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Allergic reactions are common. They happen when the immune system reacts to something in the environment that is normally harmless, e.g. food proteins, pollens or dust mites. They can be triggered by an allergen coming into contact with the skin, eyes, nose, lungs, stomach or bowel.
Many allergic reactions are mild, but some can be severe and even life threatening.
The most common causes of allergy in children are eggs, peanuts, tree nuts, cow's milk, soy, wheat, fish and shellfish. Other causes are bee or other insect bites (e.g. wasp, jumper jack ant), some medications such as antibiotics or anaesthetics, and latex (rubber).
Anaphylaxisis is the most severe form of an allergic reaction and is life threatening. Rates of anaphylaxis are not well documented, but are estimated at approximately 10 in every 1000 school children.
A reaction can develop within minutes of exposure to the allergen, but with planning and training a reaction can be treated effectively by using an adrenaline injection (EpiPen®/EpiPen®Jr or Anapen®/Anapen® Jr). An important aspect of anaphylaxis management is prevention by avoiding the cause.
A reaction will include one or more of these symptoms, and it is possible that a number of them will happen at the same time:
This term is used to describe a severe allergic reaction that involves a person's breathing and/or circulation (heart and blood). Any of these symptoms, as well as one or more of the above symptoms of a mild-moderate allergic reaction, indicates anaphylaxis:
Preventing an allergic reaction or anaphylaxis is very important. Ways you can prevent an allergic reaction or anaphylaxis include:
Banning of products that contain the allergen is NOT recommended.
Banning will not succeed in creating an "allergy free zone". It is difficult to achieve a 100% ban, for a variety of reasons. For example, product labels can be confusing, parents of non-allergic children may not comply with the ban, and staff and students can become complacent. Rather than banning foods, it is recommened that people become aware of allergy causing foods.
Food sharing between children at risk of anaphylaxis should be completely avoided. These children must only consume food provided from home or given with the parent's permission.
Any staff who are responsible for cooking or delivering food to children, including relief/casual staff, should know about the child's allergies. They should be aware of alternative words used to describe the particular allergy food. For example, cow's milk may be called casein, and egg may be called ovalbumin. They should also be aware of contamination of other foods when preparing, handling or displaying food.
Food containers or packages that contained the allergy food should not be used. Parents of children with anaphylaxis can help by checking art/craft products for hidden ingredients, because they are often more aware of the terms used.
Separate tables should be used for art/craft and food. Where this is not possible, tables must be cleaned thoroughly between uses.
The adrenalin auto-injector must be taken on all excursions and a staff member trained in its use must always be present. The EpiPen®/EpiPen®Jr or Anapen® Anapen® Jr must always be readily accessible.
The first line treatment for anaphylaxis is adrenaline, which may be given as an EpiPen® /Anapen® injection. Please read the Kids Health Info factsheet: Auto-injectors (epi-pens) for anaphylaxis - an overview.
If a child has had a history of anaphylaxis, an adrenaline auto-injector should be prescribed for the treatment or future episodes. Indications for prescribing an adrenaline auto-injector can be found at the Australasian Society of Clinical Immunology and Allergy (ASCIA). The following recommendations should be considered:
Developed by the RCH Department of Allergy and Immunology. First published in June 2007. Last reviewed in September 2012.