Allergy and epi pen other

Allergy & Epi-Pen Mandatory Training

What is an Allergy?
Allergies occur when the immune system becomes
unusually sensitive and overreacts to common
substances that are normally harmless. Examples are:
Foods – most common tree nuts, especially peanuts and fish; also, eggs, milk, wheat, soy, sesame and some food additives
Stings from bees, wasps, hornets and some ants
Medications – penicillin, sulfa drugs
Exercise
Latex (gloves/medical devices)

What is Anaphylaxis?
Occurs when a person is exposed to an allergen causing a severe, life-threatening allergic response
Reactions can occur within seconds of exposure to an allergen, but can be delayed for 2-3 hours
Affects various organ systems including the skin, respiratory, cardiovascular and gastrointestinal

Why is this life-threatening?
Causes airway obstruction/lack of oxygen to the brain
Increases risk of SHOCK, which leads to widespread tissue damage, organ failure and eventually death

Common Symptoms
Skin – hives , swelling, itching, warmth, redness, rash
Respiratory (breathing) – wheezing, shortness of breath, throat tightness, cough, hoarse voice, chest pain/tightness, nasal congestion or hay fever-like symptoms (runny itchy nose and watery eyes, sneezing), trouble swallowing
Gastrointestinal (stomach): nausea, pain/cramps, vomiting, diarrhea
Cardiovascular (heart): pale/blue colour, weak pulse, passing out, dizzy/lightheaded, shock
Other: anxiety, feeling of “impending doom” and headache
If a child is allergic to nuts and he smells them, he may develop symptoms, but not a life-threatening reaction

FACTS ABOUT EPINEPHRINE
Many people who are subject to severe allergic reactions are prescribed an epinephrine auto-injector by their physician to use when such a reaction occurs.
Some examples of severe allergies:
bee stings, peanut, nut and food allergies, latex products and shell fish

SYMPTOMS OF A SEVERE ALLERGIC REACTION
Swelling of the face, tongue and/or lips
Irritability
Loss of consciousness
Breathing difficulty, wheezing or both
Bluish color to the skin (cyanosis)
Dizziness, faintness
Flushing of face, chest, etc.
Tightness of throat and chest
Hard-to-find or weak pulse (circulatory collapse)
Seizures

Mild to Moderate Allergic Reaction : Hives and Swelling of face

Anaphylaxis: What should I do?
Symptoms of anaphylaxis can be as simple as tingling of the lips or as severe as cardiac arrest. When in doubt, administer epinephrine
If a person says they are having a reaction it is important to believe them, and immediately administer epinephrine regardless of the symptoms present
After giving the epinephrine, call the office to get the nurse and have them call 911-do not wait for the nurse
It is an emergency and the epinephrine
must be given and 911 must be called

What is a Single Dose, Epinephrine Auto-injector?
A single dose auto-injector is an easy way to give epinephrine/adrenaline to someone having an allergic reaction
E.g. EpiPen®, Twinject®
Trainers are available for practice using- please see your school nurse.

FACTS ABOUT EPINEPHRINE
Epinephrine has been prescribed for patients who are susceptible to severe allergic reactions. Epinephrine is a hormone produced by the body.
When given as a medication, it will help to raise the blood pressure and improve profusion along with helping to open the airway and improve respiration.

EPINEPRHINEAUTO-INJECTOR
Adult/Child Dosage
Called the Epi-Pen and contains 0.30 mg of epinephrine
Small Child Dosage:
Called the Epi-Pen Jr. and contains 0.15 mg of epinephrine.
The appropriate dosage for the student will be written by his/her doctor or advanced practice nurse.

Epi-Pen
THERE ARE NO CONTRAINDICATIONS WHEN EPINEPHRINE IS USED IN A LIFE THREATENING EMERGENCY
SIDE EFFECTS:
Increased heart rate, pallor, dizziness, chest pain, headache, nausea, vomiting, excitability and anxiety

IF NOT SURE TO USE EPI-PEN
If you are not sure, but the individual seems uncomfortable or in distress –
USE THE EPI-PEN
It is safer to use the Epi-Pen than to wait

EPI-PEN PROCEDURE
Have someone else call 911 and notify the parents. (In a school setting you should have a student inform the main office to alert school officials)
Check the Epi-Pen solution color – must be clear to use
Remove the gray safety cap from the Epi-Pen

EPI-PEN PROCEDURE
Hold the Epi-Pen with the black tip against the outer (lateral) area of the thigh muscle - this is the onlyarea where the Epi-Pen is to be used
If accidentally injected into your hand or foot – go immediately to the emergency room

EPI-PEN PROCEDURE
Apply moderate pressure to hear the “click” then hold for 10 seconds.
How the Epi-Pen delivers the medication:
Pushing the Epi-Pen against the outer (lateral) thigh releases a spring-activated plunger, pushing the concealed needle into the thigh muscle and delivering a dose of epinephrine

EPI-PEN PROCEDURE
Remove the Epi-Pen and massage the site (to prevent tissue damage)
If necessary, the Epi-Pen can be used directly through clothing
Be prepared to begin C.P.R.

EPI-PEN PROCEDURE
Stay with the individual, keeping them warm and resting until emergency medical help arrives
IMPORTANT: send the Epi-Pen along with the E.M.T.’s
Make sure the parent/guardian has been called

EPI-PEN
The effects of the injection can wear off after 10-20 minutes. Symptoms can recur.

What to do after giving a single dose auto-injector?
Make sure someone stays with the person
Have person lie still on his back with feet higher than the head
Loosen tight clothing and cover person with whatever is available-coat/blanket
If there is vomiting, turn person on side to prevent choking
Don’t give anything to drink
Send used auto-injector with student to hospital
A Twinject has two doses-one on each end-staff may only give one

Who Can Give the Epi-Pen?
All staff are required to be able to give the epi-pen when needed
Epi-Pen trainers are always available to borrow and practice or get 1:1 training by the nurse-they are easy to use once trained
Students with anaphylaxis and epi-pens keep their epi-pens with them or in the main office/Nurse’s office
Epi-pens must go on all field trips that an anaphylactic student attends
See the school nurses for a refresher course or to practice using Epi-Pen

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