Prevention & Recovery

Anaphylaxis 101

By: Sarah Hatten

Author: Canadian Living

Prevention & Recovery

Anaphylaxis 101

By: Sarah Hatten

In May 2005 the Ontario legislature voted unanimously to pass private member's Bill 3, also known as Sabrina's Law. The bill is designed to protect the estimated 40,000 anaphylactic students in Ontario public schools and is named after Sabrina Shannon, a 13 year-old Pembroke student who died from anaphylactic shock in 2003 after eating cross-contaminated French fries from her school cafeteria.

What Sabrina's Law means for Ontario schools
Dave Levac, the Brant MPP responsible for Sabrina's Law, explains that the precedent-setting bill is a three-pillared stool that requires every public school board to establish and maintain an anaphylaxis policy. According to a release from the Government of Ontario, the legislation requires that, as of January 1, 2006, all public school boards have policies that include:

• Training for school staff on dealing with life-threatening allergies on a regular basis (this would include training on the administering of EpiPens®);
• School administration will have prevention plans to protect students who are at risk for anaphylaxis;
• Emergency procedures in place for responding to an allergic child if he/she were to have an allergy reaction.

What is anaphylaxis?
Anaphylaxis is a serious allergic reaction that can be life threatening. Some of the most common causes of these reactions are insect stings, medicine and latex. The most common food allergens that cause reactions when ingested are peanuts, tree nuts, seafood, and egg and milk products.

What is anaphylactic shock?
Also according to Anaphylaxis Canada, anaphylactic shock is "an explosive reaction of the body's immune system to a triggering agent (allergen). It can be characterized by swelling, difficulty breathing, abdominal cramps, vomiting, diarrhea, circulatory collapse, coma and death."

Symptoms of anaphylactic shock tend to develop rapidly, though their initial onset can be deceivingly mild. This is why it is so important to teach allergic children to recognize the symptoms and to react immediately by telling an adult to get help.

Some symptoms to watch for include:
• uneasiness, upset and red in the face
• rapid heartbeat
• itchiness
• throbbing in the ears
• sneezing
• coughing
• difficulty breathing

According to Anaphylaxis Canada, as anaphylaxis progresses shock can set in causing blood vessels to become leaky and blood pressure to drop -- the victim may feel cold, clammy and faint. When anaphylaxis occurs victims need a shot of epinephrine (usually from an EpiPen®) to control the reaction, then he or she must get to a hospital.

Though Bill 3 has only been passed in Ontario, other provinces may now pass similar legislation. Laurie Harada, executive director of Anaphylaxis Canada, says it may not even need to come to implementing official legislation though. Many schools across the country already have policies and directives in place to protect anaphylactic students, and "what they have might be sufficient as long as there is accountability at the school level."

So how do we reach that accountability in our schools? Harada says it is all about shared responsibility -- parents of anaphylactic children working with school administrators and staff to educate the school population (this includes, all staff, students, parents and visitors) about anaphylaxis and what they can do to help prevent allergic reactions.

Here are some tips to help you be proactive about protecting at-risk children in your school no matter where you live in Canada.

Parents of anaphylactic children
• Ensure your child's school administrators are aware of his/her allergy.
• Provide all necessary medical information in a timely fashion.
• Provide school administrators with an in date EpiPen® that is kept in an easy-to-access location, and encourage the principal to ensure all staff members are trained to use it.
• Meet one-on-one with your child's teachers to discuss the allergy and to teach them how to use the EpiPen®.
• Suggest that necessary educational materials are available from organizations such as Anaphylaxis Canada.
• Do NOT provide a safe snack list. "These can be dangerous. Manufacturing processes can change and if people depend on a list that says company 'ABC's' cookies are ok and there is a change (in ingredients)...then that can put people at risk," Harada explains.
• Provide a safe snack box for your child. This way if another parent drops off an unsafe snack your child doesn't have to miss out.

• Always find out if there are any medical conditions you need to know about when a new student arrives at your school, whether it's in junior kindergarten or by transfer.
• Ensure all staff are aware of any students with life-threatening allergies.
• Teachers should try to meet one-on-one with the parents of allergic students in order to work together on strategies to reduce the risk of a reaction.
• Teachers should know how to use the EpiPen® and where it is stored (this information should also be available in a day book for substitute teachers).
• For really young children there needs to be closer supervision when food-related activities are taking place.
• Notify other parents that there are students with life-threatening allergies attending the school and alert them to specific allergens. Also, make them aware of the risks of cross-contamination, such as a child getting peanut butter on their hands and then playing with an allergic child.

It's important for parents of anaphylactic children to make sure they do not place all of the responsibility for their child's safety solely on the school, their child should be properly educated, as well. Harada suggests that parents who do not have an allergic child may not be as aware of the risks as those who do. "If you don't have a food-allergic child then you are not going to read food labels in the same way," Harada says, "'s better that they (parents of allergic children) teach their children to follow very strict and very simple food rules."

Anaphylactic children
NEVER share food or eat unapproved food. "The most important thing that kids need to be taught is not to share food," says Dr. Zave Chad, allergist and clinical immunologist and president of the allergy section of the Canadian Pediatric Society. Children should also never eat food with unknown ingredients.
• Know what the symptoms of anaphylaxis are so that you will know if you are having an allergic reaction.
• Never go off alone if you start to feel sick but instead alert someone immediately.

The good news about anaphylaxis is that it can be managed and tragic fatalities can be prevented. If all parents, staff and students take proper precautions to reduce the risk of allergen contact they just may be saving children's lives.

For more information on anaphylaxis visit:
Anaphylaxis Canada
The Canadian Allergy, Asthma and Immunology Foundation
Anaphylaxis- A Hand Book for School Boards
Bill 3 (Sabrina's Law)

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Prevention & Recovery

Anaphylaxis 101