An algorithm for pediatric anaphylaxis in the school setting

Anaphylaxis in the school setting is a growing concern. As epinephrine prescriptions and cases of pediatric anaphylaxis increase, the school provider faces challenges including first time allergic events at the school, missed identification of anaphylaxis symptomology, confusing mild objective findings, and incorrect or delay in treatment. Certain school populations are associated with these challenges, including: Adolescents, children with asthma, children with known food allergies, and children with prior history of anaphylaxis. School specific risk factors that may increase fatality include lack of school providers, lack of trained school staff, and accidental exposure during field trips/school parties/instruction. This algorithm takes into account the myriad of school challenges associated with anaphylaxis and defines correct treatment with epinephrine. As delay in treatment is the primary cause of anaphylaxis fatality, it is imperative that a school anaphylaxis algorithm exist.