Policy # R5142


In the St. Louis Public School District (SLPS) the School Nurse  shall oversee the administration of these procedures in consultation with the Director of Food and Nutrition Services  , the School Health Advisory Council (SHAC), the District Health and Wellness Council, Executive/Building Commissioner for Operations and Facilities Management, Executive Director of the Transportation Division , the school district Medical Director, Executive Director of Special Education, local health authorities and, where appropriate, the special education director or Section 504 coordinator.



Allergen – A substance that triggers an allergic reaction.


Allergic Reaction – An immune system response to a substance that itself is not harmful but that the body interprets as being harmful. Allergic reactions trigger inflammation in the skin (hives, itching, a rash); in the respiratory system (coughing, wheezing, difficulty breathing); in the gastrointestinal tract (vomiting, diarrhea, stomach pain); and the cardiovascular system (lowered blood pressure, irregular heartbeat, shock). Anaphylaxis is another type of allergic reaction.

Anaphylaxis – A life-threatening allergic reaction that involves the entire body. It may be characterized by symptoms such as lowered blood pressure, wheezing, nausea, vomiting or diarrhea, swelling and hives. Anaphylaxis may result in shock or death.


Emergency Action Plan (EAP) – An EAP is a written plan for students who have life-threatening conditions, such as an allergy. This plan is designed to inform school district personnel who may be called upon to respond.


Individualized Health Plan (IHP) – An IHP is a document created by the school nurse in cooperation with the parents and, when appropriate, a student’s health care provider for students who have specific health care needs. It is a nursing care plan that has student-centered goals and objectives, and describes the nursing interventions designed to meet the student’s short and long-term goals.


Life-threatening Allergy – An allergic reaction that is severe enough to potentially cause death.



In accordance with the SLPS school board policy on Student Allergy Prevention and Response, the school nurse will provide training to all school staff members about the causes and symptoms of and response to allergic reactions. This training will be provided to current school staff members within six months of the adoption of the Student Allergy Prevention and Response Policy. School staff members who are hired after this training has been conducted will be provided the information within thirty (30) days of the first day of employment. Within the first two months of the school year, the Principal will provide a platform upon which the School Nurse will be able to develop and implement the training.         


An annual review of information related to allergic reactions will be provided to all returning school staff members at the beginning of each school year.

Pursuant to SLPS school board policy, some students may carry medication for the treatment of allergies. In addition, epinephrine premeasured auto-injection devices (Epi-Pens) are available in each building and stored in the following locations:

· School site health service offices

· Individual classroom when prescribed for specific students


School staff will respond to allegations of harassment or bullying on the basis of an allergy in accordance with the district’s policy on bullying.


All school staff involved in the Food and Nutrition Services Area will be instructed by Food Service Management Company in approved cleaning methods, including the use of soap and hot water, and required to use approved methods in any location in which food is served. 


Response to an Allergic Reaction

Any school staff member who becomes aware that a student is having an allergic reaction must:

1. Stay with the student

2. Notify the school nurse immediately

3. Contact the parent/guardian


If the school staff member determines that the allergic reaction is potentially life-threatening the staff member will implement the student’s Section 504 Plan, Individualized Health Plan (IHP) or Emergency Action Plan (EAP) if the staff member is familiar with the plan.

If the student does not have a Section 504 Plan, IHP, or EAP, the staff member is not familiar with the Section 504 Plan, IHP or EAP or such plan is not immediately available, the staff member will immediately take or direct another person to take the follow actions.

1. Call 911

2. Notify the school nurse, or if the school nurse is not available, notify the Health Service Team Leader and the Manager of the Office of Health Services.

3. Administer epinephrine (Epi-Pen), if available, at the direction of the school nurse or designee. If the school nurse is not present, the school staff member may administer epinephrine (Epi-Pen), if available, if the school staff member determines it is necessary to safeguard the health of the student.

4. Notify the parent/guardian.

5. Provide first responders with information about the student’s allergy and reaction and any actions already taken.

6. A school staff member will remain with the student until a parent/guardian or emergency contact arrives or until the student is transported from the school site by first responders.


As soon as possible after the allergic reaction, the school nurse will consult with the Section 504 compliance coordinator and the student’s parent/guardian to determine whether a Section 504 Plan or IHP/EAP would be appropriate for the student.


Instructional Areas

No food preparation or consumption will take place in any instructional area unless the instructor has permission from the building administrator. Courses that include food preparation or consumption as a regular part of the curriculum are exempt from this provision, but instructors in these courses have an increased responsibility to monitor student adherence to prevention procedures.


Dining Areas

The School Nurse  or designee will provide the Director of Food and Nutrition Services , District Registered Dietitian and the Lead in the school cafeteria with a Food Allergy Plan upon receipt(this may precede the completion of the Section 504 process). Completed copy of any Section 504 Plan or IHP (Individual Health Plan) that concerns diet, along with a completed medical statement for Student Requiring Special Meals ( OHS-18). The parent needs to attach a cuurent photograph of the student to the OHS-18. The School Nurse will provide Lead in the cafeteria with an updated list of known food allergies and students in the school on a regular basis.      Any Section 504 Plan or IHP that requires food substitutions must include a written statement from a licensed physician that:

1. Describes the disability or condition.

2. Explains how the student is restricted as a result of the disability or condition.

3. Identifies the major life activities affected by the disability or condition.

4. Lists omitted and permitted foods.


Food service personnel will not act on individual requests for dietary accommodations. If a student or parent/guardian of a student who does not have a Section 504 Plan or IHP/EAP on file with the food service director requests an accommodation, he or she will be referred to the school nurse for assistance.


The Director of Food and Nutrition Services will arrange  for all food service staff to be trained in food label reading, cross-contamination avoidance, safe food handling and food item labeling requirements  If there is any change in the menu after the menu has been posted, the Lead in the cafeteria and District Registered Dietitian  will notify the School Nurse  or designee. The School Nurse or designee will notify parents of students with a Section 504 Plan or IHP/EAP for food allergies if necessary.


The building administrator may designate one (1) or more tables in the dining area as peanut and nut-free areas.   Students who use these tables may not have any food or beverage that contains or may contain peanuts or other nuts. If any student has been identified as having life-threatening allergies to a food or beverage other than peanuts or nuts, the building administrator may designate one (1) or more tables as allergen-free areas and specify the prohibited foods and beverages. School staff responsible for cleaning dining areas will clean any such designated tables prior to each use according to United States Department of Agriculture (USDA) recommendations using separate cleaning supplies. No student will be required to sit at the designated table.


School staff members supervising dining areas will promote a “no sharing/no trading” environment to prevent students from trading food, beverages or dining utensils.


Transportation and Off-Site Activities

Except as otherwise outlined in this procedure, drivers will not allow students to eat or drink on district transportation unless the student has written permission from his or her building administrator. Written permission will be provided if the student has a medical need to consume food or beverages during the time the student is transported. A student who has a medical need to consume food or beverages on district transportation must have a Section 504 Plan or IHP that addresses which foods or beverages the student may consume if he or she is transported with any other student who has a life-threatening food allergy.


Students being transported to and from activities on district transportation may be allowed to consume food and beverages if the school staff member serving as sponsor has verified that none of the students being transported have documented life-threatening food allergies.


School staff members must refer to the allergy list received from the School Nurse when taking part in off-site activities such as competitions and field trips. Upon request the School Nurse will verify which, if any, students have allergies and provide the school staff member with a copy of the relevant Section 504 Plans or IHPs or EAPs and any medications that may be needed in the case of an allergic reactions.