Prevention and management of allergic reactions to food in child care centers and schools: Practice guidelines

Waserman, Susan; Cruickshank, Heather; Hildebrand, Kyla J.; Mack, Douglas P.; Bantock, Laura; Bingemann, Theresa; Chu, Derek K.; Cuello‐García, Carlos A; Ebisawa, Motohiro; Fahmy, David; Fleischer, David M.; Galloway, Lisa; Gartrell, Greg; Greenhawt, Matthew; Hamilton, Nicola Fox; Hourihane, Jonathan; Langlois, Michael; Loh, Richard; Muraro, Antonella; Rosenfield, Lana; Schoessler, Sally; Tang, Mimi L.K.; Weitzner, Brenda; Wang, Julie; Brožek, Jan

doi:10.1016/j.jaci.2021.01.034

Cited by 46 publications

(32 citation statements)

References 184 publications

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“…Meetings with teachers, children, and their families may also increase communication and consensus on stock EAI usage and care plans [40]. Likewise, training, EAP implementation, and stock epinephrine availability align with international recommendations [11,28], and may increase staff awareness of food allergies, and help alleviate concern, anxiety, fear, and helplessness reported by teachers and school staff [43]. In turn, training may contribute to teachers and school staff's confidence, self-efficacy, knowledge, and ability to perform in emergency situations.…”

Section: Discussionmentioning

confidence: 96%

“…Moreover, early (pre-hospital) treatment decreases the risk of hospitalization [13], while delayed treatment from symptom onset was associated with the risk of having a biphasic reaction and fatality [12,24]. As the long-term effects of staff training on food allergy management knowledge are unknown, the implementation of post-training evaluation may also be beneficial [11].…”

Section: Discussionmentioning

confidence: 99%

“…Prior to the coronavirus disease (2019-nCoV/COVID-19) pandemic, about 20.0% of anaphylactic reactions occurred in schools [11][12][13], an observation that is unsurprising given that children typically spend the majority of their waking hours at school. Most in-school reactions occurred in the classroom, cafeteria, and playground [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Currently, policies surrounding food allergy management and its implementation are diverse both across and within jurisdictions [17][18][19][20]. Recently, international recommendations on the prevention and management for childcare centers and schools [11] was published based on the available scientific literature. Authors noted the utility of the guidelines as "conditional", wherein policymakers and stakeholders are to deliberate and adapt recommendations as needed to fit specific jurisdictional needs.…”

Section: Introductionmentioning

confidence: 99%

“…As school nurses may work part-time [21] and among several schools [27], distributed responsibility and training among other school staff who are at school premises at all times is warranted. In brief, policies addressing stock EAI and EAP implementation are underused despite key recommendations and available resources [10,11,27,28].…”

Section: Introductionmentioning

confidence: 99%

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Food Allergy Education and Management in Schools: A Scoping Review on Current Practices and Gaps

et al. 2022

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Currently, no synthesis of in-school policies, practices and teachers and school staff’s food allergy-related knowledge exists. We aimed to conduct a scoping review on in-school food allergy management, and perceived gaps or barriers in these systems. We conducted a PRISMA-ScR-guided search for eligible English or French language articles from North America, Europe, or Australia published in OVID-MedLine, Scopus, and PsycINFO databases. Two reviewers screened 2010 articles’ titles/abstracts, with 77 full-text screened. Reviewers differed by language. Results were reported descriptively and thematically. We included 12 studies. Among teachers and school staff, food allergy experiences, training, and knowledge varied widely. Food allergy experience was reported in 10/12 studies (83.4%); 20.0–88.0% had received previous training (4/10 studies; 40.0%) and 43.0–72.2% never had training (2/10 studies; 20.0%). In-school policies including epinephrine auto-injector (EAI) and emergency anaphylaxis plans (EAP) were described in 5/12 studies (41.7%). Educational interventions (8/12 studies; 66.7%) increased participants’ knowledge, attitudes, beliefs, and confidence to manage food allergy and anaphylaxis vs. baseline. Teachers and school staff have more food allergy-related experiences than training and knowledge to manage emergencies. Mandatory, standardized training including EAI use and evaluation, and the provision of available EAI and EAPs may increase school staff emergency preparedness.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Food Allergy Education and Management in Schools: A Scoping Review on Current Practices and Gaps

et al. 2022

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The confidence and competence of primary school staff to administer an adrenaline auto-injector

Donovan,

O’Connor

2024

Eur J Pediatr

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School teachers are often inadequately prepared to use an adrenaline auto-injector (AAI), resulting in potentially dangerous treatment delays. The purpose of this study was to assess the observed competence, and self-reported confidence, of primary school teachers in the Republic of Ireland (RoI) to use an AAI. An evaluation of whether there was a link between confidence and competence was also assessed. Teachers from four primary schools in the RoI completed a questionnaire to assess their prior level of experience, training, and confidence levels with AAI administration. The four steps in administrating trainer AAI to a mannequin simulator were then assessed. A total of 61 teachers participated (out of a population of 80). The mean self-reported confidence was 1.82 out of 5 (SD = 0.96). There was no significant difference in confidence between trained and untrained participants (U = 240.5, NS). Participants who had received AAI administration training performed significantly more of the steps correctly (mean = 3.85, SD = 0.95) as compared to those who had received no training (mean = 2.97, SD = 1.10; U = 180.5, p = 0.008). There was no correlation between confidence in administrating AAI and the percentage of steps in the procedure performed correctly (rho = −0.17, NS). Conclusion: Improvements in readiness to administer AAIs can be achieved through the application of more effective approaches to teaching clinical skills, changes to school policies and practices, and consideration of the design of AAIs in order to make their operation safer and simpler. It is important that teachers have the confidence and competence to safely administer an AAI. What is Known:• Poor ability in adrenaline auto-injector use seen across population groups—healthcare professionals, patients, carers, and school staff• Training in the use of adrenaline auto-injectors has positive impact on competency What is New:• Irish school teachers show poor levels of competency in adrenaline auto-injector use• No observed correlation between reported confidence and competency

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Underuse of Epinephrine Autoinjectors in Anaphylaxis: Who Is to Blame?

Parikh

Cruickshank

Waserman

2022

Curr Treat Options Allergy

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Prevention and management of allergic reactions to food in child care centers and schools: Practice guidelines

Cited by 46 publications

References 184 publications

Food Allergy Education and Management in Schools: A Scoping Review on Current Practices and Gaps

Food Allergy Education and Management in Schools: A Scoping Review on Current Practices and Gaps

The confidence and competence of primary school staff to administer an adrenaline auto-injector

Underuse of Epinephrine Autoinjectors in Anaphylaxis: Who Is to Blame?

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