Preparing for the Worst: Is Your Child Ready for an Anaphylaxis Event at School?

Health Professional

What if the worst possible thing were to happen to your child when he or she is out of your sight (and care) at school? What if your child went into a severe allergic reaction known as anaphylaxis?

It could happen, you know. Is your child prepared? Does he or she know what to do to prevent such an attack - or how to act if it happens?

Anaphylaxis or allergic shock, as it's sometimes called, is a severe, life-threatening condition, but it is relatively rare. Although some kids are more likely to develop anaphylaxis because of the nature of their allergic disease, it's important to understand that anaphylaxis can strike at any time and totally without warning, even if your child has never experienced anything remotely close in the past.

It's also critical to understand that anaphylaxis symptoms can sometimes be very similar to those of an asthma attack, so they're hard to recognize at first. Finally, survival of allergic shock will depend on fast treatment with epinephrine. Antihistamines (allergy medicine) or quick-relief/rescue inhalers (asthma medicine) won't work. Only epinephrine.

There is no reason why your child cannot live a normal, active life, as long as you have a plan.

The key to preparing for anaphylaxis can be summed up in 3 general strategies:

  • Education* ** Prevention*** ** Protection**

Let's look at each one in turn.

Education: Knowledge Is Power

The first step in protecting your child from anaphylaxis is education. This starts with you learning all you can about anaphylaxis, then teaching your child and school staff, so that everyone knows the dangers, what to expect, and how to act.

You can find general information on anaphylaxis in my previous article here, including common symptoms to be on the watch for. The Allergy & Asthma Network Mothers of Asthmatics (AANMA) also offers a detailed booklet on anaphylaxis.

Key facts to know are common triggers for anaphylaxis. Food allergies, especially to peanuts and tree nuts, are probably the most common. But stinging insects, such as wasps, hornets, and fire ants, and latex, which is found in disposable gloves and balloons, can also send sensitive people into allergic shock, even if they've never been allergic to them before. Even exercise can be a trigger in certain people.

Another key fact is that kids who have asthma are much more prone to anaphylaxis, which is especially dangerous since anaphylaxis symptoms can mimic asthma symptoms. It's essential to recognize that if asthma symptoms arise shortly after eating, anaphylaxis should be suspected.

Once you've educated yourself about anaphylaxis, make sure your child understands what it is and how to respond. Next, carry your education campaign into the school - to your kid's teacher, school nurse, and gym teacher, at least.

Prevention: Keep Triggers at a Distance

Taking steps to prevent anaphylaxis from occurring is the next strategy. The way to do that is to avoid all contact with possible triggers. Things like food allergies, though, can be tricky. Sometimes, trace amounts of nuts used in the preparation of foods behind the scenes can be enough to set off anaphylaxis.

Teach your kid how to read food labels and ask questions about how food is prepared and what ingredients are used. Sharing foods with friends and classmates must be strictly forbidden. Some kids are so sensitive to peanuts that even being in the vicinity of someone else who is eating peanuts or peanut butter can be enough to trigger an anaphylactic reaction.

If stinging insects are a trigger for your child, then teach him/her how to recognize such insects and where they like to hang out (for instance, fire ants love crumbly mounds of earth and hornets often nest under railings and eaves).

Latex is another allergy trigger. Often thought of in terms of health care workers and the protective gloves they wear, kids frequently come into contact with latex too - in balloons, rubber bands, bicycle handgrips, pacifiers, even rain boots. Make your child aware of all of the sources of latex if he or she is allergic.

Protection: Quick Response Is Essential!

Knowledge is power and prevention is golden, but even so, accidents happen and exposure to triggers will occur -- no matter how careful you and your child are. So, it is absolutely essential to know how to act quickly if anaphylaxis does occur.

First, you, your child and school officials need to know how to spot early signs of anaphylaxis and how to tell the difference between everyday allergy and asthma symptoms and anaphylaxis.

Second, and most important, your child should always have auto-injectable epinephrine on hand wherever she goes, and the syringe should be on the child's person at all times. If possible, keep extra syringes in the nurse's office, at grandparents' homes, at the babysitter's, etc.

Most states have what are called "right to carry" laws now that permit kids to have asthma inhalers and auto-injectable epinephrine with them in school if needed and to use them on their own (without the school nurse). In fact, only Connecticut and South Dakota have no laws along these lines. Vermont has pending legislation and a few states only permit the right to carry asthma medicines, but not anaphylaxis meds. To learn more, visit the AANMA webpage on students and medications in school.

Some parents (and probably some school staff too) are fearful of using epinephrine on their kids. But, it's critical to understand that any consequences of using an injectable medicine (including possible side effects) pale in comparison to the alternative of not treating anaphylaxis _immediately. _ You can't wait to transport your child to the ER; that may be too late. When anaphylaxis strikes, epinephrine must be given right away!

If you, your child, or school staff aren't comfortable with the prospect of administering an injection, then practice is essential. The AANMA booklet has a great tutorial and quite a few helpful tips on how to use epinephrine.

Take note:The best place to give epinephrine is in the front of the thigh and it can be injected right through clothing if necessary.

Children Have the Right to be Safe

Your child has the right to be safe from harm in school. This includes anaphylaxis. And your responsibility as a parent is to do all you can to protect your child even when he or she is not in your direct care.

So, educate yourself, your child, and your child's alternative caregivers. Take every step you can to help your child avoid possible anaphylaxis triggers. And put protection within your child's grasp, if at all possible.