Adapted from the Ministry of Education BCSTA website. Interior Health

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1 Adapted from the Ministry of Education BCSTA website Interior Health July 2013

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 peanuts, tree nuts, sesame seeds, milk eggs, seafood, soy, wheat, sulphites and mustard Insect bites bees, wasps, hornets and some ants Medications penicillin, sulfa drugs Exercise Latex gloves/medical devices Reference: Anaphylaxis Canada (2013) 2

3 WHAT IS ANAPHYLAXIS? Occurs when a person is exposed to an allergen causing a severe, life-threatening allergic response Reactions occur within minutes or, more rarely, up to a few hours after exposure Reference: Anaphylaxis Canada (2013) 3

4 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 Reference: Anaphylaxis Canada (2013) 4

5 Swollen lips/face and hives present 5

6 COMMON SYMPTOMS 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, headache, uterine cramps in females, metallic taste Reference: Anaphylaxis Canada (2013) 6

7 MOST DANGEROUS SYMPTOMS Trouble breathing caused by airway swelling A drop in blood pressure causing dizziness, light-headedness, feeling faint or weak, or passing out Reference: Anaphylaxis Canada (2013) 7

8 Anaphylactic Reaction Normal Appearance Hives and Swelling of face Important: Not all reactions have hives 8

9 health.yahoo.com/media/healthwise/h jpg 9

10 WHY ARE TEENS AT HIGHER RISK? Increased independence Increased risk taking Eating unsafe food and eating out Not carrying auto injector, The part of the brain that makes decisions is the last to mature Not telling friends, wanting to fit in Reference: Allergy Safe Communities (2013) 10

11 PREVENTION = HAVING A PLAN Ensure the medical alert list is up-to-date and familiarize yourself with students who have medical conditions and allergies Review emergency care plans for each student Note where auto-injectors are stored for each student. Ensure auto-injectors are immediately available Recognize allergy sources and triggers Know when and how to administer the auto-injector Prepare for outdoor and off school grounds activities Anaphylaxis Awareness/Avoidance Strategies and Checklist 11

12 WHAT SHOULD I DO? 1. Administer single dose auto-injector 2. Call Notify parent/guardian 4. Administer second auto-injector in 5 to 15 minutes after first dose is given IF symptoms do not improve or if symptoms recur 5. Have ambulance transport student to hospital *Epinephrine is the only way to reverse the effects of anaphylaxis. Give ASAP **Remember, the epinephrine may only last for 15 minutes, calling 911 is very important Reference: BC Anaphylactic and Child Safety Framework (2007) 12

13 WHAT SHOULD I DO? When in doubt, administer epinephrine. Symptoms of anaphylaxis can be as simple as tingling of the lips or as severe as cardiac arrest. If a person says they are having a reaction it is important to believe them, and immediately administer epinephrine regardless of the symptoms present Antihistamines and asthma medication must not be given as first line treatment for anaphylaxis 13

14 WHAT IS AN EPINEPHRINE AUTO- INJECTOR? An auto-injector is an easy way to give epinephrine to someone having an allergic reaction There are three auto-injectors available in BC: Allerject TM EpiPen Twinject 14

15 WHAT IS AN EPIPEN? A disposable, pre-filled automatic injection device that administers a single dose of epinephrine Reference: 15

16 HOW TO USE EPIPEN? Hold firmly with ORANGE tip pointing downward. Remove BLUE safety cap by pulling straight up. Do not bend or twist. Swing and push ORANGE tip firmly into midouter thigh until you hear a click. Hold on thigh for several seconds. EpiPen video link Built-in needle protection When EpiPen is removed, the ORANGE needle cover automatically extends to cover the injection needle, ensuring the needle is never exposed. Reference: 16

17 WHAT IS ALLERJECT TM? A disposable, pre-filled automatic injection device that administers a single dose of epinephrine Talks users through each step Reference: 17

18 HOW TO USE ALLERJECT TM? youtube demonstration link Pull Allerject from the outer case Pull off RED safety guard To reduce the chance of an accidental injection, do not touch the BLACK base of the auto-injector, which is where the needle comes out Place BLACK end against the middle of the outer thigh, then press firmly and hold in place for five seconds Do not inject into any other location Once the injection is complete, replace the outer case Reference: 18

19 WHAT IS TWINJECT? A disposable, pre-filled automatic injection device that contains two doses of epinephrine in a single device First dose of epinephrine is administered by auto-injection, just like the EpiPen and Allerject TM **Remember, staff are not recommended to give dose two (manual intramuscular injection of epinephrine) Reference: 19

20 FOR INFORMATION ONLY: HOW TO USE TWINJECT? Pull off GREEN end cap labeled 1. Never put thumb, finger or hand over the RED tip. Pull off GREEN end cap labeled 2 Press RED cap into outer thigh until unit activates. Hold Twinject in place for about 10 seconds video link 20 Reference:

21 WHAT TO DO AFTER GIVING EPINEPHERINE If dizzy or faint have student lie still on his or her back with feet higher than the head If nauseated or vomiting, have the student lie on their side to prevent choking If breathing is difficult, have the student sit up Loosen tight clothing and cover student with blanket Don t give anything to drink Send auto-injector with student to hospital 21

22 CONCLUSION: FOLLOW THE THREE A S Awareness Know the triggers Know the emergency plan and how to administer epinephrine via the auto-injector Avoidance Avoid contact with allergens, make classrooms safe Action Give auto-injector and call 911. Don t delay! 22

23 RESOURCES For more information contact your Public Health Nurse and see: (BC Anaphylactic and Child Safety Framework) (Anaphylaxis Canada) (Why Risk It- Teens) (Allergy/Asthma Information Assoc.) (Allerject ) (EpiPen ) (Twinject ) Medic Alert Health files BC Ministry of Education Core Anaphylaxis Resources 23

24 REFERENCES Anaphylaxis Canada (2013) AAIA Anaphylaxis Reference Kit (2007) by the Allergy and Asthma Information Association, Health Canada Anaphylaxis in Schools & Other Settings (Second Edition, 2009) by the Canadian Society of Allergy and Clinical Immunology. Allergy Safe Communities. (2013) 24

25 ANY QUESTIONS? 25

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