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Kathy Stinely, RN, BSNBooth Fickett K8 Magnet School
PRESENTATION OBJECTIVESThe participant will understand the prevalence
and types of life threatening allergies and be able to identify common triggers
The participant will be able to recognize the signs and symptoms of anaphylaxis
The participant will demonstrate competency in Epinephrine administration (EpiPen)
The participant will be able to state ways to reduce the risk of life threatening allergic reaction
ALLERGY STATISTICS6-8% of U.S. school age children have identified
food allergies. 40-50% of those persons with a diagnosed food
allergy are judged to have a high risk of anaphylaxis (a life-threatening allergic reaction).
“Researchers believe that the prevalence of food allergies is increasing and the number of deaths from food allergy induced anaphylaxis is growing, and children are the largest group of the population affected by food allergies.”
THE BIG 8The Big Eight account for 90% of
food allergies.PeanutsTree NutsMilkEggSoyWheatFishShellfish
OTHER ALLERGENS (TRIGGERS)Other foods outside of the Big 8
(seeds, fruits, vegetables, meats)Bee stingMedicationLatex – gloves, balloons, etcExercise induced (rare)
SO WHAT IS AN ALLERGYAn allergy is an abnormal response to a
normal substance due to an over reactive immune system. This is the body’s attempt to defend itself against substances that are perceived by the body to be harmful (an allergen).
Contact with the allergen starts a series of events in the cells of the immune system resulting in release of chemical mediators such as histamine . These chemicals trigger inflammatory reactions in the skin, the respiratory system, the gastrointestinal system, and the cardiovascular system.
WHAT IS ANAPHYLAXISAnaphylaxis is the life threatening form
of an allergic reaction.According to the American Lung
Association, it is a “sudden, severe allergic response that usually produces breathing difficulties, collapse and possible death.”
Usually occurs 1-15 minutes after exposure, but can occur up to 2 to 4 hours later.
Life threatening emergency. Requires immediate action – EpiPen
POSSIBLE SYMPTOMS OF AN ALLEGIC REACTION
Skin: Hives, itching, swelling.Eye/Ear/Nose/Throat: Itchy/scratchy lips, tongue, mouth and/or throat, difficulty swallowing, throat tightness or closing, red, watery eyes.Respiratory: Swelling, change of voice, coughing, wheezing, difficulty breathing, shortness of breath,.Gastrointestinal: Vomiting, stomach cramps.Cardiovascular: Fainting or loss of consciousness, flushed, pale skin, cyanotic (bluish) lips and mouth.Neurologic: Dizziness, change in mental status, fainting or loss of consciousness, sense of doom.
COULD YOU SAVE A LIFE?Think F.A.S.T….
Then ACT!
FACE: Rash, hives, swelling of lips,
tongue, eyes, face
AIRWAY: Difficulty breathing, swallowing or
talkingSTOMACH:
Abdominal pain, nausea, vomiting,
diarrhea
TOTAL BODY: Rash/hives, weak, pale, sense of doom,
loss of consciousness
ALLERGY OR ANAPHYLAXIS?Anaphylactic
ReactionsSwelling (face, lips,
tongue, throat, upper airway)
Difficulty breathing (chest tightness)
Vomiting, diarrhea, cramping
Difficulty swallowing, repeat throat clearing, voice changes
Weakness, paleness, sweating
Feeling of impending doom
Allergic Reactions
•Runny Nose
•Itchy, Red, watery eyes
•Hives, itchy rash
•Local reaction to sting, UNLESS known to be allergic to venom
Anaphylactic Reactions can involve many symptoms or just one severe symptom
Allergic reactions can progress into full anaphylaxis
HOW YOUNGER STUDENTS MAY DESCRIBE SYMPTOMS My mouth or tongue is hot, burning, tingling or itchingIt (my tongue) feels like there is hair on itMy mouth feels funnyThere’s a frog or there’s something stuck in my throatMy tongue feels full (or heavy)My lips feel tightIt feels like there are bugs in there (to describe itchy
ears)My throat feels thickIt feels like a bump is on the back of my tongue (throat)
BE SAFE, NOT SORRY!Every child is different. Some students may
complain of stomach pain first, others will start with a rash or hives, yet others will immediately have breathing problems.
Take ALL complaints from students with a food allergy very, very seriously.
Reactions can be unpredictable. Mild reactions can rapidly turn into full blown anaphylaxis.
BE PREPAREDBe able to identify your students with serious
allergiesLook for situations that may put them at risk
(students offering to share food, PB&J sandwiches at a peanut free table, students playing where bees are concentrated) and take action
Know the signs and symptoms of an allergic reaction and have a plan based on the student’sAllergy Action Plan
PREVENTION: THE FIRST LINE OF DEFENSEBe aware of the students in your classes with
life threatening allergiesKnow what the student is allergic toBe familiar with the Allergy Action PlanHave student info in sub folderProhibit sharing of foodsDo not serve foods for class activities that
contain possible allergensHave wipes and hand sanitizers/hand
washing facility available
SEVERE ALLERGY TREATMENT
Student usually develops rash/hives. May also see swelling, itching.May spread, become larger or diffuseUsually treated with Benadryl as listed in
student’s Allergy Action Plan.
TREATMENT OF ANAPHYLAXISIf possible, remove student from allergen
(remove bee stinger by brushing with ID, wash allergen off if skin contact)
Have the student sit or lie down. Keep him calm and quiet
Must first be treated with Epinephrine (EpiPen, Twinjet), then may use Benadryl as per plan
Do not hesitate to use the EpiPen if you think the student is having an allergic reaction
Most allergic reaction deaths occur because Epinephrine was not given
WHAT TO DO IF YOUR STUDENT HAS AN ANAPHYLACTIC REACTIONCall the School Nurse: give the student’s name
& that they are having an allergic reactionDO NOT ATTEMPT TO WALK TO THE HEALTH
OFFICEAsk if the student has an EpiPen with them and
assist/ administer if they doCall 911 as directed by the nurse Stay with the studentRemember the EpiPen is intended to buy time
to get to emergency care, it doesn’t take it’s place
WHAT DOES EPINEPHRINE DO?EpiPen® = Epinephrine MedicationQuickly constricts blood vessels to raise
blood pressureRelaxes smooth muscles in the lungs to
improve breathingStimulates heartbeatWorks to reverse hives and swelling around
the face and lipsWears off in 10-20 minutes, sometimes
requires a second dose, so it is critical that 911 is called and student transported to emergency room!
5 RIGHTS OF EPIPEN ADMINISTRATIONRIGHT STUDENT: Verify that the student has a
known allergy, check allergy action planRIGHT MEDICATION: EpiPen, EpiPen Jr, TwinjetRIGHT DOSE:
EpiPen for students approximately 66lbs and overEpiPen Jr for students under 66 lbs
RIGHT ROUTE: EpiPen is to be injected into the large outer thigh muscle
RIGHT TIME: As soon as possible after a reaction is identified based on symptoms and the student’s allergy action plan
EPIPEN VIDEOS http://www.nationwidechildrens.org/epipen http://www.auvi-q.com/auvi-q-demo-video
DON’T FORGET:The “Good Samaritan Law” protects all
individuals who administer an EpiPen from liability.
STEPS TO REMEMBERRemove autoinjector from box or container after
checking the name on the label to make sure it is for the RIGHT student.
Pull off the blue activation cap.Hold orange end near outer thigh.
Do not put fingers over orange end.Swing and jab firmly into outer thigh at a 90° angle
until autoinjector mechanism functions. You will hear a click.
Hold in place and count to 10. Remove device (the needle will be covered) and massage area for 10 seconds.
Give autoinjector to nurse or paramedics.
FIELD TRIPSYou must notify the nurse at least one week before
the field trip. The nurse will identify all students with health issues, medications and allergies.
If there is a student with an EpiPen, the nurse will review that student’s Allergy Action Plan with you, answer any questions. A copy of the plan and student emergency contact card will accompany the EpiPen.
You should meet with the student to explain that you have their EpiPen and will be available throughout the trip.
FIELD TRIPSThe EpiPen must be available at all times, it
should not be left on a bus or anywhere away from the student.
If the student routinely carries an EpiPen of their own, the Allergy Action Plan should still be reviewed with the nurse and you must check to make sure that the student has the EpiPen with them at all times.
Remember that you must also have a cell phone or phone access available at all times in case of emergency.
LAST STEPPlease see Kathy with your completed quiz
for a quick hands on practice, return demonstration and chance to get any questions answered to complete your training.