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Anaphylaxis in school settings

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Most allergic reactions in childhood are mild and relatively simple to manage but more severe reactions do occur. Anaphylaxis, a severe, life-threatening allergic reaction, has become an increasingly common occurrence in the UK and a significant proportion of such reactions in children occur in the school environment.

The key issues in the successful management of anaphylaxis are early recognition and prompt treatment with intramuscular adrenaline1. Each accidental reaction should also be used as a catalyst to better understand the changes that could be implemented to make a recurrence less likely.

This article uses two typical case studies to explore the issues around the management of anaphylaxis in school settings.

Anaphylaxis is defined as a severe, life-threatening allergic reaction.1,6 In practice, this means an allergic reaction with respiratory or cardiovascular features. While hypotension and shock are more commonly seen as part of anaphylaxis in adults, respiratory features are most commonly implicated in severe reactions in childhood.

The most common cause of allergic reactions in children is food. Common allergens include milk and egg (allergies which are often outgrown) as well as peanuts, tree nuts, fish and shellfish (which are seldom outgrown). Around 6-8 per cent of children in the UK suffer from a food allergy.

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