describe signs and symptoms of anaphylaxis and how to administer a single dose auto-injector should be placed in relevant areas. These areas may include playrooms, office, staff room, lunch room etc.
Individuals at risk of anaphylaxis must learn to avoid specific triggers. While the key responsibility lies with the child’s family the service must participate in creating an “allergy-aware” environment. Special care is taken to avoid exposure to allergy- causing substances. Parents are asked to consult with the childcare worker before sending in food to playrooms where there are food-allergic. The risk of accidental exposure to a food allergen can be significantly diminished by means of such measures.
Non-food allergens (e.g. medications, latex) will be identified and restricted from playrooms and common areas where a child with a related allergy may encounter that substance.
Training Strategy
A training session on anaphylaxis and anaphylactic shock will be held for all Play Together Creche staff.
The training sessions will include:
• Signs and symptoms of anaphylaxis;
• Common allergens;
• Avoidance strategies;
• Emergency protocols;
• Use of single dose epinephrine auto-injectors;
• Identification of at-risk children (as outlined in the individual Child Emergency Procedure Plan);
• Emergency plans;
• Method of communication with and strategies to educate and raise awareness of parents, children, employees and volunteers about anaphylaxis
• Distinction between the needs of younger and older anaphylactic children.
Participants will have an opportunity to practice using an auto-injector trainer (i.e. device used for training purposes) and are encouraged to practice with the auto- injector trainers throughout the year, especially if they have a child at risk in their care. Older children will learn about anaphylaxis as part of the curriculum
10. Contact Information
If you need more information about this policy, contact:
|
Name |
Iwona Sawicka
|
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Phone number or email |
0833187143 091/458167 or 091/458999 |
11. Policy Created
|
Date this policy was created |
March 2016 |
12. Signatures
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|
Name and position |
Signature |
|
Approved by |
Iwona Sawicka |
|
13. Review Date
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Reviewed |
March 2017 |
Iwona Sawicka |
|
Reviewed |
March 2018 |
Iwona Sawicka |
|
Reviewed |
March 2019 |
Iwona Sawicka |
|
Reviewed and updated
Reviewed |
March 2020
March 2021 |
Iwona Sawicka
Iwona Sawicka |
Next Review Date
|
Date this policy will be reviewed |
March 2022 |