Anaphylaxis

Policy

The purpose of this policy is to ensure schools manage students at risk of anaphylaxis and meet legislative requirements, and to ensure all staff can respond to an anaphylactic reaction.

Summary

• Under Ministerial Order 706 – Anaphylaxis Management in Victorian schools (PDF) (the Order), schools that have enrolled students who are at risk of anaphylaxis must undertake the following risk management strategies:
  • develop a school anaphylaxis management policy. This policy must include risk minimisation and prevention strategies to minimise the risk of an allergic reaction, include school management and emergency responses and outline a communication plan to advise the school community of anaphylaxis management processes. An Anaphylaxis policy template (staff login required) that meets these requirements is available for school use on the School Policy Templates Portal
  • the principal must ensure that school staff are appropriately trained in anaphylaxis management. Under the Order, all relevant school staff must participate in a twice-yearly anaphylaxis briefing, with the first to be held at the start of the school year. Relevant school staff must also participate in face-to-face or online anaphylaxis training. For more information, refer to staff training
  • develop individual anaphylaxis management plans for each student at risk of anaphylaxis
  • purchase adrenaline autoinjectors for general use to provide a back-up to the devices brought to school by students at risk of anaphylaxis and for first time allergic reactions
  • review and complete a risk management checklist each year.
• Where no students are enrolled at the school who are known to be at risk of anaphylaxis, to discharge the duty of care owed to students, schools must:
  • have at least 2 general use autoinjectors within expiry
  • in line with the First Aid for Students and Staff policy, ensure school staff have completed first aid training so that they are able to administer an autoinjector if a student has their first anaphylactic reaction at school or on a school excursion or camp.
• The department’s Anaphylaxis Guidelines assist schools to meet their duty of care to students at risk of anaphylaxis as well as other legislative requirements. It is recommended that schools refer to these guidelines and comply with all mandatory directions.
• For all school anaphylaxis management enquiries (including the implementation of Ministerial Order 706), schools can contact the Royal Children’s Hospital Anaphylaxis Support Advisory Line. Refer to contact details for more information.

Details

Anaphylaxis is a severe, rapidly progressive allergic reaction that is life threatening.

Anaphylaxis Guidelines

Anaphylaxis Guidelines (the Guidelines) have been developed to assist schools to meet their duty of care to students at risk of anaphylaxis as well as to comply with their obligations under the Education and Training Reform Act 2006 (Vic) (the Act) and the Order.

The Guidelines include information on anaphylaxis including:

• legal obligations of schools in relation to anaphylaxis
• school anaphylaxis management policy
• staff training
• individual anaphylaxis management plans
• risk minimisation and prevention strategies
• school management and emergency responses
• adrenaline autoinjectors for general use
• a communication plan
• a risk management checklist.

Ministerial Order 706 – School requirements

Ministerial Order 706 applies where a school has a student enrolled who is at risk of anaphylaxis.

The school principal is responsible for implementing the requirements of the Order. The principal can allocate tasks under the Order to other staff, such as an assistant principal or other appropriate school staff members. If tasks are allocated to other staff, the principal must ensure that they retain final oversight of the tasks that have been allocated to staff. This might be done, for example, by reviewing and formally approving documents such as plans and procedures drafted by staff, authorising procurements, reviewing receipts for purchase of autoinjectors and training and confirmation of training undertaken. The aim is to have a thorough understanding of the anaphylaxis requirements at the school and for the principal to be able to show that all the requirements in the Ministerial Order are being met.

Schools must have their own school anaphylaxis management policy

The department is committed to protecting children and young people at risk of anaphylaxis. Under the Act, in order to meet the Minimum Standards and School Registration, all schools, government and non-government, are required to have a school anaphylaxis management policy when they have an enrolled student who is at risk of anaphylaxis, covering certain matters that are set out in the Order.

An Anaphylaxis Policy Template that meets these requirements is available for school use on the School Policy Templates Portal.

Where schools have multiple campuses, the school can develop one school anaphylaxis management policy to cover all campus sites.

Staff must undertake regular training

The Order sets out the minimum requirements for anaphylaxis management training in schools and the Guidelines provide further detail on training requirements.

Under the Order school staff must undertake training in anaphylaxis management if they:

• conduct classes attended by students with a medical condition relating to allergy and the potential for anaphylactic reaction, or
• are specifically identified and requested to do so by the school principal or allocated staff member, based on the principal/allocated staff member’s assessment of the risk of an anaphylactic reaction occurring while a student is under that staff member’s care, authority or supervision.

Schools are encouraged to consider whether volunteers at the school and regular casual relief teachers should also undertake training.

The Order states that these relevant school staff must:

• successfully complete an anaphylaxis management training course (either online in the last 2 years, with verification of competency by the school anaphylaxis supervisor, or face-to-face in the last 3 years) and
• participate in the school’s twice-yearly briefings conducted by the school anaphylaxis supervisor or another member of staff nominated by the principal who has completed an approved anaphylaxis management training course in the past 2 years.

Anaphylaxis training options

Schools must deliver an in-house anaphylaxis school briefing twice a year for all relevant staff (see below for further details). It is recommended that all school staff attend this briefing.

In addition, schools must ensure relevant school staff successfully complete one of the below training options:

• Option 1 (recommended): ASCIA anaphylaxis e-training Victorian Schools course, provided free to all Victorian government schools. This option requires verification of competency by the school’s anaphylaxis supervisor.
• Option 2: face-to-face anaphylaxis management course by an accredited VET provider.

Option 1 – ASCIA anaphylaxis e-training Victorian Schools course

Requirements for school staff

Under this option, school staff must:

• complete the ASCIA e-training course every 2 years
• have their competency verified by the school anaphylaxis supervisor.

Requirements for school anaphylaxis supervisors

Two staff per school campus must perform the role of school anaphylaxis supervisor and sign the ASCIA certificates of staff within their school. To become a school anaphylaxis supervisor, staff must:

• complete the ASCIA e-training course every 2 years
• complete the Verifying the Correct Use of Adrenaline Injector Devices 22579VIC every 3 years (provided by Hero). Staff must have successfully completed the ASCIA e-training course within the previous 12 months prior to enrol in the Verifying the Correct Use of Adrenaline Injector Devices 22579VIC
• complete the First Aid Management of Anaphylaxis 22578VIC every 3 years (provided by Hero).

Option 2 – face-to-face anaphylaxis management course by an accredited VET provider

School staff with a direct teaching role of a student with anaphylaxis, and any other school staff directed by the principal or allocated staff member, can undertake fee-based face-to-face training in the following accredited anaphylaxis training course through an accredited training provider:

• Course in First Aid Management of Anaphylaxis 22578VIC delivered by a RTO completed every 3 years.

Victorian schools pay the cost of Option 2 anaphylaxis training for each staff member trained.

Please note: General First Aid training does not meet the anaphylaxis training requirements of the Order.

Twice-yearly anaphylaxis briefing requirements

In addition to the training outlined above, an in-house anaphylaxis school briefing must be conducted twice a year (with the first briefing to be held at the beginning of the school year) for all relevant staff. It is recommended that all school staff attend this briefing.

The person leading the twice-yearly anaphylaxis school briefing must have successfully completed an anaphylaxis management training course in the previous 2 years. It is recommended the briefing is led by the school anaphylaxis supervisor or another member of staff who has current anaphylaxis training.

Refer to the Staff training chapter of the Guidelines for further guidance on the information that must be provided in the biannual staff briefing.

An Anaphylaxis management briefing presentation (PPTX) has been developed by the department for schools use, which covers this required content.

Overview of how schools manage students with anaphylaxis

The below information summarises how schools manage students with anaphylaxis.

ASCIA action plans (RED)

A copy of the student's ASCIA Action Plan for Anaphylaxis (RED) (prepared by a medical practitioner or nurse practitioner) must be obtained from the parent or carer and held by the school. The plan outlines the student’s known severe allergies and the emergency procedures to be taken in the event of an allergic reaction.

It is the parent/carer’s responsibility to provide the school with a copy of their child's ASCIA Action Plan for Anaphylaxis (RED) and an up-to-date photo of the student – to be attached to this plan – and to inform the school if their child's medical condition changes.

Schools must complete an individual anaphylaxis management plan for students at risk of anaphylaxis

An individual anaphylaxis management plan (DOCX) must be completed by the principal or their allocated staff member in consultation with the parents/carer, in addition to the ASCIA Action Plan for Anaphylaxis (RED) provided by the parent/carer. The individual anaphylaxis management plan is required to set out the strategies that will be implemented by the school to minimise the risk of exposure to known allergens while the student is under the care or supervision of school staff.

The individual anaphylaxis management plan must specify:

• the emergency care to be provided at the school
• location of the adrenaline autoinjector (EpiPen and Anapen)
• emergency contact details
• allergic risks in the school environment
• actions to minimise these risks.

The plan must be reviewed on any of the following occurrences (whichever happen earlier):

• annually
• if the student's medical condition (relating to allergy and the potential for anaphylactic reaction) changes
• as soon as practicable after the student has an anaphylactic reaction at school
• when the student is to participate in an off-site activity.

Emergency response

In the event of an anaphylactic reaction, the emergency response procedures specified in the school anaphylaxis management policy must be followed, together with the school’s general first aid procedures, emergency response procedures and the student’s individual anaphylaxis management plan. Drills to test the effectiveness of these procedures should be undertaken regularly. The Anaphylaxis Guidelines also contain information on responding to an anaphylactic reaction.

Prevention strategies

The school anaphylaxis management policy must include prevention strategies used by the school to minimise the risk of an anaphylactic reaction.

Communication plan

The school anaphylaxis management policy must include a communication plan. The principal is responsible for ensuring that the communication plan is developed to provide information to all school staff, students and parents/carers (and volunteers and casual relief staff) about anaphylaxis and the school's anaphylaxis management policy and must include strategies for advising school staff and students about how to respond to an anaphylactic reaction of a student in various environments.

The template school anaphylaxis management policy (staff login required) has a communication plan included.

Annual risk management checklist

Principals, or their allocated staff member must complete an annual anaphylaxis risk management checklist (DOC) to monitor their compliance with their legal obligations and the Guidelines. If this task is allocated to another staff member, the principal must still approve the checklist.

Purchase of additional adrenaline auto-injection devices

Schools with students at risk of anaphylaxis must purchase at least 2 spare or ‘backup’ adrenaline auto-injection device(s) as part of school first aid kit(s), for general use. For example, one autoinjector that can be taken on school excursions and camps and one that can remain at school. Schools can purchase an adrenaline auto-injection device at local chemists. Schools must regularly check the expiry date of the backup device.

Even when a school has no students enrolled with a diagnosed risk of anaphylaxis, the principal or their allocated staff member must purchase at least 2 adrenaline autoinjector/s for general use as some students may experience their first anaphylactic reaction while at school or on a school camp or excursion.

Schools must determine the number of backup adrenaline auto-injector devices to be purchased for general use, taking into account:

• the number of diagnosed students attending the school
• the likely availability of a backup device in various settings, including school excursions and camps.

There are currently 2 adrenaline autoinjector devices approved by the Therapeutic Goods Administration for use in Australia: the EpiPen and the Anapen. Both devices can be used, however, the principal or allocated staff member will need to determine the type of adrenaline autoinjector to purchase for general use. For more information about which autoinjector to purchase for general use, refer to Adrenaline autoinjectors for general use.

Camps and special event participation

Schools should ask parents/carers to complete a Medical information form – day excursions (DOCX). Consideration must be given to the food provided at camps and special events to prevent anaphylactic incidents. Risk minimisation strategies relating to food provision at camps at school events should form part of the school anaphylaxis management policy and individual anaphylaxis management plans.

Related policies

• Allergies
• Asthma
• Duty of Care
• First Aid for Students and Staff
• Food Handling in Canteens
• Health Care Needs
• Managing and Reporting School Incidents (Including Emergencies)
• Medication

Relevant legislation

• Children’s Services and Education Legislation Amendment (Anaphylaxis Management) Act 2008 (Vic):
  • On 14 July 2008, the Children’s Services and Education Legislation Amendment (Anaphylaxis Management) Act 2008 came into effect amending the Children’s Services Act 1996 and the Education and Training Reform Act 2006 requiring that all licensed children’s services and schools have a school anaphylaxis management policy in place.
• Ministerial Order 90 (repealed on 22 April 2014)
• Ministerial Order 706 (PDF) (updated on 3 December 2015):
  • Ministerial Order 706 – Anaphylaxis Management in Victorian schools outlines points that schools need to ensure are included in their school anaphylaxis management policy. A revised Ministerial Order 706 came into effect on 3 December 2015.

Contacts

For all school anaphylaxis management enquiries (including the implementation of Ministerial Order 706):

Visit: Royal Children’s Hospital: Anaphylaxis Support Advisory Line
Phone: 1300 725 911 (8:30 am to 5:00 pm, Monday to Friday)
Email: anaphylaxisadviceline@rch.org.au

For all policy related anaphylaxis enquiries:

Health Promotion, Prevention and Advice Unit
Wellbeing, Health and Engagement Division
Email: health.advice@education.vic.gov.au