Schools’ anaphylaxis preparedness survey: are they equipped and ready?

Introduction: Incidence of anaphylaxis has increased threefold in the last 20 years, with 17% of preventable fatalities occurring in UK schools. The aim of this study was to measure schools’ anaphylaxis preparedness across the West of Scotland.     Methods: A survey was distributed to primary and secondary schools between January-June 2020. The objective and subjective preparedness levels were assessed by analysing item responses that reflected schools’ adherence to National/European guidelines, as well as their perception of preparedness. A scoring system was applied to classify schools as ‘equipped & ready’, ‘transitional’, ‘improvements required’ or ‘unprepared’.   Results: 155 schools responded, of which 72% (n=112) had pupils registered with severe allergies, issued with an adrenaline auto injector (AAI). 27% (n=44) had personalised allergy action plans in place, less than half of applicable schools (n=112) stored AAIs accessibly (n=54, 47%), and just 38% had canteen allergen labelling (n=59). 16% of schools had an allergy management policy (AMP, n=25), and previous experience managing anaphylaxis was associated with AMP implementation (p=0.009).  Schools rated their perceived preparedness highly, however only 5% (n=8) were categorized as ‘equipped & ready’ (score >75%) with a mean preparedness score across schools of 50%. Schools supported a need for a standardised national AMP and further training (n=151, 93%).    Conclusion: The results demonstrate a low level of schools’ anaphylaxis preparedness across the region, where experience may promote preparedness over available guidance. Statutory training may be required to support the implementation of an AMP and raise allergy awareness.