Allergy & Epi-Pen Mandatory Training

What is an Allergy?

Allergies occur when the immune system becomesunusually sensitive and overreacts to commonsubstances that are normally harmless. Examples are:

Foods – most common tree nuts, especially peanuts and fish; also, eggs, milk, wheat, soy, sesame and some food additivesStings from bees, wasps, hornets and some antsMedications – penicillin, sulfa drugsExerciseLatex (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 SymptomsSkin – hives , swelling, itching, warmth, redness, rashRespiratory (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 EPINEPHRINEMany 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 IrritabilityLoss of consciousnessBreathing difficulty, wheezing or bothBluish color to the skin (cyanosis)Dizziness, faintnessFlushing of face, chest, etc.Tightness of throat and chestHard-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 EPINEPHRINEEpinephrine 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-INJECTORAdult/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-PenTHERE 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 only area where the Epi-Pen is to be used

If accidentally injected into your hand or foot – go immediately to the emergency room

EPI-PEN PROCEDUREApply 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 PROCEDURERemove 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 PROCEDUREStay 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-PENThe 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 neededEpi-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

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