Anaphylaxis and allergy management procedures

Direction and guidance on minimising the exposure to known allergens, reducing the risk of anaphylaxis and responding in the event of anaphylaxis.

Audience

NSW public schools, public preschools, parents and carers, and school communities.

Version Date Description of changes Approved by
V02.0.0

21/06/2024

Updated under the 2023 Policy and procedure review program, including conversion into the new template, and improving readability.

Executive Director, Inclusion and Wellbeing


About the policy

Term Definition

Adrenaline injector

Often known as an EpiPen® and Anapen®, adrenaline injectors are used to treat severe allergic reactions. They contain a single, fixed dose of adrenaline and are designed to be used by anyone, including people with no medical training.

Allergen

A substance that causes an allergic reaction.

Allergic reaction

An immune response to something that is harmless to most people. Allergic reactions can be mild, moderate or severe.

Anaphylaxis

The most severe form of allergic reaction. Anaphylaxis is life-threatening and requires prompt administration of adrenaline.

ASCIA

Australasian Society of Clinical Immunology and Allergy.

ASCIA Plan

ASCIA Action Plan for Anaphylaxis (red) or an ASCIA Action Plan for Allergic Reactions (green) or an ASCIA First Aid Plan Anaphylaxis (orange) or an ASCIA Action Plan for Drug (Medication) Allergy.

Principals:

  • ensure the school has a process to record any allergy and/or medical condition detailed on enrolment forms and initiate the health support planning process with families
  • ensure student health information is collected and reviewed annually and/or following updated health advice and updated in the Enrolment Registration Number system (ERN)
  • complete a risk assessment for anaphylaxis to identify potential areas of risk. As allergen hazards cannot be eliminated, ensure the hazard is added to the school’s risk register and reviewed annually
  • commence Individual health support planning in consultation with parents and carers, the student and their medical practitioner
  • ensure the school has the student’s correct ASCIA Action Plans
  • display copies of students’ ASCIA Action Plan for Anaphylaxis and/or ASCIA Action Plan for Allergic Reactions in canteens, the front office and staff rooms, ensuring privacy requirements are considered. Where it is necessary to provide information to staff, other parents or students, the parent and where applicable the student, should be informed of this beforehand and consulted about the information to be provided. Principals should ensure that the persons provided with this information are aware of the need to deal with such information sensitively and confidentially
  • ensure that employees remain up to date with mandatory training, anaphylaxis e-learning (staff only)
  • develop and review first aid plans and procedures in consultation with staff and other stakeholders annually and/or following a major incident, ensuring that local first aid response protocols are developed and coordinated across all areas, and communicated and displayed in joint occupancy working environments
  • allocate time in staff meetings to discuss, practice and review the school’s management strategies for students with allergies, including regular practice using anaphylaxis adrenaline injector training devices
  • designate a staff member to brief new staff (including canteen staff, volunteers and/or casual relief staff) about students at risk of anaphylaxis, and the school’s procedures and strategies for minimising risk.

All school staff:

  • complete mandatory training, anaphylaxis e-learning (staff only), in anaphylaxis management and administering an adrenaline injector
  • know where general use adrenaline injectors are kept
  • know the school’s first aid and emergency response procedures
  • know their role in responding to an allergic reaction, including anaphylaxis
  • know the identities of students diagnosed with allergies who are at risk of anaphylaxis
  • know and follow workplace risk management strategies and plans
  • raise student awareness through class activities, teaching activities and the use of fact sheets or posters displayed in hallways, canteens and classrooms
  • report incidents and/or injuries to the Health, Safety and Staff Wellbeing directorate Incident Report and Support Hotline (staff only) on 1800 811 523 in accordance with the department’s Incident notification and response policy and procedures (PDF 216KB)
  • for department preschools, notify the regulatory authority of any notifiable incidents by emailing earlylearning@det.nsw.edu.au or calling 1300 083 698.

Parents or carers:

  • notify the school if their child has an allergy, and/or is at risk of anaphylaxis, at the time of enrolment or as soon as possible after diagnosis
  • inform the principal of any additional needs the student has that may impact on the management of anaphylaxis
  • provide the school with a valid ASCIA Action Plan for Anaphylaxis or ASCIA Action Plan for Allergic Reactions completed and signed by the treating doctor or nurse practitioner
  • provide the school with an ASCIA Action Plan for Drug (medication) Allergy, completed by the treating doctor or nurse practitioner, if required
  • provide the school with the student’s prescribed medication including the adrenaline injector (where prescribed), ensuring this matches the completed ASCIA Action Plan
  • collaborate with the school to develop an individual health support plan and appropriate risk management strategies. The plan must be reviewed by the parents annually, or on request by the school.

Students:

  • cooperate with staff in managing their health.

What needs to be done

Anaphylaxis is potentially life threatening and always requires an emergency response. Schools are required to work with their communities to provide safe and supportive environments for preventing and managing anaphylaxis.

All staff, regardless of their role, have a responsibility in accordance with their duty of care to administer first aid immediately (including administering an adrenaline injector) as required in an emergency.

1. Meet mandatory training requirements

Principals must ensure that staff maintain current competency through required anaphylaxis training.

Staff must complete Mandatory training for schools in the following training courses, which help staff recognise the signs and symptoms of anaphylaxis and provide instruction on how to provide an emergency response to anaphylaxis:

  • anaphylaxis management
  • administering an adrenaline injector.

Principals may also consider whether school-based staff (either paid or volunteers) in school canteens, food technology, hospitality, school cooks and chefs undertake the National Allergy Council’s All about Allergens for Schools online food allergen management training.

All school-based staff are required to complete the relevant role-specific Anaphylaxis e-learning online training module (staff only) at least once every 2 years. This training is accessed via MyPL.

Assisted School Travel Support Officers must undertake anaphylaxis training through the Assisted School Travel Program.

Pre-service teachers are required to complete the online ASCIA anaphylaxis e-training before commencing a professional experience placement. At the start of each professional experience placement, the pre-service teacher must provide the school with their training certificate and demonstrate the correct use of EpiPen® and Anapen® training devices.

RAMOAP is a practical training course facilitated by an approved registered training organisation or an accredited internal trainer. Schools must deliver this course annually for a significant proportion of staff, subject to essential student supervision requirements. Annual training can also be extended to regular casual staff, canteen staff and volunteers as determined by the school. Training courses can be found at First Aid, CPR and Anaphylaxis training.

Note: All preschools are required to comply under the National Quality Framework for Early Childhood Education and Care and are subject to mandatory training requirements set out in the Education and Care Services National Regulations. By following the anaphylaxis training requirements for NSW Government schools, department preschools will meet these mandatory training requirements.

The National Allergy Council recommends the All about Allergens for Schools online food allergen management training be undertaken, at least every 2 years.

Senior students enrolled in food technology or hospitality subjects, volunteers in school canteens or tuckshops, and anyone else involved in food handling/preparation are also encouraged to complete this training.

Where staff or students complete this training, the school may wish to include records of completion in a training register.

2. Assess and manage risk

All department workplaces must take a risk management approach to reduce exposure to allergens in the environment. Schools can access the department’s work health and safety Risk Management Procedure for advice and strategies to mitigate anaphylaxis in a school.

Work Health and Safety Advisors can help schools complete a risk assessment and develop a risk assessment plan, as a whole-school approach. This information, which can also form the basis of a student’s individual health support plan, should consider:

  • the physical school environment
  • the social and cultural environment
  • any individual characteristics of the student, including the full range of their learning and support needs when planning health support
  • how to inform the student and other students about allergies and anaphylaxis using curriculum and other communication measures
  • routine classroom activities, including lessons in other locations around the school
  • non-routine classroom and school activities
  • before school, recess, lunchtime, and other break or play times
  • sport or other programmed out-of-school activities, work placement, work experience, TAFE-delivered vocational education and training
  • excursions, including overnight excursions and camps.

3. Ensure availability of adrenaline injectors

Schools must:

  • maintain a minimum of one general use adrenaline injector (EpiPen®) stored within a school first aid kit and ensure processes are in place to determine the need and mechanism to purchase additional adrenaline injectors
  • store their ASCIA First Aid Plan for Anaphylaxis (Orange) (EpiPen®) with their general use adrenaline injector
  • undertake a risk assessment to determine additional requirements for general use adrenaline injectors considering student/staff numbers, size, and layout of the workplace, as well as off-site activities and excursions (for more information, refer to Anaphylaxis)
  • in the event of an EpiPen® shortage, email epipen@det.nsw.edu.au or call the Health, Safety and Staff Wellbeing directorate’s Incident Report and Support Hotline on 1800 811 523 to discuss solutions.

Preschools must:

  • store their supplied EpiPen® Jr adrenaline injector with the ASCIA First Aid Plan for Anaphylaxis (Orange) (EpiPen®) for use with EpiPen® Jr.
  • in the event of an EpiPen® shortage, email epipen@det.nsw.edu.au or call the Health, Safety and Staff Wellbeing directorate’s Incident Report and Support Hotline on 1800 811 523 to discuss solutions.

4. Ensure nut products are not used

Principals or canteen managers must ensure peanuts, tree nuts or any nut products are NOT used in curricula or extra curricula activities (or available in the school canteen). The Allergy and Anaphylaxis Management within the Curriculum P-12 (PDF 532 KB) procedures provide further information.

Schools must not use peanuts, tree nuts or any products where nuts are listed as ingredients, in practical food preparation classes in subjects such as:

  • Food Technology (Mandatory), Food Technology Stages 5 and 6, and Hospitality Stage 6
  • all other Key Learning Areas when food is being prepared and/or shared as part of teaching and learning.

Extra curricula activities

Schools must not provide any foods to students that include the use of peanuts, tree nuts and any foods where nuts are listed as an ingredient, including during camps and excursions.

School canteens must remove food and drink items with peanuts and tree nuts as an ingredient.

This advice does NOT include foods with precautionary allergen statements for peanuts and tree nuts, often labelled as ‘may contain’.

Schools cannot declare themselves to be NUT FREE.

An ‘allergy aware’ approach that focuses on implementing a range of appropriate risk minimisation strategies is recommended (National Allergy Council).

5. Know the students who are at risk

All schools must obtain information from parents about allergies and other health conditions that may affect their child at school. Parents and carers should also provide medical information from the student's doctor, where applicable, including information about other known health conditions and/or disabilities that may impact on the school’s overall management of the student’s health condition.

This must be done:

For children being enrolled in a department preschool, this must be done:

  • at enrolment
  • before the child commences preschool.

Information can be obtained at application to enrol in a department preschool.

Principals must provide all staff members, including casual employees, with a list and access to individual health support plans of all students who are at risk of anaphylaxis, so they can manage the risk.

6. Educate the school community

Schools must educate their communities about allergies and anaphylaxis to:

  • increase the understanding of all parents, carers and students
  • gain parent or carer and student support to minimise the risk of exposure to known allergens
  • alert other students to the need to immediately inform a teacher if they become aware a classmate has come into contact with an allergen or suddenly becomes unwell
  • minimise the potential for teasing or provocation that may result in risk taking associated with allergens.

6.1 Develop and implement a communication plan

Schools must develop a communication plan and strategies to raise allergy awareness for all staff. The plan should outline how the school will communicate with staff, volunteers, students, parents and carers, and the broader school community about allergies and anaphylaxis.

Students may be unable to communicate during an allergic reaction

It can be difficult to communicate during a reaction, particularly if they become too distressed or too unwell. It is important to reinforce the message that if a student sees a peer who is unwell or distressed, to always notify a teacher.

The communication plan should inform:

  • staff (including new and casual relief staff, volunteers and students on practical placement) about students with allergies, including any changes to their allergies
  • staff who may not have been included in anaphylaxis training, such as cleaners and grounds maintenance staff, about how the school manages allergies
  • parents and carers of students with allergies about food-related activities their child will engage in. This could include excursions and off-site activities where there may be an increased risk. An ‘allergy aware’ approach is recommended rather than focusing on banning specific food allergens
  • parents to advise the principal or their delegate of any changes in their child’s health condition
  • students who carry their own adrenaline injector to and from school and at school must complete a Request for student to carry their own EpiPen®, Anapen® or asthma reliever medication form (PDF 358 KB). This arrangement is made in consultation with the student, parent and school.

6.2 Engage with students at risk

Staff need to be aware that bullying of students at risk of anaphylaxis can occur in the form of teasing, tricking a student into eating a particular food or threatening a student with the substance that they are allergic to. Talk to the students involved so they are aware of the seriousness of anaphylaxis. Any attempt to harm a student with allergies and/or are at risk of anaphylaxis must be treated seriously and dealt with accordingly. Refer to the Student behaviour policy for more information.

6.3 Engage with parents and carers

Parents and carers of children at risk of anaphylaxis may experience high levels of anxiety about sending their children to school. It is important to encourage an open and cooperative relationship with parents and carers to ensure they feel confident that appropriate risk management strategies are in place.

Department preschools must work with families to develop a communication plan that meets all requirements under the Education and Care Services National Regulations (2011) (PDF 1MB), Regulation 90 and Regulation 91.

7. Develop an Individual health support plan for students at risk

Individual health support plans must include the Individual health support plan cover sheet found on Individual health support planning with other details included in plans, as outlined below.

Individual health support plans must include:

  • an ASCIA Action Plan for anaphylaxis or allergic reactions for the individual student, completed and signed by the treating doctor or nurse practitioner. The school cannot prepare this document
  • an emergency care/response plan (in the case of anaphylaxis – the ASCIA action plan for anaphylaxis IS the emergency response plan)
  • a statement of the responsibilities of those involved in the student's health support
  • a schedule for the administration of prescribed medication as provided by the treating medical practitioner, if required
  • a schedule for the administration of health support procedures, as provided by the treating medical practitioner, if required
  • an authorisation to contact the medical practitioner
  • arrange for supplying, storing, and replacing ASCIA Action Plans and medication, including adrenaline injectors in consultation with parents.

8. Respond to anaphylaxis and allergy reactions

All staff:

Principals or delegated staff report incidents and/or injuries to the Incident Report and Support Hotline ( or 1800 811 523).

For department preschools, notify the regulatory authority of any notifiable incidents by emailing earlylearning@det.nsw.edu.au or calling 1300 083 698.

  • The NSW Department of Education has a duty of care to take reasonable steps to keep students safe from foreseeable risk of harm while they attend school or engage in school related activities. The department meets its duty of care obligations through the actions of its staff. This includes the administration of an adrenaline injector and/or any other emergency care provided when a student has an episode of anaphylaxis at school or during school activities.
  • Any member of staff who provides an emergency response to a student who has an anaphylactic reaction at school is acting in the course of their employment.
  • The NSW Department of Education is legally responsible for what staff do in the course of their employment.
  • In the unlikely event that an employee is personally sued for providing an emergency response to a student who has been provided with an emergency response, the department will defend their claim at no expense to the staff member and pay any damages.
  • The only exception will be where the actions of the employee amount to serious and wilful misconduct. Carelessness, inadvertence (lack of attention) or a simple mistake do not amount to serious and wilful misconduct.
  • If a student’s parents or carers provide the school with a Do Not Resuscitate (DNR) order for their child, an emergency response should be provided and an ambulance called with details of the DNR provided to the paramedics when they arrive at the school.

Record keeping requirements

System for checking and updating information

Schools must maintain appropriate official records when supporting students with anaphylaxis in accordance with any legislative requirements. It may be necessary to provide records in the event of an anaphylaxis-related event.

These include:

  • training registers
  • risk assessment and the school’s Risk Register
  • the student’s current ASCIA Action Plans for Anaphylaxis and expiry dates of adrenaline injectors
  • meetings about development of the individual health support plan and emergency response
  • the annual review of individual health support plans
  • meetings of learning and support teams that assist in health support planning for the student
  • conversations and communications with parents
  • medical advice sought and provided
  • management of general use and individual student autoinjectors and expiry dates.

Privacy considerations

Schools must observe any requirements imposed by privacy legislation with most records other than the emergency response plan being kept secure and accessible only to those staff who need to see them.

Policy contact

Leader, Student Health and Safety
Student.Health@det.nsw.edu.au

The Executive Director, Inclusion and Wellbeing monitors the implementation of this procedure, regularly reviews its contents to ensure relevance and accuracy, and updates it as needed.

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