ASCIA guidelines for prevention of anaphylaxis in schools, pre‐schools and childcare: 2015 update

Abstract

Abstract:The aim of these guidelines is to assist staff in school and childcare settings to plan and implement appropriate risk minimisation strategies, taking into consideration the needs of the allergic child, the likely effectiveness of measures and the practicality of implementation. Although these guidelines include risk minimisation strategies for allergic reactions to insect stings or bites, latex and medication, the major focus relates to food allergy. This is due to the higher relative prevalence of food allergy in childhood (compared with other allergic triggers) and the higher likelihood of accidental exposure in these settings. Care of the allergic child in the school, pre-school or childcare settings requires accurate information obtained from parents and carers, staff training in the recognition and management of acute allergic reactions, planning for unexpected reactions (including in those not previously identified as being at risk), age appropriate education of children with severe allergies and their peers, and implementation of practical strategies to reduce the risk of accidental exposure to known allergic triggers. Strategy development also needs to take into account local or regional established legislative or procedural guidelines and the possibility that the first episode of anaphylaxis may occur outside the home. Food bans are not recommended as the primary risk minimisation strategy due to difficulties in implementation and lack of proven effectiveness.

Evaluation of an Online Educational Program for Parents and Caregivers of Children With Food Allergies

“…A more holistic approach is needed, including training in and management of comorbidity [10]. Even though school-aged children are capable of acquiring skills that allow them to self-manage their condition, parents still play a fundamental role in education and are responsible for their well-being until they come of age [11].…”

“…It is a disease that requires thinking beyond the usual methods recommended during regular visits to allergy outpatient clinics, because most patients do not follow the recommendations (especially with respect to the epinephrine autoinjector) [10][11][12]. Our outcomes show that information about daily life is not easy to understand, and that additional efforts in education and skill building are needed to help patients, parents, and caregivers.…”

Corticosteroids in management of anaphylaxis; a systematic review of evidence

“…Currently, the recommended mainstay of therapy in the event of an anaphylaxis is epinephrine given either intramuscularly or intravenously in specialist settings (14,(30)(31)(32)(33). It counters most of the pathophysiogical processes giving rise to anaphylaxis (11,34).…”

Advances in food allergy oral immunotherapy: toward tolerance

“…We focus on the contributions of these studies to addressing current challenges in FA OIT, including its safety, efficacy, need for mechanistic understanding (Figure 1), and the complexity arising from the variety of FA and the presence of multiple FAs in 30% of FA patients. The need to address the heterogeneity among OIT trials has been excellently reviewed elsewhere [8]; and standard guidelines for FA immunotherapy [9] and FA prevalence, prevention and management are emerging [10,11,12]. …”