title: Management of children with potential anaphylactic reactions in the community: a training package and proposal for good practice.
abstract: BACKGROUND
  The increase in potentially dangerous food allergic reactions (e.g. to peanuts and nuts) in children had lead to an increase in the prescription of adrenaline, including adrenaline for self- or parent-injection. This raises problems in the management of these children in schools. Our experience in response to this is described.
  
  
  OBJECTIVE
  To develop a training package to ensure that each child can continue at school but receive optimum emergency treatment in a safe environment. To provide education, training and support to school staff, and to support parents.
  
  
  RESULTS
  This paper describes a model of good practice in the support of children with potentially fatal anaphylactic reactions. The following points are emphasized. Children with a history of anaphylactic reactions should be expertly assessed prior to the prescription of adrenaline injection. A written treatment plan is essential. Parents need expert support in managing the child. Schools need training and support. Children should lead a normal life, and not be stigmatized or labelled by their problem. Close liaison between primary care, acute services, community services and education services are essential for the successful management of this problem. Data from a questionnaire showed the training package was of benefit, with considerable reduction in anxiety in school staff and parents.
  
  
  CONCLUSIONS
  A broad training package is essential: training in administration of adrenaline is only one aspect, and emphasis is placed on education, recognition of allergic reactions and prevention. The presence of children in school needing access to adrenaline is no longer perceived as a problem in our area. We recommend other health authorities provide a similar service.
authors.affiliation: Lifespan Healthcare NHS Trust, Ida Darwin, Fulbourn, Cambridge, UK.
authors.forename: D W
authors.initials: DW
authors.lastname: Vickers
authors.forename: L
authors.initials: L
authors.lastname: Maynard
authors.forename: P W
authors.initials: PW
authors.lastname: Ewan
mesh_terms: D000707:Anaphylaxis / Q000628:therapy*; D002648:Child; D004493:Education / Q000592:standards; D004632:Emergency Medical Services; D004837:Epinephrine / Q000008:administration & dosage / Q000494:pharmacology; D005069:Evaluation Studies as Topic; D005512:Food Hypersensitivity / Q000276:immunology / Q000628:therapy; D006801:Humans; D007267:Injections; D010290:Parents / Q000523:psychology; D017410:Practice Guidelines as Topic / Q000592:standards; D012111:Residence Characteristics; D012574:Schools; D011795:Surveys and Questionnaires / Q000592:standards
chemical_list: D004837:Epinephrine