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

Based on the review of the annual data reports, the following have been implemented in Massachusetts:

1) Each school needs to have a comprehensive policy on the management of students with life threatening allergies.
2) The school nurse is the manager of the LTA program, assuming responsibilities for establishing the individual health care plan, training and supervising adequate numbers of staff, ensuring access to the medications, and communicating as needed with the prescribing physician, etc.
3) The individualized health care plan should include plans for before and after school programs, as well as field trips.
4) School nurses need to ensure that all parents of newly diagnosed students with LTAs understand the need for prevention of exposure and the appropriate response to an unintended exposure.
5) Because close to 1/4 of the administrations were to individuals not previously diagnosed with an allergic condition, the MDPH advises school districts to be prepared for the individual with no known allergy who might experience an anaphylactic event; this includes having the school physician write a standing order and protocol for the administration of epinephrine, as well as the maintenance of a stock supply of the medication in all school buildings.
6) Based on incidents where the student respiratory arrested en route to the hospital, the MDPH advises that all individuals receiving epinephrine be transported by emergency medical services to the nearest emergency department.
7) Students need to learn self administration as they prepare for self care as adults. This includes carrying the medication at all times.

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.

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