Anaphylactic Emergency Plan (please print) 

Food & Nutrition Food Substitute Form (please print)

Purpose:

 Provide guidance in managing students with allergies who are at risk for anaphylaxis at school.

 Family’s Responsibility

• Notify the School Nurse of life threatening allergy.
• Texas Education Code Chapter 25, Section 25.0022, GISD requests annual disclosure of anaphylactic allergies by the parent/guardian on the pink Student Health History card. This form is in the enrollment packet or in the school office.
• An Anaphylaxis Emergency Action Plan must be completed by the parent and student’s physician and submitted to the school nurse at the beginning of each school year.
• A Special Diet Request form must be completed by the parent and physician for any diet modifications or substitutions of meals purchased through GISD cafeterias related to allergies. This form is available from GISD Food and Nutrition Service at 800 S. Morris St.  Completed forms need to be submitted to the Food and Nutrition Service and the school nurse.  The nurse and the Food and Nutrition Administrator will then contact the campus cafeteria manager.
• A new form must be turned in whenever their student’s dietary needs change.
• Parents are required to provide the school with the emergency medication their child needs to ensure their safety if an exposure/reaction should occur.
• Medication must be properly labeled and replaced after use or upon expiration.
• No student will be excluded from school activities solely based on their life threatening allergy, unless prescribed medication and paperwork isn’t received from the parent.
• Parents need to communicate with the student’s teacher to develop a plan for classroom parties and field trips.
• Students are allowed to carry their own epinephrine, if age appropriate, after approval from the student’s physician/clinic, parent, and school nurse.

Student’s Responsibility

• Should not trade or accept food from other students.
• Should not eat anything with unknown ingredients or known to contain any allergen.
• Students who carry their Epi-pen should be involved in the care and management of their food allergies and reactions.
• Should notify an adult immediately if they eat something they believe may contain the food to which they are allergic.

School’s Responsibility

School Nurse:

• The school nurse and food service manager will work with the parent and student to establish a prevention plan once the Severe Allergy Action Plan and Special Diet Request form (if substitute needed) has been received.
• Train all GISD staff annually in responding to allergic reactions and administration of Epi-pen.
• Document severe allergy on students “Health Alert” in computer.

  Teachers & Classroom Activities:

• Non-food items should be used in the classroom for rewards.
• Pre-packaged food items only with ingredients listed should be used in the classroom for projects, activities and celebrations.
• Check all snacks coming into the classroom for possible food allergens.
• Collaborate with parents when planning field trips or classroom parties.
• Ensure substitutes are informed of student’s with food allergies.
• Ensure that the student’s prescribed Epi-pen and Severe Allergy Action Plan is taken on field trips. (District supplied Epi-pen will NOT be taken on field trips).
• Take threats or harassment against an allergic child seriously.

 GISD Food and Nutrition Service:

• Provide appropriate paperwork to the family in need of food modifications and substitutes.
• Upon receipt of the completed Special Diet Request form, and if applicable, make appropriate substitutions or modifications for meals and snacks served to student with food allergies, as specified by the healthcare provider.
• Monitor participation of food service staff to be trained annually on allergic reactions and Epi-pen administration.
• Maintain documentation of trained staff.
• Train all food service staff to read product food labels and recognize food allergens.
• Follow food handling, cleaning, and sanitation protocol to avoid cross-contamination.
• Student allergy is flagged in the computer system.

 Transportation Department:

• Transportation Director will notify the child’s bus driver of the allergy.
• Enforce no consumption of food/drink on buses (exception: student with diabetes).
• Trained annually on allergic reactions and Epi-pen administration.
• Call 911 if you suspect a possible allergic reaction.
• Recommend that all buses have communication devices in case of emergency.

 Custodial Staff:

• Ensure cafeteria tables are cleaned appropriately between students.
• Any classroom surface that has been exposed to a food allergen should be thoroughly cleaned.