Care for Students with Severe Allergies

1. Care for Students with Severe Allergies

2. Anaphylaxis: Definition and Interesting Facts • Anaphylaxis: • Is a rapid, severe allergic response • Is not always due to an obvious cause • Is notalways easy to avoid, even when the cause is known • Is not always accompanied by hives

3. The most commonly documented causes of anaphylaxis include: • Food allergies • Insect venom • Medications • Latex Exercise & “unknown” cause are less common causes of anaphylaxis

4. The most distinctive symptoms of anaphylaxis include: • Hives/itchy skin • Swelling of the throat, lips, tongue, or around the eyes • Difficulty breathing or swallowing

5. Other common symptoms of anaphylaxis may include the following: • A metallic taste or itching in the mouth • Generalized flushing, itching, or redness of the skin • Abdominal cramps, nausea, vomiting, or diarrhea • Increased heart rate, rapidly decreasing blood pressure (paleness) • Anxiety or an overwhelming sense of doom • Weakness, collapse, loss of consciousness [Always askif there are “any know allergies”]

6. Epinephrine (AKA:Adrenaline): • Medication of choice for severe allergic reactions • Constricts blood vessels • Relaxes lung muscles to improve breathing • Reverses swelling • Increases heart rate

7. Epinephrine, continued: • Available by prescription in a single-dose auto-injector called an Epi-pen (or double dose Twin-Jet) • Site of injection: thigh • Can be given through clothing • Needle should be held in place for 10 seconds • Call 911

8. Side effects of Epinephrine include: • Rapid heart rate • Palpitations • Sweating • Nausea and vomiting • Respiratory difficulty • Other cardiac (heart) problems

9. Everyone experiencing a severe allergic reaction: • Must have 911/emergency medical care following the administration of epinephrine • One dose of epinephrine may not be enough!! • Can have a biphasic reaction: a reoccurrence requiring additional treatment

10. Be Prepared • Know where the EpiPens are stored • ◦ EpiPens are stored at room temperature • Be familiar with students who have EpiPens • Review the health care plans for students who have EpiPens • Frequently review CPR

11. Administration of Epi-Pen • Remove pen from cylinder/ check expiration date and fluid clarity • Grasp the EpiPen and form a fist around the unit. • With the other hand, pull off the GRAY Safety cap. • Hold the black tip near the outer thigh. • Never put thumb, fingers, or hand over the black tip

12. Jab the black tip firmly into the OUTER THIGH so that the auto injector is perpendicular (at a 90 Degree angle) to the thigh. You will hear a click. (The EpiPen can be injected through the victims clothing, if necessary.) • Hold the EpiPen firmly in place for 10 seconds • and then remove it from the thigh.

13. m • Massage the injection site for 10 seconds. • Check the black tip: • ◦ If the needle is exposed, the dose has been given • ◦ If the needle is not exposed, repeat • Return the used EpiPen to the plastic container. • Give the used EpiPen to paramedics.

14. Repeat Epi- Pen Administration • If symptoms continue and paramedics do not arrive, use a new EpiPen and re-inject 15 to 20 minutes after the initial injection. • Continue to monitor the victim’s airway and breathing

15. Continue Monitoring • Observe the victim for signs of shock. • Cover the victim with a blanket. • Monitor the victim’s airway and breathing. • Begin CPR immediately if the victim stops breathing.

16. Students at WHRHS with a documented risk of anaphylaxis : • Are advised to carry an auto-injector (Epi-pen) and be allowed to self-medicate as needed (if capable). • Are sent an Anaphylaxis Care Plan to be completed. • Includes instructions & authorization for use of medication from MD and parent (example of approved care plan attached) • Are asked to provide an extra Epi-pen to be stored in the Health Office in an unlocked storage site.

17. Summary at WHRHS response to symptoms of anaphylaxis for students with documented risk: • REACT QUICKLY: radio communication/alert • Allow student to self-medicate when possible • If incapable, administration of Epi-pen by trained personnel • Call 911-notify EMS if Epinephrine has been given • Call parent, &/or others as directed on care plan or emergency card • Document event & place in health file

18. Epinepherine Auto-Injector (Epi-Pen) Designees needed

19. Special thanks to: Jean Litarowsky, School NurseSan Mateo Union High School, and the Vista Unified School District, California for presentation content