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Caring for Children with Allergies, Anaphylaxis and Seizures
- 1. “I feel funny” Caring for Children with Allergies, Anaphylaxis and Seizures 1 Presented by: Child Care Nurse Consultant September 2018
- 2. Disclaimer This training is not: A substitute for written individual special needs care plans Verifying competency in epinephrine administration or anti-convulsant medications 2 September 2018
- 3. Learning Objectives At the end of this training, you will be able to: Identify common allergies Recognize and respond to allergic reactions Recognize common seizure types and their possible impact on children Recognize when a seizure is a medical emergency Learn how to develop a special needs “action plan” Know appropriate first aid Provide support to children with special medical needs 3 September 2018
- 4. What is an allergy? 4 September 2018
- 5. What is an allergy? Allergies are among the most common chronic conditions worldwide Body’s immune system mistakes an otherwise harmless substance as an invader The immune system overreacts to the allergen by producing Immunoglobulin E (IgE) antibodies IgE antibodies travel to cells that release histamine causing an allergic reaction 5 September 2018
- 6. Allergy Exposure Allergy exposure can occur through: Touching or contact with the allergen (environmental allergy, food allergy, bee/wasp stings) Breathing in the allergen (environmental or food allergy) Ingestion (food allergy) 6 September 2018
- 7. Allergens A number of different allergens are responsible for allergic reactions. The most common include: Pollen Dust Food Insect stings Animal dander Mold Medications/Drugs Latex 7 September 2018
- 8. Poll Question 1 How can allergy exposure occur? a) Touching or contact with the allergen b) Breathing in the allergen c) Ingestion d) a and c e) All of the above 8 September 2018
- 9. Food Allergies One in every 13 children has a food allergy! The 8 most common food allergies are: Milk Egg Peanut Tree nuts Soy Wheat Fish Shellfish 9 September 2018
- 10. Food Allergies Any food can cause a food allergy. Other foods that can cause allergic reactions include: Fruits Seeds (sesame, sunflower, poppy, etc..) Corn Meat Gelatin 10 September 2018
- 12. Food For Thought - A Day in the Life of a Food Allergy Mom video 12 September 2018
- 13. Allergic Reaction An allergic reaction typically triggers symptoms in the nose, lungs, throat, sinuses, ears, lining of the stomach or on the skin. For some people, allergies can also trigger symptoms of asthma. In the most serious cases, a life-threatening reaction called anaphylaxis (an-a-fi-LAK-sis) can occur. 13 September 2018
- 14. Anaphylaxis Anaphylaxis is a severe, life threatening allergic reaction that affects the entire body Symptoms can begin within minutes to several hours after exposure to the allergen The most common anaphylactic reactions are to foods, insect stings, and medications Every 3 minutes a food allergy reaction sends someone to the emergency room 14 September 2018
- 15. Anaphylaxis Symptoms Symptoms of Anaphylaxis MOUTH itching, swelling of lips and/or tongue THROAT* itching, tightness/closure, hoarseness SKIN itching, hives, redness, swelling GUT vomiting, diarrhea, cramps LUNG* shortness of breath, coughing, wheezing HEART* weak pulse, dizziness, passing out Only a few symptoms may be present. Severity of symptoms can change quickly. *Some symptoms can be life-threatening. ACT FAST! 15 September 2018
- 16. How do you know that a child is having an allergic reaction? Itching and redness 16 September 2018
- 17. How do you know that a child is having an allergic reaction? Hives 17 September 2018
- 18. How do you know that a child is having an allergic reaction? Facial (lip) swelling Facial (eye) swelling 18 September 2018
- 19. What a child might do when having an allergic reaction… Signs of an allergic reaction in children can include: Putting their hands in their mouths Pulling or scratching at their tongues Slurring their words Their voices may change (e.g., become hoarse or squeaky) 19 September 2018
- 20. How a child might describe an allergic reaction… A child might use words like these to describe a reaction: "This food is too spicy." "My tongue [or mouth] is hot [or burning, tingling, itching]." "It feels like something’s poking my tongue." "It [my tongue] feels like there is hair on it." “I feel funny." "There’s something stuck in my throat." "It feels like a bump is on the back of my tongue [throat]." 20 September 2018
- 21. How a child might describe an allergic reaction… A child might use words like these to describe a reaction: "My lips feel tight." "It feels like there are bugs in there." [to describe itchy ears] “My eyes are burning [or itchy].” “My skin feels itchy.” “My stomach [or tummy] hurts.” “My chest is tight.” “Something is wrong” or “Something bad is happening.” 21 September 2018
- 22. Poll Question 2 What might be signs of an allergic reaction in a child? a) Putting their hands in their mouths b) Pulling or scratching at their tongues c) Slurring their words d) Their voices may change (e.g., become hoarse or squeaky) e) All of the above September 2018 22
- 23. Allergic Reaction – What do I do? Three questions to ask yourself: Is the allergic reaction mild? Does the child have a diagnosed allergy? Is there an Action Plan? When in doubt… Call 911! 23 September 2018
- 24. Refer to the Action Plan! Anaphylaxis Action Plan Food Allergy Action Plan Both forms are available for free download on the Healthy Child Care Iowa website https://www.idph.iowa.gov/hcci/products 24 September 2018
- 25. Action Plan An Action Plan may include these medications Topical Antihistamine Inhaler (if allergy triggers asthma symptoms) Nebulizer (if allergy triggers asthma symptoms) Epinephrine 25 September 2018
- 26. Treating Mild or Moderate Allergic Reactions Symptoms of an allergic reaction can affect different parts of the body. Mild to moderate symptoms include: Nose: itchy/runny nose, sneezing Skin: a few hives, mild itch Gut: mild nausea/discomfort 26 September 2018
- 27. Treating Mild or Moderate Allergic Reactions Available Treatments Refer to the Action Plan! Antihistamines are appropriate for a single mild symptom, such as a few hives. They cannot control a severe reaction and are no substitute for epinephrine. If symptoms multiply or worsen, give epinephrine Antihistamines, known as H1 blockers, reduce or block histamines/ chemicals your body releases when it comes into contact with an allergen Examples of Antihistamines include diphenhydramine (Benadryl®) and cetirizine (Zyrtec®) Antihistamines may be topical or oral 27 September 2018
- 28. Allergic Reaction-Be Aware! Anyone having an allergic reaction should be watched closely for changes Remember that allergy reactions are unpredictable The way that your body reacts to an allergen one time cannot predict how it will react the next time Stay with the child and alert his or her parents or emergency contacts Symptoms can also worsen quickly, progressing to the life- threatening condition anaphylaxis Epinephrine is the only treatment for anaphylaxis! 28 September 2018
- 29. Epinephrine Epinephrine is the first-line treatment for life-threatening allergic reactions A delay in administering epinephrine can be life-threatening Immediately call 911 After epinephrine is given emergency care is required One dose of Epinephrine lasts approximately 20 minutes A second dose may be needed Only give a second dose if directed by the 911 operator or EMS Give the used epinephrine (and the second unused dose if available) to the EMS personnel 29 September 2018
- 31. Time to practice using an Epi pen 31 September 2018
- 32. For more information Food Allergy Research & Education (FARE) https://www.foodallergy.org Information and resources on food allergies Posters Videos Be a PAL (support for children) program 32 September 2018
Editor's Notes
- Caring for Children with Allergies, Anaphylaxis and Seizures (HCCI September 2018, revised for virtual training 05/01/2020) Insert your name
- Notes: Child Care Nurse Consultants (CCNC) are available to train child care providers/staff on a child’s special needs care plan (action plan) and medications/treatments to be given. Encourage participants to contact you for specific training on individual care/action plans Encourage participants to take the 2-hour Medication Administration Skills Competency course for additional training on the administration of medications in child care.
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- *All photos purchased and used with permission from istock. Photos are non-transferable and cannot be copied. Please do not copy and use photos in this presentation for personal or professional use. To purchase photos or for more information go to https://www.istockphoto.com
- Notes: Allergies are among the most common chronic conditions worldwide. An allergic reaction begins in the immune system. Our immune system protects us from invading organisms that can cause illness. If you have an allergy, your immune system mistakes an otherwise harmless substance as an invader. This substance is called an allergen. The immune system overreacts to the allergen by producing Immunoglobulin E (IgE) antibodies. These antibodies travel to cells that release histamine and other chemicals, causing an allergic reaction. Source: American Academy of Allergy Asthma and Immunology https://www.aaaai.org/conditions-and-treatments/allergies
- Notes: Allergy exposure can occur through touching or contact with the allergen, breathing in the allergen or through ingestion. Examples of environmental allergies are pollen, dust, mold, latex, pet dander. People can also be allergic to bee/wasp stings. Ingestion of certain foods and medications can also cause an allergic response.
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- Answer d. all of the above
- Review slide Source: Food Allergy Research & Education (FARE) https://www.foodallergy.org/common-allergens
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- Notes: Food allergy is more common in children than adults. Often children will “outgrow food” allergies with age. However, food allergy can sometimes become a lifelong concern. According to the CDC the prevalence of food allergy may be increasing in the United States and in other countries. Food allergies can greatly affect children and their families’ well-being. Source: Centers for Disease Control (CDC) https://www.cdc.gov/healthyschools/foodallergies/
- 2.32 minutes This video is a production of FARE. The video is available at https://www.youtube.com/watch?time_continu e=27&v=sMEvRVKOEc8
- Review slide Source: https://www.aaaai.org/conditions-and-treatments/allergies
- Review slide Source: https://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis
- Review slide Source: https://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis
- The following slides show what a provider might see when a child is having an allergic reaction. Point out and discuss what they might see.
- Notes: Hives can start with a few red spots and can spread quickly
- Notes: Precious time can be lost when adults do not immediately recognize that a reaction is happening or don’t understand what a child is telling them. Signs of an allergic reaction in children, especially very young ones, can include: Putting their hands in their mouths Pulling or scratching at their tongues Slurring their words Their voices may change (e.g., become hoarse or squeaky) Source: https://www.foodallergy.org/life-with-food-allergies/newly-diagnosed/how-a-child-might-describe-a-reaction
- Review slide Source: https://www.foodallergy.org/life-with-food-allergies/newly-diagnosed/how-a-child-might-describe-a-reaction
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- Answer e All of the above
- Notes: it’s important to act fast when you see a child with an allergic reaction. Three questions to ask yourself: Is the allergic reaction mild? Does the child have a diagnosed allergy? Is there an Action Plan?
- Notes: Children with a diagnosed allergy should have an “Action Plan”. It is important to ask the child’s parent to have the child’s doctor complete the action plan with specific instructions what to do and how to mange the child’s allergy while in your care. The Anaphylaxis Action Plan is for all types of allergic reaction (non-food). The Food Allergy Action Plan is specific for food allergies.
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- Review slide Source: https://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis
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- Review slide Source: https://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis
- https://www.epipen.com/about-epipen-and-generic/how-to-use-epipen#video
- Notes: After viewing the video, participants should practice using an Epi Pen trainer and Auvi-Q trainer (if available)
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- Notes: Time for questions. Remember, if the provider is caring for a child with an action plan and has specific training needs on medications/treatments, schedule a time to review that child’s action plan and for follow-up/additional training.