Children with allergies in group settings and the PAI

The Individualised healthcare plan (PAI – French school system) organises attendance for a child or teenager whose health requires adjustments, care or medicines while in a group setting.

1. Contact management - The family asks the setting to establish or continue the PAI.
2. See the doctor - The doctor caring for the child prepares the useful medical information and required prescriptions.
3. Organise attendance - The setting coordinates adjustments with the professionals involved.
4. Check together - Before attendance begins, the family ensures that documents, the kit and practical arrangements are operational.

The national template has three essential parts:

• Part 1: administrative information;
• Part 2: arrangements and adjustments to implement;
• Part 3: the medical ‘Emergency instructions’ sheet completed by the doctor caring for the child.

In other childcare settings — for example a nursery or leisure centre — practical organisation may be adapted to how they operate. The PAI remains the framework specifying the child’s needs and the measures required for safety.

• administrative sections and arrangements completed with the setting;
• the medical emergency-instructions sheet completed and signed by the doctor caring for the child;
• an up-to-date prescription matching the medicines in the kit, in accordance with the rules applicable to the setting;
• up-to-date contact details for legal guardians and people to contact;
• any additional document requested by the setting or competent healthcare professional.

Its contents must match the prescription and emergency-instructions sheet. Medicines remain in their original packaging with the child’s name clearly visible.

The family checks regularly

• the presence of every prescribed medicine and item;
• expiry dates and the condition of devices;
• agreement between the prescription, emergency sheet and actual contents;
• immediate replacement of any medicine used, damaged or close to expiry;
• the agreed location and immediate accessibility of the kit.

Arrangements are agreed case by case with the family and setting: usual meals with adjustments, an adapted meal provided by catering, or a packed meal prepared by the family under the agreed rules.

• I ask who reads labels, manages substitutions and checks the meal served.
• I flag activities involving food: cooking, birthdays, celebrations, workshops, trips or educational projects.
• I do not give broader avoidance instructions than those medically validated.
• When useful and accepted, I provide a clearly identified alternative for snacks or events.

If the child has asthma, the PAI also specifies treatments and what to do for respiratory symptoms. Breathing difficulty after allergen exposure may be anaphylaxis: adults then follow the personalised emergency sheet without delay.

Management organises information for the professionals involved in the child’s attendance. Parents may ask how information is passed to substitute staff, catering staff, activity leaders and trip supervisors.

• The adults involved know where the PAI and kit are kept.
• They can recognise the situation described in the emergency sheet and perform the prescribed actions.
• Useful numbers and procedures for calling emergency services are immediately available.
• Information shared is limited to what is needed to welcome and protect the child.

See the ‘Adrenaline auto-injector’ sheet on sosallergo.fr to review principles of use. It does not replace your child’s personalised emergency plan.

Independence develops gradually according to age, development and ability. It never transfers full responsibility for safety to the child.

• Help them name their allergy in simple words.
• Teach them not to exchange food or medicines and to ask before eating an uncertain product.
• Encourage them to report any symptom or exposure immediately.
• When able, practise showing their kit and explaining that an adult must be called.

• I have asked the setting’s management to establish or continue the PAI.
• The doctor caring for my child has prepared the medical emergency-instructions sheet.
• The prescription matches the medicines provided and is current.
• The kit is complete and identified, and medicines are in date.
• The kit’s location and accessibility have been checked.
• Arrangements for meals, snacks and activities involving food are defined.
• Before/after-school care, trips, travel, transport and placements have been anticipated.
• My contact details and those of people to contact are current.
• I know whom to contact in the setting for a question or change.

• I ask to continue the PAI according to the school or setting’s procedure.
• I provide an up-to-date prescription and medicines whose expiry dates have been checked.
• I have the emergency sheet updated if the medical situation requires it.
• I immediately replace any used or damaged medicine.
• I report any change in treatment, health or required organisation.
• I reassess arrangements before each trip, journey or change of setting.