Allergy Concerns

[T-ROD]

Can you tell me how your school goes about kids with severe allergies. I am talking the ones that if they touch oil left behind by a PB sandwich they can have a reaction.

Our school has never really had this to deal with.

We only have 2 in total district with this type of reaction. One is a senior and the other just started.

Next year I am adding 2 kindergartners that are this level and have had limited exposures.

I already use tags to help staff recognize. Next year we are thinking the lunch assigned tables and such. Any ideas that really work for you all.

[T-ROD, LPN]

You mentioned using tags; if this is something the kids wear to let others know they have an allergy , you can't do that.

I think you're talking about flags for the cafeteria staff to make sure Sweet Pea doesn't purchase anything peanut or allergen-laden accidentally, which is OK.

Yes, this is exactly what I mean.

[OldDude]

You mentioned using tags; if this is something the kids wear to let others know they have an allergy , you can't do that.

I think you're talking about flags for the cafeteria staff to make sure Sweet Pea doesn't purchase anything peanut or allergen-laden accidentally, which is OK.

Yes, this is exactly what I mean.

If it's a "flag" that pops up on the cafeteria computer screen to alert staff not to serve something to that student, yes, that's fine. If it's something that is attached to the student, no.

[JenTheSchoolRN, BSN, RN]

My school is peanut and nut free. We don't have a cafeteria and students eat in classroom, so they made that choice.

It is not a perfect system. I try and remind folks of it, but really having a good allergy action plan is most important. I had a severe allergy student eat lunch next to a kid that brought in peanut butter energy bar and have a fairly severe reaction that manifested about 20 minutes after exposure. Followed plan, went straight to Epi, outcome good. (I do work with other kids, full disclosure, and the world isn't peanut/nut free, so we talk about avoiding/being prepared for allergens in the real world as well.) I reminded staff about our guidelines after this incident (we will provide a student with a nut free lunch option if they accidentally bring in a nut containing lunch), but it is very, very hard to police. I can't do it 100%.

But I'm honest about that. Starting a kid young to recognize what foods they are allergic to and shouldn't eat isn't a bad idea. I'm not talking reading labels, etc, but understanding that if offered a peanut sandwich to say "no, I'm allergic to that" or to tell someone if they eat something and feel a certain way.

Cafeteria workers should know. I like the idea of a flag popping up for student if they try and purchase food with their allergen in it - we do have a similar system at my school even though the lunches are delivered daily and automatically tree nut and peanut free.

[iggywench, BSN, RN]

I have a high school student with a severe peanut allergy. Our district is not peanut-free, and we spent a week preparing for her when she enrolled. Teachers wipe down her desk before she arrives, she sits in a designated spot in her classes, she is allowed to leave classes five minutes early to avoid walking in the hallway with other students who may be consuming peanut products (we have a lot of athletes who ride shuttle buses back and forth between the main and 9th-grade campus, and eat when they can), she is supposed to wear a mask in the hallway, she eats lunch in one of her classrooms (her choice), all of her teachers and our administrators are trained to administer epi, she uses designated faculty restrooms, and she rides a special transportation bus with a bus monitor, and has a designated seat. She's been with us since the end of January, and so far, so good.

[Flare, ASN, BSN]

I have a high school student with a severe peanut allergy. Our district is not peanut-free, and we spent a week preparing for her when she enrolled. Teachers wipe down her desk before she arrives, she sits in a designated spot in her classes, she is allowed to leave classes five minutes early to avoid walking in the hallway with other students who may be consuming peanut products (we have a lot of athletes who ride shuttle buses back and forth between the main and 9th-grade campus, and eat when they can), she is supposed to wear a mask in the hallway, she eats lunch in one of her classrooms (her choice), all of her teachers and our administrators are trained to administer epi, she uses designated faculty restrooms, and she rides a special transportation bus with a bus monitor, and has a designated seat. She's been with us since the end of January, and so far, so good.

that sounds like a really profound allergy! Just curious if the student's parents take the same precautions in the "real world"? Like do they bother to bring her to the grocery store - my store has a kiosk to grind fresh peanut and almond butter (i think - i've never used it because it's expensive). And I know they sell fancy natural peanut butter in glass jars that have in the past broken. (again, too expensive for this cat - it's Skippy for me). Are they concerned with the possibility that someone could have just had their pbj lunch and used the same handrail for the steps to the bank (or store or lab or dr, etc) and didn't wash hands? I am just always interested when i see such extreme measures put in place and wonder in the child is practically being kept in a bubble at home.

[iggywench, BSN, RN]

that sounds like a really profound allergy! Just curious if the student's parents take the same precautions in the "real world"? Like do they bother to bring her to the grocery store - my store has a kiosk to grind fresh peanut and almond butter (i think - i've never used it because it's expensive). And I know they sell fancy natural peanut butter in glass jars that have in the past broken. (again, too expensive for this cat - it's Skippy for me). Are they concerned with the possibility that someone could have just had their pbj lunch and used the same handrail for the steps to the bank (or store or lab or dr, etc) and didn't wash hands? I am just always interested when i see such extreme measures put in place and wonder in the child is practically being kept in a bubble at home.

When she enrolled, mom stressed the severity of her allergy, and said that she has had anaphylaxis before when a teacher ate peanut butter and talked to her afterward. Mom acted like she doesn't go anywhere, and wears a mask and gloves anytime she does go in public. I do wonder if it is as severe as she previously said, because the student has told me that she goes to the mall and to the movies.

[XingtheBBB, BSN, RN]

that sounds like a really profound allergy! Just curious if the student's parents take the same precautions in the "real world"? Like do they bother to bring her to the grocery store - my store has a kiosk to grind fresh peanut and almond butter (i think - i've never used it because it's expensive). And I know they sell fancy natural peanut butter in glass jars that have in the past broken. (again, too expensive for this cat - it's Skippy for me). Are they concerned with the possibility that someone could have just had their pbj lunch and used the same handrail for the steps to the bank (or store or lab or dr, etc) and didn't wash hands? I am just always interested when i see such extreme measures put in place and wonder in the child is practically being kept in a bubble at home.

We have one student with these precautions except for the mask, and from what I've gathered one parent does keep the child in a bubble at home but the other parent takes the child out to restaurants that are not allergy safe when that parent is out of town- risks I would not take with that kid but I'm glad that the child gets some exposure to the real world and learning how to be as safe as practical there!

[JenTheSchoolRN, BSN, RN]

We have one student with these precautions except for the mask, and from what I've gathered one parent does keep the child in a bubble at home but the other parent takes the child out to restaurants that are not allergy safe when that parent is out of town- risks I would not take with that kid but I'm glad that the child gets some exposure to the real world and learning how to be as safe as practical there!

Yeah, I wonder how this child will learn to function with this allergy if the real world if not exposed to it. Will they choose a work from home career, for example, to make sure they don't run into a co-worker that may have eaten a peanut product? Will a work place have to take these precautions? Interesting to ponder...and to be honest, I'm not how I might fully approach it if I had a child like this.

[Amethya]

I have some peanut allergies here, but not severe enough like this. I haven't had an issue of this, but my students know what not to eat or touch, so it helps that they are educated in that sense. As well most of our food is nut free, but because no one likes the food here, they tend to bring their own food.

[Julius Seizure]

When she enrolled, mom stressed the severity of her allergy, and said that she has had anaphylaxis before when a teacher ate peanut butter and talked to her afterward. Mom acted like she doesn't go anywhere, and wears a mask and gloves anytime she does go in public. I do wonder if it is as severe as she previously said, because the student has told me that she goes to the mall and to the movies.

Something tells me that mom might have overstated some things in the interest of making sure that staff took her seriously.

[SavyNurse, ADN, EMT-B]

I have started a power point that I will go over at the district start up meeting. I also have training's set up for teachers on Epi pen usage. I am surprised though about the young age you allow them to carry. I love the idea just a little surprised. I do get though that they need to self aware. My son is one of the venom epis and he just knows what to avoid.

We have this in our school where a second grader carries his epi around in a fanny pack with zip ties so that they can not get into it unless emergent. We also have the teachers carry an epi from class to class for the other severe students. The parents for the one with the fanny pack insisted on it. They had a bunch of paperwork for themselves and the doctor to fill out so that the school was not to be held responsible.

[WineRN]

We are an "allergy aware school". We have at least 1 room in each grade that is peanut/tree nut free, an allergy free table at lunch, I go around doing the be a pal program for each allergy free room, all staff are epi pen trained.

BUT as OD said there really is only so much you can do. I have a kg who has a hx of contact reactions from peanuts who went into anaphylaxis due to another student having peanut butter toast in the morning, did wash their hands and then played with her on the bus. The driver gave the epi and all was well and thankfully that is one of my few parents who really understands that we can't control everything in school. Most of my allergy parents are the opposite and believe we should ban all of the major allergens.