Vickers D W, Maynard L, Ewan P W
Lifespan Healthcare NHS Trust, Ida Darwin, Fulbourn, Cambridge, UK.
Clin Exp Allergy. 1997 Aug;27(8):898-903.
The increase in potentially dangerous food allergic reactions (e.g. to peanuts and nuts) in children had lead to an increase in the prescription of adrenaline, including adrenaline for self- or parent-injection. This raises problems in the management of these children in schools. Our experience in response to this is described.
To develop a training package to ensure that each child can continue at school but receive optimum emergency treatment in a safe environment. To provide education, training and support to school staff, and to support parents.
This paper describes a model of good practice in the support of children with potentially fatal anaphylactic reactions. The following points are emphasized. Children with a history of anaphylactic reactions should be expertly assessed prior to the prescription of adrenaline injection. A written treatment plan is essential. Parents need expert support in managing the child. Schools need training and support. Children should lead a normal life, and not be stigmatized or labelled by their problem. Close liaison between primary care, acute services, community services and education services are essential for the successful management of this problem. Data from a questionnaire showed the training package was of benefit, with considerable reduction in anxiety in school staff and parents.
A broad training package is essential: training in administration of adrenaline is only one aspect, and emphasis is placed on education, recognition of allergic reactions and prevention. The presence of children in school needing access to adrenaline is no longer perceived as a problem in our area. We recommend other health authorities provide a similar service.
儿童中潜在危险的食物过敏反应（如对花生和坚果的过敏反应）有所增加，这导致肾上腺素处方量上升，包括用于自我注射或家长注射的肾上腺素。这给学校管理这些儿童带来了问题。本文描述了我们对此的应对经验。
开发一套培训方案，以确保每个儿童能够继续在学校上学，但能在安全环境中接受最佳的紧急治疗。为学校工作人员提供教育、培训和支持，并为家长提供支持。
本文描述了支持有潜在致命过敏反应儿童的良好实践模式。强调了以下几点。有过敏反应病史的儿童在开具肾上腺素注射处方前应接受专业评估。书面治疗计划至关重要。家长在管理孩子方面需要专业支持。学校需要培训和支持。儿童应过上正常生活，不应因其问题而受到污名化或贴上标签。初级保健、急症服务、社区服务和教育服务之间的密切联络对于成功管理这一问题至关重要。问卷调查数据显示培训方案是有益的，学校工作人员和家长的焦虑程度大幅降低。
广泛的培训方案至关重要：肾上腺素给药培训只是其中一个方面，重点在于教育、过敏反应的识别和预防。在我们地区，学校中有需要使用肾上腺素的儿童这一情况不再被视为问题。我们建议其他卫生当局提供类似服务。
