Vale Sandra, Smith Jill, Said Maria, Mullins Raymond James, Loh Richard
Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney, New South Wales, Australia.
ASCIA Anaphylaxis Working Party, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2015 Oct;51(10):949-54. doi: 10.1111/jpc.12962.
The aim of these guidelines is to assist staff in school and childcare settings to plan and implement appropriate risk minimisation strategies, taking into consideration the needs of the allergic child, the likely effectiveness of measures and the practicality of implementation. Although these guidelines include risk minimisation strategies for allergic reactions to insect stings or bites, latex and medication, the major focus relates to food allergy. This is due to the higher relative prevalence of food allergy in childhood (compared with other allergic triggers) and the higher likelihood of accidental exposure in these settings. Care of the allergic child in the school, pre-school or childcare settings requires accurate information obtained from parents and carers, staff training in the recognition and management of acute allergic reactions, planning for unexpected reactions (including in those not previously identified as being at risk), age appropriate education of children with severe allergies and their peers, and implementation of practical strategies to reduce the risk of accidental exposure to known allergic triggers. Strategy development also needs to take into account local or regional established legislative or procedural guidelines and the possibility that the first episode of anaphylaxis may occur outside the home. Food bans are not recommended as the primary risk minimisation strategy due to difficulties in implementation and lack of proven effectiveness.
这些指南的目的是帮助学校和儿童保育机构的工作人员制定并实施适当的风险最小化策略，同时考虑到过敏儿童的需求、措施的可能效果以及实施的可行性。尽管这些指南包括针对昆虫叮咬、乳胶和药物过敏反应的风险最小化策略，但主要重点是食物过敏。这是因为儿童食物过敏的相对患病率较高（与其他过敏诱因相比），且在这些场所意外接触的可能性更大。在学校、学前班或儿童保育机构照顾过敏儿童，需要从家长和照顾者那里获取准确信息，对工作人员进行急性过敏反应识别和管理方面的培训，针对意外反应制定预案（包括那些之前未被认定有风险的情况），对严重过敏儿童及其同龄人进行适龄教育，并实施切实可行的策略以降低意外接触已知过敏诱因的风险。策略制定还需要考虑当地或地区既定的立法或程序指南，以及过敏反应首次发作可能发生在家外的情况。由于实施困难且缺乏已证实的有效性，不建议将食物禁令作为主要的风险最小化策略。
