[Individualized Reception Project at school and for school food services for children with a food allergy].
The circulars of 1992, 1993 and more recently of 10th November 1999, illustrate the significant progress of schools in the reception of sick children and the help in execution of the medical regulations. The National Education physician is a privileged interlocutor of families, the treating physician and the education authority to make the link between the caregivers and the school. Application of the 1999 circular, which has the objective of taking into account the food allergies in the 1993 plan of action, raises difficulties of three types: Difficulties of a medical type raised by the frequent confusion between the Protocol for urgent intervention and the individualised reception plan. The Protocol for urgent intervention, of which the National Education physician is the recipient, must be accompanied by a letter from the allergy physician that takes into consideration simple immunological sensitization and true allergy and to appreciate the risks that concern food disparities that are not always the same. The almost systematic prescription of adrenaline in protocols for urgent intervention, without argument and in the absence of commercialisation of an auto-injectable pen at the time of distribution of the circular, was a source of resistance by education authorities to catering services. Difficulties of a human type concerning the creation of fear in families, in the education authorities, in the catering services and the time-lag between some families and their careful vigilance with regard to the dietary observance and the conduct to be taken in the case of acute symptoms. Difficulties of administrative or legal types knowing that the scholars catering is a service which does not have the obligatory character of the teaching plan, and which accepts the sole competence of the authorities for 1st degree education. In total the teaching plan and pupil catering for children with a food allergy needs making the parents aware of the responsibility between the allergy physician and the National Education physician who have equal responsibility. With clear and well argued diagnostic and therapeutic information the National Education physician will be able to contribute to the installation of a calm climate that is indispensable to a quality reception.
Deniaud-Morin
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Responsable départemental, Inspection Académique de Maine-et-Loire, Cité Administrative, 15 bis, rue Dupetit-Thouars, 49047 Angers.
D002648:Child; D004630:Emergencies; D004837:Epinephrine / Q000008:administration & dosage; D005512:Food Hypersensitivity / Q000188:drug therapy; D005522:Food Services / Q000331:legislation & jurisprudence*; D005602:France; D006801:Humans; D007267:Injections; D008612:Menu Planning; D010290:Parents; D012017:Referral and Consultation; D012572:School Health Services / Q000331:legislation & jurisprudence*; D012574:Schools / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D012646:Self Administration; D020458:Third-Party Consent
D004837:Epinephrine