If in doubt, always give adrenaline. A dose of adrenaline given using an AAI into the muscle is safe and potentially life-saving. If medical and parental consent are not in place, then dial 999 for advice.
After giving adrenaline:
- Always call for an ambulance (999)
- Do not move the pupil, as standing someone up with anaphylaxis has triggered cardiac arrest
A person receiving an adrenaline injection should always be taken to hospital for monitoring afterwards.
If a pupil is pregnant and having a severe allergic reaction can you still administer an AAI or will this harm the baby?
After giving adrenaline place the young pregnant person on their left side to avoid putting too much pressure on the large vein that leads to the heart.
The regulations allow registered schools, independent educational institutions and local authority nurseries to buy AAIs for emergency use, without a prescription.
Those institutions described in regulation 22 of the Human Medicines (No.2) Regulations 2014 may legally hold “spare” AAIs.
Nurseries and early childcare centres which are not funded by local authorities are not able to obtain “spare” AAIs under this legislation.
A number of different brands of AAIs are available in different doses, depending on the manufacturer.
Advice as to which brand to purchase, and which dose, can be found here. Schools may wish to purchase the brand most commonly prescribed to its pupils.
Pharmacies will charge for the cost of adrenaline auto-injectors and may add a handling charge. Unfortunately, there are no funds held centrally or by local authorities to cover the cost.
No. Schools should decide themselves whether they would like to purchase “spare” AAI(s) for emergency use.
What should happen when a pupil who is at risk of anaphylaxis goes on a school trip or attends a different school to take part in a sporting activity?
Schools should conduct a risk-assessment for any pupil at risk of anaphylaxis taking part in a trip off school premises, in much the same way as they already do so with regards to safe-guarding etc.
Pupils at risk of anaphylaxis should have their AAI(s) with them, and there should be staff trained to administer AAIs in an emergency.
Schools may wish to consider whether it may be appropriate, under some circumstances, to take spare AAI(s) obtained for emergency use on some trips.
If the club happens on school premises as part of official school activities, then there should be access to the school’s spare AAIs.
The change in legislation does not apply to other circumstances: children at risk of anaphylaxis should have their own prescribed AAI(s) with them in the event of a reaction.
Yes, this change covers all the devolved nations in the UK; the responsible departments have produced their own guidance documents, accessible via this link.
“Spare” AAIs can be obtained, without prescription, from a pharmacy in small quantities on an occasional, and not-for-profit basis. The school will need to give the pharmacy a written request signed by the principal or head teacher stating:
- the name of the school for which the product is required;
- the purpose for which that product is required, and
- the total quantity required.
A template letter which can be used for this purpose can be accessed here. A healthcare professional does not need to sign this letter.
Pharmacies are not required to provide AAIs free of charge, the school must pay for them as a retail item. Unfortunately, there are no funds held centrally or by local authorities to cover the cost.
The school’s “spare” AAI(s) should only be used on pupils known to be at risk of anaphylaxis, and for whom both medical authorisation and written parental consent for use of the spare AAI has been provided. This includes children who have not been prescribed their own AAI, so long as the school has medical authorisation and parent/guardian consent.
The British Society for Allergy and Clinical Immunology (BSACI) has produced a range of Allergy Plans which can be used for this purpose, and can be downloaded here. All children with a diagnosis of food allergy and at risk of anaphylaxis should have a written Allergy Management Plan.
The school’s spare AAI(s) can be administered to a pupil whose own prescribed AAI cannot be given correctly without delay.
If a pupil has anaphylaxis but does not have the necessary approvals in place for them to receive the “spare” AAI:
- Immediately call 999 and seek advice
- If spare AAIs are available, tell this to the call handler/emergency medical dispatcher, as they can authorise use of the spare AAI if appropriate.
Any member of staff may volunteer to take on this role. In most schools, a number of staff members should be trained to administer AAIs, to avoid any delay in treatment and ensure cover when staff are on leave.
Staff should have appropriate training and support, relevant to their level of responsibility. This is a legal requirement.
Further information on staff training can be found here.
No. The legislation only allows for the “spare” AAI(s) to be used in registered pupils, in whom both medical authorisation and parent/guardian consent have been obtained.
If an adult has anaphylaxis whilst on school premises, immediately call 999: if “spare” AAIs are available, tell this to the call handler/emergency medical dispatcher, as they can authorise use of the “spare” AAI if appropriate.