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Understanding anaphylaxis

If your child has been diagnosed with an allergy that could affect their learning or wellbeing at school, it is important to inform the school as soon as possible. This includes any severe allergies or anaphylaxis, as these conditions may require emergency responses.

Anaphylaxis is a severe allergic reaction that can occur suddenly and may be life-threatening. It always requires an emergency response, including the administration of adrenaline (epinephrine) via an injector such as an EpiPen® or Anapen®. School staff are trained to support the management of anaphylaxis as part of their overall health and safety responsibilities.

Minimising the risk of exposure to allergens

Schools must take steps to minimise the risk of exposure to known allergens. For example, peanuts, tree nuts, and nut products are not to be used in curriculum or extracurricular activities. However, this does not include foods labelled as "may contain traces of nuts." Even if your child is not known to have a severe allergy, these precautions are taken to protect all students.

School canteens must remove food and drink items with peanuts and tree nuts as an ingredient.

Schools promote an allergy aware approach to the prevention and management of anaphylaxis. An allergy aware approach is recommended rather than implementing food bans. Banning foods, and use of terminology such as ‘nut free’ is not an effective strategy for preventing or managing anaphylaxis in schools. Such claims can create a false sense of security.

If an anaphylactic reaction is suspected in a student who was not previously known to be at risk, the school will activate emergency procedures and seek appropriate medical assistance immediately. For all instances where an adrenaline injector has been administered, an ambulance will be called.

Anaphylaxis and allergy management procedures in schools

Schools follow the Anaphylaxis and allergy management procedures to support students with diagnosed and undiagnosed allergies who are at risk of anaphylaxis. These procedures are mandatory for all NSW government schools and their preschools.

If your child has been diagnosed with anaphylaxis, the school will develop a Health support plan. The plan is developed in consultation with parents/carers, the student (where appropriate) and relevant health professionals. The ASCIA Action Plan for Anaphylaxis (RED) must be used in developing the plan and will be followed as an emergency response.

In an emergency, if a second adrenaline injector is required, the school's general use adrenaline injector (EpiPen®) should be used. However, in an emergency it may be necessary to use another student's adrenaline injector.

Each school is issued with general use EpiPen® adrenaline injectors. If an adrenaline injector is administered to your child:

• An ambulance will be called and your child will be transferred to hospital
• The time of administration will be noted and communicated to the ambulance personnel when they arrive
• If there’s no improvement in your child’s condition after five minutes, a second dose may be required, using either the school’s general-use adrenaline injector or another student’s adrenaline injector if necessary
• If another student's adrenaline injector has been administered and there are concerns that the other student may be placed at risk, that student can be transported in an ambulance to hospital.

ASCIA Action Plans and First Aid Plans for anaphylaxis

The Australasian Society of Clinical Immunology and Allergy (ASCIA) provides Action Plans for Allergy and Anaphylaxis for personal use, and a First Aid Plan for general use. The plan details the emergency response for anaphylaxis, including instructions for using the adrenaline injector. These plans are:

• ASCIA Action Plan for Anaphylaxis (RED) – for a specific student who has been prescribed an adrenaline injector (different versions of the plan are available for each type of adrenaline injector)
• ASCIA Action Plan for Allergic Reactions (GREEN) – for a specific student who has mild to moderate allergies, but has not been prescribed an adrenaline injector
• ASCIA Action Plan for Drug (Medication) Allergy (GREEN) – for a specific student with drug (medication) allergies who may not have been prescribed an adrenaline injector
• ASCIA First Aid Plan for Anaphylaxis (ORANGE) – this does not include information about a specific student and can be used as a poster (different versions of the plan are available for EpiPen® and Anapen® adrenaline injectors and generic adrenaline injectors).

Adrenaline (epinephrine) injectors

Adrenaline injectors, such as EpiPen® and Anapen®, are designed to administer a single dose of adrenaline as a first aid treatment during an anaphylactic reaction. They are available in different doses depending on your child’s weight.

A student's Health support plan for anaphylaxis should outline a process for replacing used and expired adrenaline injectors in a timely way. It is the parent/carer responsibility to ensure that their child’s adrenaline injector is in date and to replace it when necessary.

The role of the parent/carer

If your child is at risk of anaphylaxis, your child’s school must be informed and you must supply the school with:

• your child’s current ASCIA Action Plan for Anaphylaxis (RED): This plan, completed and signed by your child’s doctor or nurse practitioner, outlines the steps to take in an emergency, including how to use an adrenaline injector like an EpiPen® or Anapen®
• at least one of your child’s prescribed adrenaline injectors.

If your child has a confirmed allergy diagnosis, your child’s school must be informed and you must supply the school with:

• your child’s current ASCIA Action Plan for Allergic Reactions (GREEN) or ASCIA Action Plan for Drug (Medication) Allergy (GREEN)

You must provide updated plans and replace expired adrenaline injectors to the school, as needed.

Keeping the school informed and up to date with your child’s health needs is vital in ensuring their safety and wellbeing while at school. If you have any questions or need further assistance, please contact your child’s school.

The school may also require you to complete a request form which will be used in developing your child’s Health support plan. This will allow the school to contact your child’s medical practitioner for further information about their health condition and treatment, which can assist to safely manage their health needs at school.

Students carrying their own medication

It is important that:

• students have immediate access to their medication
• the school knows the students who carry their own medication to, from, and at school.

High school students, and in some cases upper primary students, may carry their own adrenaline injectors or asthma reliever puffers if it is age-appropriate. This supports your child’s independence in managing their health condition/s.

Principals do not approve students to carry controlled medications, such as schedule 8 medications.

Arrangements will be agreed in writing between the school and parent/carer as part of your child’s planned health support.

Anaphylaxis and asthma

Where a student has a medical diagnosis of asthma and anaphylaxis, the student's Health support plan takes into account both conditions and outlines the steps staff should undertake in managing asthma or anaphylaxis.

For students with asthma who have been prescribed adrenaline devices, and suddenly start to have difficulty breathing, schools will follow the ASCIA Action Plan for Anaphylaxis, then continue asthma first aid.

Frequently asked questions

Contact details

For further information, please contact correspondence-studenthealthandwellbeing@det.nsw.edu.au.