Abstract
BackgroundThe United Kingdom incidence of anaphylaxis has increased very sharply over the last decade, with the highest rates of hospital admissions occurring in school-aged children. This raises concerns about the extent to which schools are aware of approaches to the prevention and treatment of anaphylaxis. Methods and Findings We undertook a national postal survey of 250 Scottish schools enquiring about approaches to managing children considered to be at risk of anaphylaxis. We obtained responses from 148 (60%) schools, 90 (61%) of which reported having at least one at risk child. Most (80%) schools with children considered to be at risk reported having personalised care plans and invariably reported having at least one member of staff trained in the emergency treatment of anaphylaxis. Access to adrenaline was available on-site in 97% of these schools. However, significantly fewer schools without children considered to be at risk reported having a trained member of staff (48%, p < 0.001), with access to adrenaline being very poor (12%, p < 0.001). Overall, 59% of respondents did not feel confident in their school's ability to respond in an emergency situation. Conclusions Most schools with children considered to be at risk of anaphylaxis report using personal care plans and having a member of staff trained in the use of, and with access to, adrenaline. The picture is, however, less encouraging in schools without known at risk children, both in relation to staff training and access to adrenaline. The majority of schools with at risk children have poorly developed strategies for preventing food-triggered anaphylaxis reactions. There is a need for detailed national guidelines for all schools, which the Scottish Executive must now ensure are developed and implemented.
Highlights
Anaphylaxis is an acute, potentially life-threatening allergic reaction due to a systemic allergic reaction [1]
Most schools with children considered to be at risk of anaphylaxis report using personal care plans and having a member of staff trained in the use of, and with access to, adrenaline
Stratified random sampling was employed in order to ensure that we sampled from all Local Educational Authorities, and as comparable numbers of schools were in each strata, we used computer-generated random sampling to sample ;9% of schools within each strata
Summary
Anaphylaxis is an acute, potentially life-threatening allergic reaction due to a systemic allergic reaction [1]. Thousands of people develop anaphylaxis each year in the United Kingdom, and of these about 20 die annually [2,3,4,5]; the majority of these reactions and deaths are believed to be preventable. The United Kingdom incidence of anaphylaxis has increased very sharply over the last decade, with the highest rates of hospital admissions occurring in school-aged children. This raises concerns about the extent to which schools are aware of approaches to the prevention and treatment of anaphylaxis. In the United Kingdom, thousands of people develop anaphylaxis each year, and the number appears to be increasing. Anaphylaxis can develop both in people known to have a tendency (risk) of getting the condition and in those with no known risk
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