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 are required to develop a school-level anaphylaxis management policy.
• The department has developed Anaphylaxis Guidelines to 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.
• The principal must ensure that school staff are appropriately trained in anaphylaxis management. Under the Order, all 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.
• Hero HQ is the provider of anaphylaxis supervisor training in Victorian schools. For more information about how to access anaphylaxis training, refer to staff training.
• For all school anaphylaxis management enquires, (including the implementation of Ministerial Order 706) schools can contact the Royal Children’s Hospital Anaphylaxis Support Advisory Line. Please 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

Schools must have their own local 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 local anaphylaxis management policy 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.

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, based on the principal’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 school staff must:

• successfully complete an anaphylaxis management training course (either online in the last 2 years 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.

Online training course

It is recommended that all school staff undertake the free Australasian Society of Clinical Immunology and Allergy (ASCIA) e-training course which has been developed by ASCIA in conjunction with the department for all school staff, to increase the quality and consistency of training. The online course is free and can be accessed on ASCIA's website.

Competency to use an adrenaline auto-injector

To successfully complete this training staff will also be required to show that they are able to appropriately and competently use an adrenaline auto-injector.

This capability must be tested within 30 days of completion of the online training course.

School staff that complete the online training course will be required to repeat that training and the adrenaline auto-injector competency assessment every 2 years.

Verifying competency

Schools should nominate 2 staff members from each campus to become school anaphylaxis supervisors who undertake competency checks on all staff that have successfully completed the online training course. To become a school anaphylaxis supervisor and undertake these competency checks, nominated school staff should undertake face-to-face training to skill them in providing competency checks to assess their colleagues’ ability to use an adrenaline autoinjector (EpiPen and Anapen) and become school anaphylaxis supervisors. Training in Verifying the Correct Use of Adrenaline Injector Devices 22579VIC is available from Hero HQ who have been appointed as the department’s anaphylaxis training provider for Victorian government schools.

Alternatively schools can opt to undertake fee-based face-to-face training in one of the accredited anaphylaxis training courses that meet the requirements of the Order:

• course in First Aid Management of Anaphylaxis 22578VIC
• course in Allergy and Anaphylaxis Awareness 10710NAT.

First aid training does not meet the training requirements of the Order.

Anapen workshop training

On 1 September 2021 the Anapen adrenaline (epinephrine) autoinjector was introduced into Australia for the treatment of anaphylaxis and schools will need to ensure relevant staff are trained to use them.

For more information about the Anapen Workshop Training, refer to staff training.

Twice-yearly anaphylaxis briefing requirements

In addition to the training outlined above, an in-house anaphylaxis school briefing must be conducted twice a year. It is recommended that all school staff attend this briefing.

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

An Anaphylaxis management briefing presentation (PPTX) has been developed by the department for schools use.

Overview of how schools manage students with anaphylaxis

The below information summarises how schools manage students with anaphylaxis.

ASCIA action plans

A copy of the students ASCIA Action Plan for Anaphylaxis (prepared by a medical 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 and an up-to-date photo of the student – to be appended to this plan – and to inform the school if their child's medical condition changes.

Current ASCIA action plans are the General and EpiPen 2021 versions, and the 2022 Anapen version. However, prior versions (2021, 2020 and 2018) are still valid for use in 2022 and 2023.

Individual anaphylaxis management plan

An individual anaphylaxis management plan should be completed by the principal or their nominee in consultation with the parents/carer and be informed by the ASCIA Action Plan for Anaphylaxis provided by the parent.

The individual anaphylaxis management plan should 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 and actions to minimise these risks.

The plan should 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 (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.

Annual risk management checklist

Principals must complete an annual anaphylaxis risk management checklist to monitor their compliance with their legal obligations and the Guidelines.

Purchase of additional adrenaline auto-injection devices

Schools with students at risk of anaphylaxis must purchase a spare or ‘backup’ adrenaline auto-injection device(s) as part of school first aid kit(s), for general use. Schools can purchase an adrenaline auto-injection device at local chemists. (Schools must regularly check the expiry date of the backup device).

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 and 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, these are the EpiPen and the Anapen. Both devices can be used, however, the principal 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.

Definitions

Anaphylaxis
Anaphylaxis is a severe and sudden allergic reaction when a person is exposed to an allergen. Common allergens include:

• eggs
• peanuts
• tree nuts such as cashews
• cow's milk
• fish and shellfish
• wheat
• soy
• sesame
• insect stings and bites
• medications.

Signs of mild to moderate allergic reaction include:

• swelling of the lips, face and eyes
• hives or welts
• tingly mouth
• abdominal pain and/or vomiting (signs of a severe allergic reaction to insects).

Signs of anaphylaxis (severe allergic reaction) include any 1 of the following:

• difficult/noisy breathing
• swelling of tongue
• swelling/tightness in throat
• difficulty talking and/or a hoarse voice
• wheeze or persistent cough
• persistent dizziness or collapse
• pale and floppy (young children)
• abdominal pain and/or vomiting (signs of a severe allergic reaction to insects).

EpiPen and Anapen
An EpiPen and an Anapen are autoinjectable devices that deliver the drug epinephrine. They are used when someone is experiencing a severe allergic reaction.

Related policies

• Allergies
• Asthma
• Duty of Care
• Health Care Needs

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 an 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 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 enquires:

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