A146: Strategies for Assessment and Management of Severe Environmental Allergies at “Camp JRA”

Background/Purpose: Camp JRA (Juveniles Reaching Achievement) has been offering a week of fun, education, friendship, independence and support for 17 years to children with arthritis and related diseases. The number of campers has grown from 28 the first year to 120 maximum capacity for the past few years. Experienced Pediatric Rheumatology nurses and physicians provide hands‐on care in the “Med Shed” at Camp JRA. Medical information is completed by parents, pediatric rheumatologists and primary care providers. The senior medical staff review and verify the information. Over the past 5 years we identified that coping with environmental allergies consumed a disproportionate amount of time for the staff and we felt unprepared to optimally address these issues. We wish to share our strategy in addressing the growing concern about environmental sensitivities in a residential week long camp for children with rheumatic diseases. Mindfulness of drug allergies is standard of care in any environment where medications are given. Coping with food allergies has assumed a significant position in our hierarchy of medical responsibilities in the Med Shed, as well. We found ourselves struggling to manage the increasing complexity of this issue. We found that some campers had multiple allergies listed that had not been reported, and no details were provided. For many years, we have run a very organized medical camp, however, this issue confounded our care of these complex children. Methods: The emergence of the multiple allergies issue was a barrier to providing a confidently safe camp environment. New approaches were developed and implemented. 1. We developed new allergy history questionaire that triggered progression to further detailed information. 2. We consulted with our Pediatric Allergist to develop an algorithm for assessment of symptoms (Attached to poster). 3. We developed an Allergy Action Plan specific to each camper with allergy issues, approved in advance by parent and signed. 4. We developed a system for Epi‐pen storage: over the door holder with multiple clear pockets, with the Epi‐pen, the child's photo, the signed Allergy Action Plan.Results: We oriented all medical staff who worked in the Med‐Shed to the new system. When implemented at Camp JRA in July 2013 and we experienced no allergy response problems. Increasing allergy sensitivities in patients requires a proactive plan for residential camps. We have developed a model for assessing allergies and reaction preparedness. This plan has improved our confidence that we can provide safe rheumatologic AND allergy response care. Conclusion: The development of increasing allergy sensitivities and concerns by families and patients requires a proactive plan for residential camps of children with rheumatic disease. We hve developed a model for assessing allergies and reaction preparedness.