Protocols for Managing Food Allergies in Elementary and Secondary Schools

The prevalence of food allergies is on the rise; nearly 8% of children worldwide are affected. The most common allergens-milk, eggs, peanuts, tree nuts, shellfish, fish, and wheat-account for 90% of serious allergic reactions. A literature review of online databases in CINAHL, PubMed Central, Education Resources Information Center (ERIC), Google Scholar, Health Resource Center Academic, and archival searching was performed to identify evidenced-based practices for managing food allergies in schools. There is no cure for food allergies. The current management standard is to avoid the allergen, treat a mild reaction with antihistamine and observation, and treat anaphylaxis with an intramuscular injection of epinephrine. Due to COVID-19 social distancing recommendations, food consumption in schools has moved from cafeterias and lunchrooms into classrooms and other spaces. This in turn necessitates strict adherence to hand washing and disinfecting all surfaces that come in contact with food. Managing food allergies in schools requires cooperation among school administrators, nurses, teachers, staff, families, and health care providers. Resources for managing food allergies in schools are presented offering information for parents, school administrators, nurses, teachers, and staff for planning and implementing strategies for preventing and reducing allergic reactions and treating life-threatening food allergy reactions.