Statement regarding the inquest of Ishmaeel Ashraf

24th August 2017

The Anaphylaxis Campaign was saddened to learn of the death of 9 year old Mohammad Ismaeel Ashraf earlier this year and has been in attendance at the coroner’s inquest that has been taking place this week in Birmingham to understand if lessons can be learned from this case.

The inquest raises a number of issues which are likely to be of concern to parents and carers of school-age children, as well as schools and teachers, as the jury concluded that not following the care plan and a delay in administering an auto-injector may have contributed towards Ismaeel’s death.

This illustrates the importance of schools making sure they have individual care plans in place and training and support for all school staff; from school nurses to teachers, from receptionists to caterers.

Every school is likely to have at least one pupil who is severely food-allergic, and many schools will have more; in the UK it is estimated that 5–8 % of children have a food allergy (Food Standards Agency 2015). The vast majority of the children affected are happily accommodated in mainstream schools thanks to good communication among parents, school staff, doctors and education authorities. With sound precautionary measures and support from the staff, school life may continue as normal for all concerned.

However, tragic incidents such as the death of Ismaeel Ashraf are a reminder of the importance of all school staff being able to understand allergies and anaphylaxis and how to manage and care for children at risk.

The Anaphylaxis Campaign helps raise awareness of severe allergies and anaphylaxis within schools and provide support to parents and carers of school age children.

• • We have campaigned successfully for the Government to amend the Human Medicines Act to allow schools to buy auto-injectors from a pharmaceutical supplier, without prescription, for use in emergencies. This has been a two year long process and we are delighted that new legislation is coming into effect on 1st October 2017. You can read more on our website here.
  • We also provide training to schools through AllergyWise. AllergyWise for Schools is a course designed to ensure that staff in schools are fully aware of the signs and symptoms of anaphylaxis, how to provide emergency treatment and the implications for management of severely allergic children from Key Stages 1 to 5 in an education setting. Access to this training course is now FREE thanks to a grant from ALK. Visit our website for more information here.
  • We provide a “train the trainer” course for school nurses and other healthcare professionals who are training school and early years teams in the management of severely allergic children.  This course is accredited by the Royal College of Nursing.  Visit our website for more information here.
  • We also provide advice and support to Healthcare Professionals, including school nurses, through our membership programme. You can find out more about membership here.

Our fact sheet aims to answer aims to answer some of the questions frequently asked by parents and schools. You can read this on our website here.

We also have addressed some of the frequently asked questions associated with allergies in schools below.

If you have any concerns please contact our helpline team at info@anaphylaxis.org.uk or call 01252 542 029.

Some Frequently Asked Questions

What is anaphylaxis and how is it treated?

Anaphylaxis is an extreme and severe allergic reaction. The whole body is affected, often within minutes of exposure to the substance which causes the allergic reaction (allergen) but sometimes after hours.

The treatment for a severe allergic reaction is an injection of adrenaline (also called epinephrine), delivered into the muscle in the side of the thigh. The adrenaline injectors prescribed in the UK at present are  EpiPen® and Jext®.

Emerade devices in all doses (150mcg, 300mcg and 500mcg) have been recalled and are not currently available. Read the latest statements on this in our Latest News section here.

These injectors are easy to use and designed for self-administration or administration by any suitably trained individual. If an injector has been prescribed, it should be available at all times – with no exceptions. The emergency services (ambulance) should still be called after use as symptoms may return after a short period and more than one injection of adrenaline may be required to control the reaction.

Our Think ABC video explains how you can spot an anaphylaxis reaction and how to safely treat it.

What are the responsibilities of schools?

Statutory guidance was issued to schools in May 2014 setting out the practical support schools are expected to provide to support children with medical conditions, such as making sure they have individual care plans in place and training and support for all school staff.

Tips that might help the school to ensure the safety of an allergic child include:

• • Ensure that catering supervisors are aware of an allergic child’s requirements. Review health records submitted by parents.
  • Include food-allergic children in school activities. Pupils should not be excluded based on their allergy.
  • School activities should be designed and developed to ensure the inclusion of food allergic pupils.
  • Ensure the staff have received high-quality training in managing severe allergies in schools, including how to use an adrenaline auto injector. The Anaphylaxis Campaign offers online training through its AllergyWise training programme.
  • Identify a core team to work with parents to establish prevention and treatment strategies.
  • Arrange staff training. (Your school nurse should be able to help you to arrange this). Ensure all staff can recognise symptoms; know what to do in an emergency, and work to eliminate the use of allergens in the allergic pupil’s meals, educational tools, arts and crafts projects
  • Ensure that medications are appropriately stored, and easily accessible in a secure location (but not locked away) central to designated staff members
  • Review policies after a reaction have occurred. The statutory guidance is available here.

What are care plans?

The Paediatric Allergy Group of the BSACI has Allergy Action Plans available for children at risk of anaphylaxis.

These plans have been designed to facilitate first aid treatment of anaphylaxis, to be delivered by people without any special medical training nor equipment apart from access to an adrenaline auto-injector (AAI). They have been developed following an extensive consultation period with health professionals, support organisations, parents of food-allergic children and teachers.

The plans are medical documents, and should be completed by a child’s health professional (and not by parents or teachers, for example).

You can access care plans from the BSACI website here.