Case Studies

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Food Allergy Case Study #1

During a visit to a local nature center, a 9-year-old student participated in a “discovery table” activity, where children were invited to dig through what appeared to be small decorative gravel or ground cork to look for fossils, stones, and rubber bugs.

After a few minutes of participation, the student had an allergic reaction. As he was rushed out of the center to seek treatment, the center’s receptionist was asked what was in the discovery table, and she said the material contained ground walnut shells.

How Can Your School Prevent a Similar Tragedy?

  • Inquire about the possible use of food ingredients in any activity in which the student will be participating—whether it’s in the classroom or on a field trip.
  • Develop a plan for how an allergic reaction will be handled. Who will accompany the child to the hospital? Who will remain with the other children?
  • Make sure teachers and chaperones can identify students with food allergies, recognize the symptoms of a reaction, and know where the medication is kept and how it is used.
  • Ask the parents of students with food allergy to review their child’s Food Allergy Action Plan and ensure that the information is up to date.

 

Food Allergy Case Study #2

Parents of an elementary school student who is allergic to milk were asked to provide a list of prepackaged foods that were “safe” for their daughter. Parents of the girl’s classmates used the list as a guideline when purchasing snacks for the class.

During the course of the school year, a celebration was planned. One parent, using the list of approved snacks, purchased doughnuts.

Unbeknownst to this parent, the manufacturer had reformulated the product to include milk. The girl with the milk allergy ate a doughnut and had a reaction. The parent who had bought the doughnuts was confused and felt that the list was misleading. The girl’s parents were angry that their child had a reaction.

How Can Your School Prevent a Similar Situation?

  • Instruct teachers not to use, or ask parents for, lists of “safe” products. Product ingredients and manufacturing processes can change without notice. Parents who are not managing food allergy on a daily basis may be unaware of food labeling laws and the voluntary use of precautionary statements (i.e., “May contain”).
  • Invite the parents of children with food allergy to volunteer to help plan class celebrations. Ask the teacher to provide a calendar of upcoming events to the parents so that they can plan ahead to provide safe food.
  • Ask parents of students with food allergy to verify the ingredients in advance to be sure that the foods to be served at class parties are safe for their child to eat.
  • Create a back-up plan for times when a parent of the student who has food allergies isn’t available to read ingredient labels. Have parents of children with food allergy provide some nonperishable treats that can be kept at the school for such times.
  • Substitute activities, such as extra recess time or a game, for food for class celebrations.

 

Food Allergy Case Study #3

The mother of an elementary school student with severe allergies to milk, eggs, tree nuts, peanuts, and sesame worked with her daughter’s school to ensure that her child would be safe. On more than one occasion, she presented information to the staff and faculty about food allergies and the importance of using epinephrine right away.

However, when the child had a reaction to a food she ate during lunch, the school director called the mother for further direction and was told to wait for the mother to drive to the school and evaluate her daughter. As the mother later explained to FAAN, the description of her daughter’s symptoms (wheezing, swelling of the lips, and a rash) did not sound too severe. Most of all, she hated to put her child through what she felt would be a traumatic experience — a shot of epinephrine and a trip to the hospital via ambulance.

Upon arriving at the school and seeing how lethargic her daughter was, however, she had school staff call 911 and the child was taken to the emergency room. Although the girl was okay, her doctor expressed displeasure that epinephrine had not been administered immediately.

How Can Your School Prevent a Similar Situation?

  • Have parents of children with food allergies provide a Food Allergy Action Plan (FAAP), signed by the child’s doctor. Ask parents to provide an updated FAAP if there are any changes in the child’s medical condition, such as the child outgrowing the allergy, gaining new allergies, or becoming more or less sensitive to an allergen.
  • Instruct all staff responsible for the child’s safety to follow the FAAP in an emergency. This means administering medication as instructed and calling emergency services before calling the parent. During a life-threatening reaction, the sooner epinephrine is administered, the better the outcome will be.
  • Use an auto-injector trainer (available for EpiPen® and TwinJect® epinephrine auto-injectors) to teach all staff responsible for the child’s safety how to use the device. Include school bus drivers, physical education instructors, and substitutes. Explain to staff that it is much safer to err on the side of caution and administer epinephrine during a reaction.