Name of ProtocolAllergies Protocol
Reviewed by Lead Nurse/DFO
Date9th Oct 2023
Review DateOct 2024

Introduction

This protocol is primarily focused on the systems and procedures the school should implement in order to effectively manage the risks associated with allergies and anaphylaxis.

More detailed information on food allergens and food intolerances in general and how they should be managed in the catering environment, is included in the Food Allergies section on the HUB.

 Allergies, Food Intolerances and Coeliac Disease – What’s the Difference?

An allergy is the response of an allergic person’s immune system to a substance (allergen) that is normally harmless.

· Allergic reactions can range from mild to severe (anaphylaxis) and can be fatal. Even a tiny amount of the allergen can trigger a severe reaction in a highly allergic person.

· Allergic reactions can occur within minutes of contact with the allergen.

· Allergies are common, particularly in children.

· Some allergies go away as a child gets older, although many are lifelong.

· It is essential that people with severe allergies avoid contact with their allergens and carry emergency medication (Adrenaline Auto-Injectors (AAI and antihistamine) at all times.

Food intolerances are much more common than food allergies. The body has difficulty digesting certain foods and has an unpleasant physical reaction to them. Symptoms usually occur if a substantial amount of the food is eaten, the onset of symptoms happens gradually, may last for several hours, and whilst unpleasant are not life threatening. Avoidance is the mainstay of managing the condition.

Coeliac Disease is neither an allergy or a food intolerance, it is a serious lifelong autoimmune disease which causes the body’s immune system to attack itself when gluten, a protein found in wheat, barley and rye is eaten. This causes damage to the lining of the gut which prevents the body properly absorbing nutrients from food. Coeliac symptoms can manifest themselves at any age.

Coeliacs need to follow a strict gluten free diet which excludes wheat, rye and barley. Although oats contain a different protein, they are often milled in the same factories as wheat, rye and barley and can be contaminated, therefore they are best avoided by coeliacs.

Allergies - Causes

The main causes of allergies are:

  • Tree and grass pollen (hay fever)
  • House dust mites
  • Food
  • Animal fur, particularly from pets like cats and dogs
  • Insect stings, such as bee and wasp stings
  • Some drugs / medicines

In some people, exercise can trigger an allergic reaction, either on its own or in combination with other factors such as food or drugs

Fourteen types of food are responsible for the majority of food allergies. By law these must be clearly identified on food labels:

  • Peanuts
  • Tree nuts eg walnuts, almonds, Brazil nuts, hazelnuts
  • Milk
  • Eggs
  • Fish
  • Molluscs eg mussels
  • Crustaceans eg prawns
  • Cereals containing gluten eg wheat and barley
  • Soya / soybeans
  • Sesame
  • Celery
  • Mustard
  • Lupin
  • Sulphur dioxide and sulphites
  • Other foods can also trigger serious allergic reactions in a small proportion of people eg:
  • Legumes such as peas and chickpeas
  • Fruits and vegetables eg onions, tomatoes and citrus fruits
  • Seeds eg sunflower seeds, poppy seeds and pine nuts
  • Herbs and spices eg cinnamon, garlic and chives

If anyone is allergic to foods not included in the ‘top 14’ it’s important to carefully check ingredient lists and ingredient labels as they will not be highlighted on caterer’s allergen trackers or warning labels.

Allergic Reactions

Mild allergic reactions often present as:

· Rashes – red, itchy, raised in nature, Weals

· Swelling of the lips, eyes, other parts of face or body

· Tingling where contact has been made with allergen

· Sneezing / coughing / mild wheezing

· Vomiting, abdominal cramping

· Diarrhoea

Management of allergies

  • It is the parent's responsibility to notify the school of any allergy that their child suffers from
  • It is the parent's responsibility to ensure the child has 2 in date AAI pens at all times, 1 in the yellow bag and 1 on their person or both in yellow bag.
  • The school has emergency generic AAI pens at the following sites;  Medical room, Dining hall, Nursery Road
  • All allergies are recorded on SIMS and an up to date report on these is shared with the catering department weekly.
  • Allergies are highlighted to all form tutors in the start of year medical review meetings and to the trip leader in all trip reviews.
  • All junior staff involved in supporting the juniors with eating have specific allergy awareness training (Navitas)

Severe allergies
  • All children with a known severe allergy will have an individualised care plan and their medication kept in a yellow bag as per the management of medicines policy.
  • Pupils yellow bags must be taken with them to all trips and fixtures off school site
  • Pupils will not be allowed off school site unless they have 2 in date AAI pens 

Treatment 

Where available follow the pupil’s Individual Healthcare Plan, otherwise:

· Administration of antihistamine medication eg Chloropheramine

· If person is wheezing and has an inhaler (or has severe asthma) give 6 – 10 puffs of salbutamol inhaler

· Monitor the person to ensure that the symptoms are improving within 30 minutes.

· Parents should be informed of the reaction and treatment given.

· The incident should be recorded on CPOMS and Sphera.

Further Information

[1] Recommended by the Medicines and Healthcare Products Regulatory Agency (MHRA) – referenced in DoH guidance on the use of ‘Adrenalin Auto-Injectors in Schools’

[2] - Ditto

[3] - Recommended by the Medicines and Healthcare Products Regulatory Agency (MHRA) – referenced in DoH guidance on the use of ‘Adrenalin Auto-Injectors in Schools