Keeping Kids Safe
Anaphylaxis management is a shared responsibility among allergic students, parents, caregivers and the entire school or childcare community. Teachers and staff can help to reduce risks and create an allergy-safe environment for all students by following certain guidelines.

Identifying kids at risk:
  • Administrators should collect information about a student's medical condition at the time of registration.
  • All staff including supply or substitute teachers must be aware of students with a severe allergy and have access to their allergy information.
  • Information about children with life-threatening allergies should be readily available.
  • Students at risk should wear medical identification such as a MedicAlert® bracelet.

The Action Steps for Anaphylaxis Management flowchart shows the steps to be taken to ensure that allergic students are properly identified and their individual anaphylaxis plans developed and implemented.

School Anaphylaxis Plans


All schools should have a comprehensive written School Anaphylaxis Plan which clearly defines roles and responsibilities based on:
  • Respect for others
  • Sound medical information
  • Good avoidance strategies
  • Staff training
  • Realistic expectations of what the school community can do to safeguard allergic students

For more information see the School Anaphylaxis Plan sample.

In Elementary Schools

Many elementary schools have adopted different practices to reduce the risk of food-related allergic reactions such as:
  • A "no sharing" policy for food-allergic children.
  • Procedures for proper hand washing and cleanup to be monitored by lunch supervisors.
  • Some schools have appealed to the community to keep peanut butter and other peanut/tree nut products out of the school.
  • Some schools require that children who bring peanut/tree nut products to school eat lunch at a designated table in the lunchroom or ask that food-allergic children sit at a table that has been designated "allergy-safe".

Strategies to reduce the risk for other food allergens (e.g., milk, egg, sesame) and stinging insect allergy are usually developed in consultation with school staff, nurses (where available) and parents/guardians of allergic children.

In Secondary Schools

In high school, students generally take on the responsibility for managing their allergies. Since students move around large campuses it is much harder to control their environment than in smaller elementary school settings. Supervision by staff during lunch periods may also be limited.

The management of allergens in high school is a balancing act between safety and a normal social life. Some ways that schools can help reduce risks include:
  • having fewer products containing allergens in vending machines
  • encouraging eating in the cafeteria instead of hallways and classrooms

Student Anaphylaxis Emergency Plan


Every student at risk of anaphylaxis should have an Anaphylaxis Emergency Plan. All staff should be aware of each student at risk, what the emergency plan is and how to implement it, and be trained on the use of an epinephrine auto-injector.

The Anaphylaxis Emergency Plan includes the following:
  • student's photo and allergy information
  • signs and symptoms of anaphylaxis
  • instructions on what to do in an emergency
  • emergency contact information
  • consent to administer medication
  • signature of the child's physician, if required
  • auto-injector instruction sheet

To respond effectively during an emergency, follow these five emergency steps:
  1. Give epinephrine auto-injector (e.g.EpiPen® or Twinject®) at the first sign of a known or suspected anaphylactic reaction.
  2. Call 9-1-1 or local emergency medical services. Tell them someone is having a life-threatening allergic reaction.
  3. Give a second dose of epinephrine in 5 to 15 minutes IF the reaction continues or worsens.
  4. Go to the nearest hospital immediately (ideally by ambulance), even if symptoms are mild or have stopped. The reaction could worsen or come back, even after proper treatment. Stay in the hospital for appropriate period of observation as decided by the emergency department physician (generally about 4 hours).
  5. Call emergency contact person (e.g. parent, guardian).

School Trips and Events


When students are in new situations they can be at greater risk for a reaction because their normal routine is changed. School trips and special events are not part of the daily routine and may present new risks.

Take extra care before leaving on a school trip to ensure that:
  • Allergic students carry their auto-injectors.
  • Teachers on the trip carry a back-up auto-injector, in case a second injection is necessary before medical help arrives.
  • Teachers carry a cell phone.
  • All teachers and volunteers on the trip know the Anaphylaxis Emergency Plan of the students at risk.
  • Each student brings their own parent/guardian-approved food. Or, teachers consult with allergic students ahead of time (and their parents/guardians, for younger children) about foods or other allergens to avoid during the trip or event.
  • Any food that is part of the outing (e.g., animal food at a petting zoo, food used in craft demonstrations) is checked for potential allergens.

  • I Am An Educator
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