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PURPOSE
To explain to North Melbourne Primary School including the North Melbourne Primary School – new campus (interim name) parents, carers, staff and students the processes and procedures in place to support students diagnosed as being at risk of suffering from anaphylaxis. This policy also ensures that North Melbourne Primary School is compliant with Ministerial Order 706 and the Department’s guidelines for anaphylaxis management.

SCOPE
This policy applies to all North Melbourne Primary School Campuses and includes:
• all staff, including casual relief staff and volunteers
• all students who have been diagnosed with anaphylaxis, or who may require emergency treatmentfor an anaphylactic reaction, and their parents and carers.

POLICY
School Statement
North Melbourne Primary School will fully comply with Ministerial Order 706 and the associated guidelines published by the Department of Education and Training.

Anaphylaxis
Anaphylaxis is a severe allergic reaction that occurs after exposure to an allergen. The most common allergens for school-aged children are nuts, eggs, cow’s milk, fish, shellfish, wheat, soy, sesame, latex, certain insect stings and medication.

Symptoms
Signs and symptoms of a mild to moderate allergic reaction can include:
• swelling of the lips, face and eyes
• hives or welts
• tingling in the mouth

Signs and symptoms of anaphylaxis, a severe allergic reaction, can include:
• difficult/noisy breathing
• swelling of tongue
• swelling/tightness in throat
• difficulty talking and/or hoarse voice
• wheeze or persistent cough
• persistent dizziness or collapse
• student appears pale or floppy
• abdominal pain and/or vomiting.
Symptoms usually develop within ten minutes and up to two hours after exposure to an allergen but can appear within a few minutes.

Treatment
Adrenaline given as an injection into the muscle of the outer mid-thigh is the first aid treatment for anaphylaxis. Individuals diagnosed as being at risk of anaphylaxis are prescribed an adrenaline auto-injector (commonly known as an epipen) for use in an emergency. These adrenaline auto-injectors are designed so that anyone can use them in an emergency.

ASCIA Anaphylaxis Action Plan & Individual Anaphylaxis Management Plans
All students at both North Melbourne Primary School (main campus) and NMPS Additional campus (interim campus) who are diagnosed by a medical practitioner as being at risk of suffering from an anaphylactic reaction must have an ASCIA Individual Anaphylaxis Action Plan. Once this is obtained by the school, the principal of North Melbourne Primary School (including the North Melbourne Primary School – new campus (interim name)) is responsible for developing an Individual Anaphylaxis Management Plan for each student diagnosed as anaphylactic; in consultation with the student’s parents/carers.

Where necessary, an Individual Anaphylaxis Management Plan will be in place as soon as practicable after a student enrols atNorth Melbourne Primary School and the North Melbourne Primary School – new campus (interim name), and where possible before the student’s first day.


Parents and carers must:
• obtain an ASCIA Action Plan for Anaphylaxis from the student’s medical practitioner and provide a
copy to the school as soon as practicable
• the ASCIA Anaphylaxis Action Plan must have the prescribing doctors stamp and signature
• immediately inform the school in writing if there is a relevant change in the student’s medical
condition and obtain an updated ASCIA Action Plan for Anaphylaxis
• ensure that the ASCIA Anaphylaxis Action Plan is reviewed annually, or as indicated by the prescribing
doctor
• provide an up-to-date photo of the student for the ASCIA Action Plan for Anaphylaxis when that Plan is provided to the school and each time it is reviewed
• provide the school with a current adrenaline auto-injector for the student that has notexpired;
• participate in annual reviews of the student’s plan.


Each student’s Individual Anaphylaxis Management Plan must include:
• information about the student’s medical condition that relates to allergies and the potential for
anaphylactic reaction, including the type of allergies the student has
• information about the signs or symptoms the student might exhibit in the event of an allergic reaction
based on a written diagnosis from a medical practitioner
• strategies to minimise the risk of exposure to known allergens while the student is under the care or
supervision of school staff, including in the school yard, at camps and excursions, or at special events
conducted, organised or attended by the school
• the name of the person(s) responsible for implementing the risk minimisation strategies, which have been identified in the plan
• information about where the student’s medication will be stored
• the student’s emergency contact details
• an up-to-date ASCIA Anaphylaxis Action Plan completed by the student’s medical practitioner.

Review and updates to ASCIA Anaphylaxis Action Plans & Individual Anaphylaxis Management Plans
A student’s ASCIA Anaphylaxis Action Plan will be reviewed and updated on an annual basis (or as prescribed by the consulting doctor) in consultation with the student’s parents/carers and the prescribing doctor. The Individual Anaphylaxis Management Plan will also be reviewed and, where necessary, updated in the following circumstances:
• as soon as practicable after the student has an anaphylactic reaction at school
• if the student’s medical condition, insofar as it relates to allergy and the potential for anaphylactic
reaction, changes
• when the student is participating in an off-site activity, including camps and excursions, or at special
events including fetes and concerts.
North Melbourne Primary School may also consider updating a student’sIndividual AnaphylaxisManagement Plan if there is an identified and significant increase in the student’s potential risk of exposure to allergens at school.


Location of plans and adrenaline auto-injectors
North Melbourne Primary School (main campus) adrenaline auto-injector and management plan locations:
• there must be an adrenaline auto-injector supplied for each student which will be stored in the school First Aid room within a named red epibag which also contains their management plan; to ensure quick access when required. Antihistamine medication is also stored within this epibag if required for a student that may experience mild allergic symptoms
• each building has access to a generic school adrenaline auto-injector, which is stored in a central location for quick access in the event of an anaphylactic reaction
• depending on the age of the student and as disclosed by their parents/carers, a student at risk of
anaphylaxis may carry a secondary adrenaline auto-injector on their person or within their school bag. This is done with the approval by North Melbourne Primary School and will be documented on their Individual Anaphylaxis Management Plan
• teachers of students diagnosed with anaphylaxis will be given a hard copy of their ASCIA Anaphylaxis
Action Plan and Individual Anaphylaxis Management Plan to store in their classroom in the event of an
anaphylactic reaction
• All of the student ASCIA Anaphylaxis Action Plans and Individual Anaphylaxis Management Plans are also filed in the First Aid Room and are uploaded to Compass and attached to the student’s medical file
North Melbourne Primary School – new campus (interim name) adrenaline auto-injector and management plan locations:
• there must be an adrenaline auto- injector supplied for each student which will be stored in the school First Aid room within a named red epibag which also contains their management plan; to ensure quick access when required. Antihistamine medication is also stored within this epibag if required for a student that may experience mild allergic symptoms
• each level has access to a generic school adrenaline auto-injector, which is stored in a central location for quick access in the event of an anaphylactic reaction
• depending on the age of the student and as disclosed by their parents/carers, a student at risk of
anaphylaxis may carry a secondary adrenaline auto-injector on their person or within their school bag. This is done with the approval by North Melbourne Primary School and will be documented on their Individual Anaphylaxis Management Plan
• teachers of students diagnosed with anaphylaxis will be given a hard copy of their ASCIA Anaphylaxis
Action Plan and Individual Anaphylaxis Management Plan to store in their classroom in the event of an
anaphylactic reaction
• All of the student ASCIA Anaphylaxis Action Plans and Individual Anaphylaxis Management Plans are also
filed in the First Aid Room and are also uploaded to Compass and attached to the student’s medical file

Risk Minimisation Strategies
North Melbourne Primary School ensures the safety of all children while in their care and take responsibility in implementing risk minimisation strategies that reduce the possibility of a student suffering from an anaphylactic reaction at school. This includes:
• during classroom activities (including class rotations, specialist, and elective classes)
• between classes and other breaks
• during recess and lunch times
• before and after school – once students enter the school grounds and on collection from parents/carers
• camps and excursions, or at special events conducted, organised or attended by the school (eg. class
parties, elective subjects and work experience, cultural days, fetes, concerts, events at other schools,
competitions or incursions)

North Melbourne Primary School also takes steps to ensure the safety of all students and to minimise the exposure to allergens. This includes a detailed risk mitigation strategy which has been devised based upon the recommendations outlined in Chapter 8 of the Department’s Anaphylaxis Guidelines. These are also described in each student’s Individual Anaphylaxis Management plan, and include:
• staff and students are regularly reminded to wash their hands after eating;
• students are discouraged from sharing food
• garbage bins at school are to remain covered with lids to reduce the risk of attracting insects
• gloves must be worn when picking up papers or rubbish in the playground.
• school kitchen staff are trained in appropriate food handling to reduce the risk of cross contamination
• year groups will be informed of allergens that must be avoided in advance of class parties, events
or birthdays
• a general use EpiPen will be stored at the school kitchen, First Aid Room and located centrally in
every building for ease of access in the event of an anaphylactic reaction
• planning for off-site activities will include risk minimisation strategies for students at risk of
anaphylaxis including supervision requirements, appropriate number of trained staff, emergency
response procedures and other risk controls appropriate to the activity and students attending.
Adrenaline auto-injectors for general use

North Melbourne Primary School will maintain a supply of adrenaline auto-injectors for general use, as a back-up to those provided by parents and carers for specific students, and also for students who may suffer from a first time reaction at school.


Adrenaline auto-injectors for general use will be stored:
• North Melbourne Primary School (main campus) – in the First Aid room and labelled “general use”
• North Melbourne Primary School – new campus (interim name) – in the First Aid room and labelled
“general use” The Principal is responsible for arranging the purchase of adrenaline auto-injectors for general use, and will consider:
• the number of students enrolled at North Melbourne Primary School, including the North Melbourne
Primary School – new campus (interim name), at risk of anaphylaxis
• the accessibility of adrenaline auto-injectors supplied by parents
• the availability of a sufficient supply of auto-injectors for general use in different locations at both
school campuses, as well as at camps, excursions and events
• the limited life span of adrenaline auto-injectors, and the need for general use adrenaline auto-injectors to be replaced when used or prior to expiry.
• the weight of the students at risk of anaphylaxis to determine the correct dosage of adrenaline
auto-injector/s to purchase

Emergency Response
In the event of an anaphylactic reaction (on or off-site), the emergency response procedures in this policy must be followed, together with the school’s general first aid procedures, emergency response procedures and the student’s Individual Anaphylaxis Management Plan.


A complete and up-to-date list of students identified as being at risk of anaphylaxis is maintained by the North Melbourne Primary School Nurse & OHS Officer for both campuses and is stored in the First Aid Room Anaphylaxis Folder at both the main campus and additional campus. For camps, excursions and special events, a designated staff member will be responsible for maintaining a list of students at risk of anaphylaxis who are attending the special event. This will be kept with the student’s Individual Anaphylaxis Management Plans and adrenaline
auto-injectors, where appropriate. If a student experiences an anaphylactic reaction at school or during a school activity, school staff must:

Step Action

  1. • Lay the person flat
    • Do not allow them to stand or walk
    • If breathing is difficult, allow them to sit
    • Be calm and reassuring
    • Do not leave them alone
    • Seek assistance from another staff member or reliable student to locate the student’s
    adrenaline auto-injector or the school’s general use auto-injector, and the student’s
    IndividualAnaphylaxis Management Plan, stored in the First Aid Room/their named
    red epibag. If off-site, the teacher-in-charge of the off-site activity will have immediate
    access to items listed above
    • If the student’s plan is not immediately available, or they appear to be experiencing
    a first time reaction, follow steps 2 to 5

2. Administer an EpiPen or EpiPen Jr
• Remove from plastic container
• Form a fist around the EpiPen and pull off the blue safety release (cap)
• Place orange end against the student’s outer mid-thigh (with or without clothing)
• Push down hard until a click is heard or felt and hold in place for 3 seconds
• Remove EpiPen
• Note the time the EpiPen is administered
• Retain the used EpiPen to be handed to ambulance paramedics along with the time of
administration
OR
Administer an Anapen® 500, Anapen® 300, or Anapen® Jr.

• Pull off the black needle shield
• Pull off grey safety cap (from the red button)
• Place needle end firmly against the student’s outer mid-thigh at 90 degrees (with or without
clothing)
• Press red button so it clicks and hold for 10 seconds
• Remove Anapen®
• Note the time the Anapen is administered
• Retain the used Anapen to be handed to ambulance paramedics along with the time of
administration

3. Call an ambulance (000)

4. If there is no improvement or severe symptoms progress (as described in the ASCIA Action
Plan for Anaphylaxis), further adrenaline doses may be administered every five minutes, if
other adrenaline auto- injectors are available.

5. Contact the student’s emergency contacts.
If a student appears to be having a severe allergic reaction but has not been previously diagnosed with an allergy or being at risk of anaphylaxis, school staff should follow steps 2 – 5 as above.
Schools can use either the EpiPen® and Anapen® on any student suspected to be experiencing an anaphylactic reaction, regardless of the device prescribed in their ASCIA Action Plan.

Where possible, schools should consider using the correct dose of adrenaline auto-injector depending on the weight of the student. However, in an emergency if there is no other option available, any device should be administered to the student.

North Melbourne Primary School recognises, as guided by the Anaphylaxis Guidelines, that it is better to use an adrenaline auto-injector than not use it, even if in hindsight the reaction is not anaphylaxis. Under-treatment of anaphylaxis is more harmful and potentially life threatening than over-treatment of a mild to moderate allergic reaction. Refer to ‘Frequently asked questions’ on the Resources tab of the Department’s Anaphylaxis Policy.

Communication Plan
This policy will be available on North Melbourne Primary School’s website so that parents and other members of the school community can easily access information about North Melbourne Primary School’s anaphylaxis management procedures. The parents and carers of students who are enrolled at North Melbourne Primary School including the North Melbourne Primary School – new campus (interim name) and are identified as being at risk of anaphylaxis will also be provided with a copy of this policy.

The principal (and/or the chosen representative) is responsible for ensuring that all relevant staff, including casual relief staff, kitchen staff and volunteers are aware of this policy and North Melbourne Primary School’s procedures for anaphylaxis management. Casual relief staff and volunteers who are responsible for the care and/or supervision of students who are identified as being at risk of anaphylaxis will also receive a verbal briefing on this policy, their role in responding to an anaphylactic reaction and where required, the identity of students at risk.

The principal (and/or the chosen representative) is also responsible for ensuring relevant staff are trained and briefed in anaphylaxis management, consistent with the Department’s Anaphylaxis Guidelines.

Staff training
The principal will ensure that the following school staff are appropriately trained in anaphylaxis management:
• School staff who conduct classes attended by students who are at risk of anaphylaxis
• School staff who conduct specialist classes, educational support staff, all kitchen staff, admin staff, first aiders and any other member of school staff as required by the Principal based on a risk assessment.

Staff who are required to undertake training must have completed:
• an approved face-to-face anaphylaxis management training course in the last three years, or
• an approved online anaphylaxis management training course in the last two year

North Melbourne Primary School Staff including the North Melbourne Primary School – new campus (interim name) will undergo the following Anaphylaxis training:
• ASCIA Anaphylaxis e-training Victoria (all staff) followed by a competency check by the School Anaphylaxis
Supervisor. To perform the competency check, the anaphylaxis supervisor must have completed
Course in Verifying the Correct Use of Adrenaline Injector Devices 22579VIC.
• 22579VIC Course in Verifying the Correct Use of Adrenaline Auto-injector Devices (staff who are leaders in
first aid management at North Melbourne Primary School including the North Melbourne Primary School
– new campus (interim name))
• 10710NAT Course in Allergy and Anaphylaxis Awareness run by Asthma Australia (staff who are
leaders in first aid management at North Melbourne Primary School)

Staff are also required to attend a briefing on anaphylaxis management and this policy at least twice per year (with the first briefing to be held at the beginning of the school year), facilitated by the School Anaphylaxis Supervisor, who has successfully completed an anaphylaxis management course within the last 2 years. Each briefing will address:
• this policy
• the causes, symptoms, and treatment of anaphylaxis
• the identities of students with a medical condition that relates to allergies and the potential for
anaphylactic reaction, and where their medication is located
• how to use an adrenaline auto-injector, including hands on practice with a trainer adrenaline auto-injector
• the school’s general first aid and emergency response procedures
• the location of, and access to, adrenaline auto-injectors that have been provided by parents or
purchased by the school for general use.


When a new student enrols at North Melbourne Primary School including North Melbourne Primary School – new campus (interim name) who is at risk of anaphylaxis, the principal/chosen representative will develop an interim plan in consultation with the student’s parents and ensure that appropriate staff are trained and briefed as soon as possible.


A record of staff training sessions will be maintained through the school’s OH&S folder on Google Drive.
The principal/chosen representative will ensure that while students at risk of anaphylaxis are under the care or supervision of the school outside of normal class activities, including in the school yard, at camps and excursions, or at special event days, there is a sufficient number of school staff present who have been trained in anaphylaxis management.

FURTHER INFORMATION AND RESOURCES
All anaphylaxis questions or information should be directed to our school nurse.
• Allergy & Anaphylaxis Australia
• ASCIA Guidelines: Schooling and childcare
• Royal Children’s Hospital: Allergy and immunology
• Confidential Medical Information Form for Excursions
• Department’s Policy and Advisory Library (PAL):
o Anaphylaxis
o Risk Assessment for Local and Day Excursions

• Related Policies:
o Administration of Medication Policy
o First Aid Policy
o Health Care Needs Policy
o Medication Administration Log
o Medication Authority Form

REVIEW CYCLE AND EVALUATION
Policy last reviewed May 2022
Approved by Principal
Next scheduled review date: May 2023 to ensure ongoing relevance and continuous improvement,
this policy will be reviewed annually.


The principal and/or chosen representative will complete the Department’s Annual Risk Management Checklist for anaphylaxis management to assist with the evaluation and review of this policy and the support provided to students at risk of anaphylaxis.