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Ge t the F AACT s ABOUT F OOD AL L E RGIE S IN SCHOOL S

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T o da y’ s Mo de ra to r She rry Co le ma n Co llins, MS, RDN, L D Co nsulta nt/ Re g iste re d Die titia n Nutritio nist Na tio na l Pe a nut Bo a rd T witte r: @ Pe a nutRD

T o da y’ s Spe a ke rs Gitta Gre the r- E le a no r Ga rro w-Ho lding Swe e ne y,MSRD Pre side nt & CE O, F AACT F o o dse rvic e Dire c to r, PPS

Ob je c tive s  Ga in a n unde rsta nding o f the fa c ts a b o ut fo o d a lle rg ie s  L e a rn to a pply the se fa c ts to the k-12 fo o dse rvic e e nviro nme nt  L e a rn to disting uish b e twe e n fa c t a nd fic tio n with re g a rd to fo o d a lle rg y myths a nd misc o nc e ptio ns

Disclosures / Acknowledgements Disc losur e s Na tio na l Pe a nut Bo a rd Spo nso re d Pre se nta tio n  Spe a ke rs re c e ive d no mo ne ta ry o r in-kind c o mpe nsa tio n  Ac knowle dge me nts F o o d Alle rg y & Ana phyla xis Co nne c tio n T e a m (F AACT ). • 2014 Ce nte r fo r Dise a se Co ntro l a nd Pre ve ntio n (CDC). • Vo luntary Guide line s fo r Managing F o o d Alle rgie s in S c ho o ls and E arly Care and E duc atio n Pro grams . Wa shing to n, DC: US De pa rtme nt o f He a lth & Huma n Se rvic e s (DHH); 2013 o uis Childre n’ s Ho spita l. F o o d Alle rgy Manage me nt & St. L • E duc atio n (F AME ) pro gram. 2014

F AACT : Who a nd Wha t  F AACT 's missio n is to e duc a te , a dvo c a te , a nd ra ise a wa re ne ss fo r a ll individua ls a nd fa milie s a ffe c te d b y fo o d a lle rg ie s a nd life -thre a te ning a na phyla xis.  F AACT o ffe rs ma ny e duc a tio n pro g ra ms a nd ha nds- o n c ivil rig hts a dvo c a c y suppo rt in the sc ho o l se tting .  F AACT e duc a te s a nd info rms fo o d-a lle rg ic individua ls o f the ir rig hts to sa fe ly a nd e q ua lly pa rtic ipa te a lo ng side individua ls witho ut fo o d a lle rg ie s, pa rtic ula rly in sc ho o ls.  F AACT ’ s we b site o ffe rs a n E duc a tio n Re so urc e Ce nte r a nd Civil Rig hts Advo c a c y Re so urc e Ce nte r with ma ny fre e a nd do wnlo a da b le re so urc e s.  F AACT o ffe rs visua l a ids fo r sc ho o ls: b o o kma rks, po ste rs, e tc .

Emergency Action Plans

3 F ood Alle r gy – Pr e vale nc e F o o d a lle rg ie s a ffe c ts 4-6% o f US Childre n • 18% inc re a se a mo ng c hildre n b e twe e n 1997 – • 2007 50% inc re a se a mo ng c hildre n b e twe e n 2009-2011 • 2 Stude nts pe r c la ssro o m, U.S. • F o o d a lle rg ie s & a sthma in c hildre n = 29% •  Hig he r risk fo r a na phyla xis # g e tthe F AACT sa b o utfo o da lle rg ie s

Slide 10 3 Should the last bullet also include eczema?: "Individuals who also have athma or eczema, in addition to food allergies, are at a higher risk for anaphylaxis." Karen Harris, 7/26/2014

Food Allergy – FACT’s T he re is NO c ure fo r fo o d a lle rg ie s • Stric t a vo ida nc e is ke y • 18% o f c hildre n re a c te d while a t sc ho o l • 25% o f first time se ve re re a c tio ns o c c ur in • the sc ho o l se tting F a ta litie s ha ve o c c urre d in sc ho o ls due to • de la ys in pro pe rly re c o g nizing a nd tre a ting se rio us a lle rg ic re a c tio ns (a na phyla xis)

“ Food Allergy” –The Term • “F o o d Alle rg y” • F o o d re la te d c o nditio ns & dise a se s o fte n c o nfuse d with a fo o d a lle rg y • F ood alle r gy c an be fatal  F AAP sig ne d b y a me dic a l do c to r # g e tthe F AACT sa b o utfo o da lle rg ie s

Food Allergy  90% o f fo o d a lle rg ic re a c tio ns in the U.S. a re c a use d b y e ig ht fo o ds: Milk Whe a t E g g So y F ish Pe a nuts Crusta c e a n She llfish T re e -nuts  Any fo o d c a n c a use a n a lle rg ic re a c tio n # g e tthe F AACT sa b o utfo o da lle rg ie s

Anaphylaxis  Ana phyla xis (a n-a -fi-L AK -sis) is a se ve re a lle rg ic re a c tio n tha t is ra pid in o nse t a nd ma y c a use de a th. Ana phyla xis fro m fo o d = (within minute s – • se ve ra l ho urs) De a th fro m fo o d = (30 min – 2 hrs. o f e xpo sure ) •

Anaphylaxis – FACT’s  Ca n b e F AT AL if no t tre a te d pro mptly  Ca n inc lude a wide ra ng e o f sig ns & sympto ms  Sympto ms c a n o c c ur a lo ne , o n in c o mb ina tio n  Re q uire s imme dia te tre a tme nt (fo llo w stude nt’ s e me rg e nc y a c tio n pla n o n file )  I nje c tio n o f e pine phrine  911  Ob se rva tio n in E R (2-24 hrs. re c o mme nde d) # g e tthe F AACT sa b o utfo o da lle rg ie s

Anaphylaxis Triggers  F o o d  I nse c t ve no m  Me dic a tio ns  L a te x  Wha t is the le a ding c a use o f a na phyla xis o utside o f the ho spita l se tting ? # g e tthe F AACT sa b o utfo o da lle rg ie s

Anaphylaxis Triggers  Food = leading cause of anaphylaxis outside of the hospital setting #gettheF AACTsaboutfoodallergies

Anaphylaxis Risk Factors Groups at Higher Risk  De la y o f e pine phrine  Adolescents  Re lying o n  Y oung adults a ntihista mine s (i.e .  Children with Be na dryl, Zyrte c … ) known food allergy  Alc o ho l  History of c o nsumptio n anaphylaxis

Signs & Symptoms L ung Mouth • Shortne ss of bre ath • Itc hy • Whe e zing • Swe lling of tongue , lips, • Re pe titive Cough or r oof of mouth • Che st pain / tightne ss Cir c ulation/ He ar t E ye s/ Nose • Che st pain • Re d Wa te ry E ye s • L ow blood pre ssure • Runny / Stuffy No se • Pale blue skin c olor • Sne e zing • Dizzine ss or fainting • Swo lle n E ye s • We ak pulse • L e tha rg ic Skin • Itc hing Me ntal • Hive s or othe r rash • Anxie ty • Re dne ss/ flushing • Panic • Swe lling • Se nse of doom T hr oat • Confusion • Itc hy • T Gut ightne ss / c losure • Hoarse ne ss • Nause a • T • Abdominal pain (a r ouble bre a thing / swa llowing sha rp sta bbing pa in) • Hac king c ough • Vomiting • Stridor • Diarrhe a

Epinephrine (adrenaline)  F irst line tre a tme nt fo r a na phyla xis  Na tura lly pro duc e d in the b o dy  E a rly use to tre a t a na phyla xis impro ve s a pe rso n’ s c ha nc e fo r surviva l  E ffe c ts a re no t lo ng la sting , a dditio na l do se s ma y b e ne e de d  Administe r e pine phrine = c a ll 911  All sta ff sho uld b e tra ine d o n e pine phrine a dministra tio n # g e tthe F AACT sa b o utfo o da lle rg ie s

Risk Reduction S trategies Cleaning measures • Reading food labels • Creating a safe • environment Educating parents, students • and school staff

Cleaning Measures Hands S urfaces  Yes  Yes Lysol sanitizing wipes • S oap and water • Formula 409 •  Yes Commercial cleaning • Hand wipes • wipes (*Wet Ones / Tidy Target brand cleaner • Tykes) with bleach X No Other common • household cleaning Plain water • agents X No X No Hand S anitizer • Liquid dish soap •

Food Labels – FALCPA  Food Allergen Labeling Consumer Protection Act  Applies to top eight allergens  Consult with parents

Creating a S afe Environment Goal - To create a safer learning environment by reducing children’s exposure to potential allergens  S chool bans?  Alternatives?  Allergen S afe Zones / Food Free Zones  (classrooms or eating area in cafeteria; library, buses)  Allergy –Aware (classroom, school)  Limiting food in the classroom  Rewards  Birthdays  Holidays

Creating a S afe Environment Ensure the daily management of food allergies in 1. individual children Prepare for food allergy emergencies 2. Provide professional development on food 3. allergies for staff members Educate children & family members about food 4. allergies Create and maintain a healthy & safe 5. educational environment

Prepare for an Allergic Emergency I f a n a lle rg ic re a c tio n o c c urs o n the pla yg ro und,  wha t me a ns o f c o mmunic a tio n is a va ila b le ? Who will re trie ve e pine phrine , inc luding se c o nd  do se a nd/ o r sto c k, if no t c a rrie d b y stude nt? Who is re spo nsib le fo r a dministe ring e pine phrine ?  Who is re spo nsib le if no sc ho o l nurse is o n-site ?  Who is c a lling 911?   Who is o utside to a le rt first re spo nde rs o f lo c a tio n? Who will do c ume nt time s?  Who will c o nta c t the pa re nts?  Who will ride with the stude nt?  Who will spe a k to stude nts who ma y ha ve  witne sse d? Who will spe a k to the fa milie s o f o the r fo o d a lle rg ic  stude nts?