This document provides information about allergies, anaphylaxis, epinephrine auto-injectors (EpiPens), and EpiPen training. It defines allergies and anaphylaxis, lists common allergens and symptoms, and explains why anaphylaxis is life-threatening. It describes how EpiPens contain epinephrine to treat anaphylaxis, the proper procedures for administering an EpiPen, and the importance of calling emergency services afterwards. It stresses that all school staff should be trained on EpiPen use in case a student experiences anaphylaxis.

1. Allergy & Epi-Pen
Mandatory Training

2. 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)

3. 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

4. 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

5. 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

6. 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

7. 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

8. Mild to Moderate Allergic Reaction :
Hives and Swelling of face

10. 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

11. 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.

12. 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.

13. EPINEPRHINE
AUTO-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.

14. 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

15. 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

16. 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

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

18. 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

19. 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.

20. 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

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

22. 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

23. 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