Bringing food allergy management and awareness to your community

The Management of Life Threatening Allergies in School: Lessons Learned from Massachusetts

The Massachusetts Experience

In 2001, after three school related deaths from anaphylaxis, the Massachusetts Department of Public Health (MDPH) and the then Massachusetts Department of Education (MDOE) established a multidisciplinary committee to develop comprehensive guidelines for the care of children with life threatening allergies in the school setting. The guidelines are intended to teach schools how to (a) prevent exposure to the allergen and (b) provide a rapid emergency response should an unintended exposure occur. Key features of the guidelines include, but are not limited to:

Mass Guidelines

1) communication by the child’s physician to the school nurse regarding the diagnosis of a life threatening allergy (LTA) and appropriate medication orders;
2) a team meeting and the development of an individual health care plan prior to school entry;
3) education of all staff on food allergies and the importance of preventing exposure;
4) a full time school nurse in any building where the child with a LTA is enrolled;
5) involvement of food service personnel;
6) epinephrine as the first line of treatment for anaphylaxis .
7) training of unlicensed personnel to administer epinephrine by auto-injector, as well as the availability of the auto-injector where an exposure is likely to occur; and
8) the importance of an annual visit to the allergist
(The guidelines may be found at


In 2002 the Massachusetts Department of Education published and distributed the guidelines to all schools within the Commonwealth. Calls to the MDPH from frantic parents prior to school entry decreased, and deaths from anaphylactic events in the school setting have not occurred since the guidelines’ publication.

All excerpts taken from the Management of Life Threatening Allergies in School: The Massachusetts Experience.
Written by: Michael Pistiner MD, MMSc and Anne H. Sheetz RN, MPH, NEA-BC.
This piece was originally published in the American Academy of Pediatrics, Council on School Health, Spring/Summer 2009 Newsletter.
We thank the AAP for granting permission to post and to update mandated reporting data within this article.

All information contained on the website is intended for informational and educational purposes. The information provided on this website is not intended to be a replacement or substitute for professional medical advice. Any information that you have received from should be verified with your licensed health care provider. Furthermore, decisions regarding medical care should not be based solely upon the content of this website but made after discussions with your health care provider. Consumers should never disregard or delay seeking medical advice due to the content of this site.

Your use of this site does not create a patient-physician relationship between you and

Medical information changes constantly. Therefore the information on this site or on the linked websites should not be considered current, complete or exhaustive, nor should you rely on such information to recommend a course of treatment for you or any other individual. Reliance on any information provided on this site or any linked websites is solely at your own risk.

Please note that AllergyHome is not affiliated with Boston Children’s Hospital

Accept Decline