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Bus Drivers and Transportation
Food allergy is a growing safety and public health concern in the United States. Schools and transportation staff continue to face challenges each year due to the increasing number of students with food allergies. Bus drivers and transportation staff are an important part of food allergy management plans and should attend all meetings involving the care for students with food allergies.
When school staff, physicians, parents, and other adults who interact with students join forces, it helps to create comprehensive management plans for students. Thorough details and guidance outlined in management plans will help to support the efforts of all those involved in caring for food-allergic students and will help make the school setting a safer environment.
- There is no cure for food allergies. Strict avoidance of the food(s) is the only way to prevent a food allergy reaction from occurring.
- Every food allergy reaction has the possibility of developing into a life-threatening and potentially fatal allergic reaction.
Food Allergies on the Move
Students with food allergies can be particularly vulnerable on the bus travelling to and from school. Staff who are familiar with a student’s medical needs are absent. Due to the lack of direct adult supervision, students may be at a greater risk for exposure to food allergens, either intentionally or accidentally; bullying; and other factors that present a risk.
So it is important for school personnel, or other designated representative, to inform bus drivers and other transportation staff about students’ allergies and train transportation staff how to identify and respond to a student who may experience anaphylaxis. This pertains to students who have a known allergy as well as students who may experience anaphylaxis for the first time without a history of allergic reactions.
- In approximately 25 percent of epinephrine administration cases involving students and staff members, school personnel were not aware that the individual had a life-threatening allergy.2
- Approximately 20 percent of cases requiring epinephrine administration in the school setting occurred outside the school building on the playground, traveling to and from the school, or on field trips.2
Signs & Symptoms
Signs and symptoms of an allergic reaction usually appear within a few minutes to several hours after exposure to a food allergen. If not treated promptly, food allergy reactions can be fatal. The student can also experience a second phase of their reaction called a biphasic reaction. This means the student may respond initially to treatment but experience symptoms later that are less severe, as severe, or even more severe than the initial reaction. After the administration of epinephrine, 9-1-1 should be called and students should always be transported to an emergency room for further treatment.
Understanding district policies and procedures on how to enact emergency protocol in the event of an emergency will help ensure swift action that can save lives.
Review the Bus Driver and Transportation Checklist to assist staff in planning for the management of students with life-threatening food allergies. You may also visit FAACT’s Education Resource Center for additional tools and resources, some of which are listed at the bottom of this page.
Best Practices for Bus Drivers and Transportation Staff
Bus drivers and/or transportation department head should:
1. Attend all scheduled planning meetings involving the student(s), including:
- Training on how to use each student’s prescribed epinephrine auto-injector.
- Emergency procedures.
- Developing IEPs/504 plans.
- Understanding the student’s Allergy and Anaphylaxis Emergency Plan.
- Food label reading and cross-contact.
- Peer support and psychosocial needs.
2. Ensure you understand the role of the transportation staff in the child’s daily care:
- Where the Allergy and Anaphylaxis Emergency Plan is kept for each student.
- Location of epinephrine auto-injectors and other emergency medication and how to administer it for each student.
- How to report food allergy bullying or complaints from the student.
- Ensuring communication devices are in working order prior to each transport.
- A plan for substitute bus drivers and making them aware of procedures, policies, and students.
3. Creating a safe environemtn for food allergic students:
- Cleaning methods/procedures.
- Enforcing a “No Food or Beverages” policy (exception for children with a medical condition).
- Student placement on the bus (while limiting potential for social isolation).
- Understand policy on how to directly communicate with the student’s parent(s).
- Understand federal and state laws that protect the privacy and confidentiality of the student’s medical information and other legal rights of students with food allergies.
- Help with the daily management of food allergies for students being transported by bus.
Prepare To Act
It is important that bus drivers and other transportation personnel prepare for and understand how to respond to a food allergy emergency. Steps to take include:
- Annual food allergy and anaphylaxis training for all transportation personnel
- Learn the signs and symptoms of an allergic reaction
- Learn how to use the student’s epinephrine auto-injector device and other medications
- Advocate for emergency drills
- Learn the procedure for activating EMS in an emergency
- In the event of an emergency, follow the instructions provided by the physician on the student’s emergency action care plan.
- Additional concerns school and transportation staff need to prepare for in an emergency include:
- Who will give epinephrine? (Note the time the device was used – and write it on the device, if possible – for first responders)
- Who will call 9-1-1 and by what method?
- Who will retrieve the second epinephrine auto-injector and where will it be stored?
- Who will ride with the student to the hospital and how will other students get to school or home?
- Who will contact the parents?
- Where will the emergency numbers for the parents be located?
- Who will comfort remaining students and notify their parents (if needed)?
Investigate and Review
If an allergic reaction does take place on the school bus or while students are being transported in other ways, transportation personnel should:
- Meet with staff, parents, and the student to review facts about the reaction and steps taken following the reaction.
- Implement changes, as needed, to prevent another reaction from occurring or to improve the current plan of action.
- Meet with staff members for support.
- Comfort and reassure other students who may have witnessed the emergency and follow up with their families as required.
- Review any updates to the student’s emergency action care plan and ensure all substitutes and bus aides are updated.
- Confirm the replacement of all emergency medications.
Resources and Downloads
- Bus Driver and Transportation Checklist
- Cleaning Methods
- Signs and Symptoms of Anaphylaxis
- More About Epinephrine
- Food Allergy Management & Education (FAME) Toolkit
- Teenagers and young adults with food allergies are at the highest risk of fatal, food-induced anaphylaxis.
- 25% of first-time allergic reactions reported in the school setting were those of students with no-known history of an allergy.
What is Anaphylaxis?
Anaphylaxis (an–a–fi–LAK–sis) is a serious allergic reaction that often involves swelling, hives, lowered blood pressure, and, in severe cases, shock. If anaphylactic shock isn’t treated immediately, it can be fatal.