Administering Allergy Medications in Culpeper County Public Schools In the event a student or other person suffers an allergic reaction while at school:
1. The school nurse, administrators, and designated staff shall be familiar with the
protocol for Albuterol, Benadryl, and Epi-pen use.
2. There shall be a food or other allergen care plan on record for every student with a
diagnosis of a life threatening allergy.
3. The allergy plan shall be completed by the child’s parent/guardian and physician
and signed by both. Student should sign if feasible.
4. Medications as prescribed for each student with an allergy will be provided to the
school nurse by the parent/guardian upon enrollment and at the start of each school year.
5. In the event the allergy care plan for a life threatening allergy is not returned in a
timely manner, a follow-up letter will be sent by the school nurse. A follow-up phone call will also be made as applicable.
6. Nurses will tag students with a “medical alert” in the student database.
Administrators (including activity directors), teachers, paraeducators, bus drivers, and cafeteria mangers will be given a medical alert list of students with life threatening allergies as needed from the school nurse. Substitute teachers will be made aware of any students in the class with life-threatening allergies through alerts on the class roll. Activity Directors will check team rosters for such students and notify trainers and coaches.
7. At least two members of the school staff must have annual training to administer
8. Each school must have an allergen/ peanut- free eating area designated for
students with severe allergies. A sign will posted indicating the products banned from the designated area.
9. The school clinics are not accessible for medications for before or after school
activities. Therefore, parents/guardians must provide information to before/after- school daycare, club advisors, or coaches when their child is participating in these non-school hour activities. The proper medication must be given to those individuals as needed.
Epinephrine Protocol for Culpeper County Public Schools Epinephrine is the first drug to be used in the emergency management of a child or other person having a potentially life-threatening allergic reaction. There are no contraindications to the use of epinephrine for a life threatening allergic reaction. The avoidance of a specific allergen is the cornerstone of management in preventing anaphylaxis. In students or other persons who have had anaphylactic reactions, it is recommended that epinephrine be given at the start of any reaction occurring in conjunction with exposure to a known or suspected allergen.
The foods that most commonly cause allergic symptoms in children or other persons are peanuts/nuts, milk, eggs, soy, fish, and wheat. Environmental causes are commonly bee stings, fire ant bites, exposure to latex or certain plants, chemicals or drugs reactions. All individuals receiving emergency epinephrine shall immediately be transported to a hospital even if symptoms appear to have been resolved. Assistive personnel shall activate the 911 system and contact parent/guardian ASAP. All school clinics in Culpeper County Public Schools will stock Epi-Pens (2), and (2) Epi-Pen Juniors in each clinic. These will be used in the event of a life threatening anaphylactic allergic reaction. Once used, the Epi-Pens will be replaced as soon as possible. Prescriptions will be obtained by the School Nurse Coordinator from the school division’s prescribing physician. Students and staff will provide their own Epi-Pens when a known potential for a life threatening allergy exists. School nurses will have an allergy health care plan on file provided by the parent/guardian for each student with such allergy. School nurses will be responsible for the annual training of staff in their building prior to the start of each school year. The School Nurse Coordinator will be responsible for training bus drivers and their aides throughout the school division. Activity Directors will ensure the training of coaches by proper staff prior to the start of their sport’s season. Use of Epi-pen or Epi-pen Junior shall be considered by trained school staff in the following situations: 1. Use a student's Epi-pen after an exposure to a documented allergen has occurred. The allergy care plan will be specific and explain what symptoms to look for and when to administer the Epi-pen. School personnel will administer the clinic stock Epi-pen if the student Epi-pen is not available. 2. Allergic reaction with any of the following: Skin symptoms- Hives, swelling, itchy red rash, and eczema flare Gut- cramps, nausea, vomiting, diarrhea Respiratory- itchy watery eyes, runny nose, stuffy nose, sneezing, coughing, itching or swelling of lips, tongue, throat, change in voice, difficulty swallowing, tightness of chest, wheezing, shortness of breath, repetitive throat clearing Cardiovascular- reduced blood pressure, fainting, shock, chest pain Neurological- feeling of impending doom, weakness 3. Symptoms seen above that are worsening. For some children symptoms appear in only one bodily system, in others they appear in several. For some individuals, the reaction begins slowly and gradually gets worse, for others it develops more quickly and can become life threatening within a few minutes, which is why all reactions need to be taken seriously and treated promptly. Albuterol protocol for Culpeper County Public Schools
Please administer Albuterol 0.083% solution, one unit, (you may repeat in 15 minutes if needed) via nebulizer to children or staff who are having the following and there is no medication of their own available for use. The following problems include:
1. Wheezing with retractions 2. Dusky or pale skin color with history of shortness of breath 3. Difficulty speaking 4. Uncontrolled coughing
If symptoms are not resolving with the Albuterol treatment, call 911 for further evaluation by the emergency services personnel. Benadryl protocol for Culpeper County Public Schools Benadryl is useful in treating minor symptoms of an accidental allergen exposure or for new allergy symptoms and is most effective when administered immediately. It can be used when there is no history of severe reactions to allergen or for a minor reaction such as a runny nose or if a mild case of hives is present. Benadryl can also be useful as a first line of defense of a severe allergy prior to a life threatening allergic reaction. Students with known allergies should have a medical administration form on file filled out by the student’s parent/guardian. Benadryl is to be provided by the parent/guardian. In an event of an allergic reaction were non- life threatening symptoms are present Benadryl provided by the school clinic can be administered. Benadryl will be stocked in the Culpeper County Public Schools clinic in liquid form at the elementary schools, and capsule/pill form in the secondary schools. School stocks of Benadryl are to be used as a one- time immediate medical need, not as part of any routine treatment of allergy symptoms for the student. Verbal permission will be obtained by the parent/guardian prior to the administration of Benadryl when feasible. School nurses or their designees have permission to treat allergy symptoms with Benadryl when an accidental ingestion or environmental allergen threatens the health of the student. Benadryl is to be given based on weight and dosage requirements per individual. Approved:
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