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Severe Allergies & Epi-Pen Administration Health Services Department

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Presentation Overview Impact of food allergies on children What is a food allergy? Triggers that worsen food allergies Mild signs & symptoms of allergies Medical management of mild signs & symptoms Anaphylaxis (severe signs & symptoms of an emergency; interventions) Medical management of severe signs & symptoms Preventative measures

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Why You Have This Training In accordance with Education Code (EC) Section 49414, legislation was enacted to develop minimum standards of training for school personnel in the administration of epinephrine auto-injectors. It is estimated that severe allergies affect nearly 40 million Americans in all age groups and put those individuals at risk of death from anaphylaxis.

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Impact of Food Allergies Four out of every 100 children have a food allergy. Food allergies are becoming more common AND hospitalizations related to food allergies are also increasing. Children with food allergies are two to four times more likely to have other related conditions such as asthma and other allergies, compared with children without food allergiesAND are more likely to experience anaphylactic reactions to foods and be at higher risk of death.

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What are Food Allergies? A food allergy is an abnormal response to a food triggered by the bodys immune system. No food allergy symptoms occur on the first time a person is exposed to the food First exposure can be: By eating or ingesting a food allergen Touching a food allergen Using or eating other products with the food allergen No cure

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Allergy Triggers The eight major food allergens identified are: 1. Milk 2. Eggs 3. Fish (e.g., bass, flounder, cod) 4. Crustacean shellfish (e.g., crab, lobster, shrimp) 5. Tree nuts (e.g., almonds, walnuts, pecans) 6. Peanuts 7. Wheat 8. Soybeans

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Other Severe Allergy Triggers Common causes: Food Insect stings (bees, hornets, yellow jackets) Medication (e.g. antibiotics, aspirin, and non-steroidal anti-inflammatory drugs) Latex Uncommon causes: Food dependent exercise induced anaphylaxis (rare) Idiopathic anaphylaxis

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Food Allergies vs. Food Intolerance Food allergies are different from a food intolerance A food intolerance is the bodys abnormal reaction to a food but DOES NOT involve the immune system A doctor can confirm the presence or absence of a food allergy and/or food intolerance Types of Food Intolerance: - Lactose Intolerance -Food additives -Gluten Intolerance -Food poisoning -Histamine toxicity Signs & Symptoms: -Bloating -Abdominal pain or cramping -Diarrhea -Nausea & vomiting

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Mild Signs & Symptoms Symptoms of food allergies typically appear from within a few minutes to two hours after a person has eaten the food to which he or she is allergic. Allergic reactions can include: Hives Flushed skin or rash Tingling or itchy sensation in the mouth Itching (of any part of the body) Face, tongue, or lip swelling (or any body part) Vomiting and/or diarrhea Abdominal cramps Coughing or wheezing Dizziness and/or lightheadedness Swelling of the throat and vocal cords Difficulty breathing Loss of consciousness

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Medication Management Diphenhydramine (Benadryl) An antihistamine Relieves mild signs & symptoms like: Hives Flushed skin or rash Tingling or itchy sensation in the mouth Face, tongue, or lip swelling Minor throat or airway irritation Follow the directions labeled on the package or bottle prior to giving the medicine. Can have side effects: Drowsiness Dry mouth, nose & throat Excitement (especially in children)

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Severe Signs and Symptoms A severe, life-threatening allergic reaction is called anaphylaxis. This can lead to: Constricted airways in the lungs Severe lowering of blood pressure and shock (anaphylactic shock) Suffocation by swelling of the throat

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Medication Management

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What To Do in An Emergency Notice the signs & symptoms Take all reactions seriously Try to keep calm Initiate EPI-PEN medication treatment as prescribed by the doctor immediately CALL FOR AN AMBULANCE THEN CALL THE PARENT(S) 1 in 4 will have a latent reaction

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Epi-Pen Video

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How to Prevent a Reaction Strict avoidance of food allergens Know mild & severe signs & symptoms of allergic reactions Read food labels prior to consumption If an individual is known to have severe reactions to food allergens then have an Epi-Pen prescribed by a doctor on hand Know how and when to administer an Epi-Pen Have an action plan

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What You Need at School An Emergency Care Plan A Dietary Prescription completed by physician (for food allergies only) A Medication Administration Authorization form An Epi-pen CPR training

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Sample Emergency Care Plan

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Sample Dietary Prescription

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Medication Authorization Form

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Resources Center for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA 30333, USA 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 E: cdcinfo@cdc.gov http://www.cdc.gov/asthma/ (800) 822-2762 Food Allergy and Anaphylaxis Network 11781 Lee Jackson Highway, Suite 160 Fairfax, VA 220333309 8009294040 www.foodallergy.org Food Allergy Initiative 1414 Avenue of the Americas, Suite 1804 New York, NY 100192514 2122071974 www.faiusa.org National Institute of Allergy & Infectious Diseases 6610 Rockledge Drive, MSC 6612 Bethesda, MD 20892-6612 United States of America Phone: 301-402-1663 Email: niaidnews@niaid.nih.gov Fax: 301-402-0120niaidnews@niaid.nih.gov www.niaid.nih.gov U.S. Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 Ph. 1-888-INFO-FDA (1-888-463-6332) http://www.fda.gov/

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References Branum, A. M., & Lukacs, S. L. U.S. DEPARTMENT OF, National Center for Health Statistics. (2008). Food allergy among U.S. children: Trends in prevalence and hospitalizations. Retrieved from Centers for Disease Control and Prevention website: http://www.cdc.gov/nchs/data/databriefs/db10.htmhttp://www.cdc.gov/nchs/data/databriefs/db10.htm Centers for Disease Control and Prevention, (2012). Food allergies in schools. Retrieved from website: http://www.cdc.gov/healthyyouth/foodallergies/ http://www.cdc.gov/healthyyouth/foodallergies/ Mondello, W. (2009, Oct/Nov). Food-allergic children and their emotional wellbeing. Living Without, Retrieved from http://www.livingwithout.com/issues/3_6/Emotional-State-Food-Allergic-Children-1022- 1.htmlhttp://www.livingwithout.com/issues/3_6/Emotional-State-Food-Allergic-Children-1022- 1.html National Center for Biotechnology Information, U.S. National Library of Medicine (2011). Diphenhydramine. Retrieved from PubMed Health website: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000704/ National Institutes of Health, National Institute of Allergy and Infectious Diseases. (2010). Food allergy: An overview. Retrieved from NIH Publication website: http://www.niaid.nih.gov/topics/foodAllergy/Documents/foodallergy.pdf http://www.niaid.nih.gov/topics/foodAllergy/Documents/foodallergy.pdf U.S. Food and Drug Administration, Silver Spring, MD. (2010). Food allergies: What you need to know. Retrieved from website: http://www.fda.gov/downloads/Food/ResourcesForYou/Consumers/UCM220117.pdf http://www.fda.gov/downloads/Food/ResourcesForYou/Consumers/UCM220117.pdf U.S. Food and Drug Administration. (n.d.). Food allergies: Reducing the risks (video) [Web]. Retrieved from http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm182842.htm

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Post Test