Epinephrine Administration Training for Unlicensed School Personnel

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1 Epinephrine Administration Training for Unlicensed School Personnel Management of Life-Threatening Allergies in the School Setting Dover and Sherborn Schools

2 EpiPen Administration This program is designed for the school staff member who is willing to administer an EpiPen in the event that a student or staff member with a known life threatening allergy has a lifethreatening allergic reaction. You must first complete viewing Management of Life-Threatening Allergies in the School Setting and complete a post test.

3 Purpose of Training To provide unlicensed school personnel with the basic knowledge and skills to administer epinephrine by auto-injector in the event of a life threatening allergic reaction.

4 Learning Objectives: With successful completion of this training the participant will be able to describe and/or correctly demonstrate: Common causes of emergency allergic reaction How to recognize specific warning signs of a possible emergency allergic reaction Correct identification of student for whom epinephrine is prescribed Correct use of epinephrine for emergency allergic reactions

5 Learning Objectives Accurately identify student for whom epinephrine is prescribed Correct identification of epinephrine by the prescription label Accurately follow directions from the label Preparation of Epinephrine for administration by auto-injector Correct administration of Epinephrine Safe handling of auto-injector Understanding of how to activate the Emergency Medical System

6 Key Terms Anaphylaxis - A life-threatening, hypersensitivity reaction of the immune system that involves multiple body systems including skin, respiratory, gastrointestinal and circulatory. Epinephrine Medication that is the treatment of choice for life threatening allergic reactions to any substance. It quickly constricts blood vessels, relaxes smooth muscles in the lungs to improve breathing, stimulates the heart, and works to reverse hives and swelling around the face and lips. Effects of epinephrine are immediate but begin to wear off in about 15 minutes. Therefore it is imperative to call 911 once it is determined that there is a life threatening allergic reaction. Intramuscular - a medication route by injection into the muscle which encourages rapid transport by the bloodstream

7 Life Threatening Allergic Reactions Some examples of things that can cause severe allergic reactions: bee stings, peanuts, nuts, many types of foods, latex products, shell fish, medications, exercise People can be allergic to multiple substances Anaphylaxis

8 Anaphylaxis is an over-reaction of the Immune System Sudden, severe allergic reaction involving the whole body Widespread immune system response causes itching, hives & swelling including swelling of the throat and lungs resulting in difficulty breathing May cause nausea and vomiting May also cause circulatory shock and collapse leading to cardiac arrest

9 SYMPTOMS OF A SEVERE ALLERGIC REACTION Swelling of the face, tongue and/or lips Irritability Tightness of throat and chest Breathing difficulty, wheezing or both Flushing of face, chest, etc. Dizziness, faintness Loss of consciousness Bluish color to the skin (cyanosis) Hard-to-find or weak pulse (circulatory collapse) Seizures

10 What A Child Might Say My tongue itches My face is itchy My mouth feels funny My throat feels thick I am having trouble swallowing Something is stuck in my throat I am having trouble breathing My lips feel tight I feel funny

11 Examples of Epinephrine The prescription should have: The student s name Name of medication Expiration date Dosage- EpiPen 0.3 mg (over 66 lbs) Or EpiPen Jr. 0.15mg (under 66 lbs)

12 How is epinephrine stored? Stable at room temperature until the marked expiration date Do not freeze, refrigerate, or expose to extreme heat or sunlight it will cause it to oxidize, go bad and turn brown.

13 Rights of Drug Administration 1. Right person 2. Right drug 3. Right dose 4. Right route

14 Steps in EpiPen Administration Call for HELP! Call 911 Have student lie down Look at the directions on the EpiPen: Remember the 4 rights 1. Form fist around auto-injector (black tip down) 2. With your other hand, pull off gray cap. 3. Hold black tip near outer thigh 4. Swing and jab firmly into outer thigh so auto-injector is perpendicular (at 90 degree angle) to thigh. You will hear a click. 5. Hold firmly in thigh for at least 10 seconds 6. Remove and massage area 7. Any student who receives epinephrine should be transported to a hospital emergency room, even if symptoms appear to have subsided.

15 On Line Resources (copy and paste into your browser) Epi-Pen : EpiPen YPE3Uw Epipen4schools.com

16 Right route The EpiPen is administered into the large outer thigh muscles

17 Intramuscular Injection 90º

18 EPIPEN PROCEDURE How the EpiPen delivers the medication: Pushing the EpiPen against the outer (lateral) thigh releases a spring-activated plunger, pushing the concealed needle into the thigh muscle and delivering a dose of epinephrine. Once the medication is delivered the needle automatically retracts into the container.

19 EPI-PEN PROCEDURE Once injected leave the EpiPen in place for 10 seconds Remove the EpiPen and massage the site (to prevent tissue damage) If necessary, the EpiPen can be used directly through clothing Be prepared to begin C.P.R.

20 Side Effects of Epinephrine Will Occur: Heart racing Feeling anxious Headache Tremor, weakness Pallor, sweating Nausea & vomiting Pain, redness at the injection site

21 IF NOT SURE TO USE EPIPEN If you are not sure, but the individual has been exposed to a known allergen and/or symptoms of anaphylaxis are present and the person seems uncomfortable or in distress USE THE EPI-PEN It is safer to use the EpiPen

22 EPIPEN PROCEDURE Stay with the individual, keeping them warm and resting until emergency medical help arrives Protect the airway and be prepared to start CPR If it has been 15 minutes and the person continues to have symptoms you may administer a 2 nd EpiPen Send the EpiPen (s) along with the E.M.T. s Make sure the parent/guardian has been called

23 Can I Be Sued If I Make A Mistake? Our school has been granted EpiPen delegation by the Department of Public Health. This means that If you complete this program and are willing to do this for a student or staff person with a known life threatening allergy, you will have delegation rights to administer this medication in the event of an emergency. In addition, you will have been trained by the parent/guardian and or the school nurse about the student s specific allergy action plan. Just remember to follow all of the guidelines you have been taught.

24 What If the EpiPen Was Not Needed If you do administer Epinephrine to a child with a known allergy who is complaining of symptoms but the child did not need it, you will do any major harm to the child. The risk of not using the EpiPen when you suspect an allergic reaction may result in serious illness or death. Remember, the effects of the EpiPen wear off in 15 minutes. It is far better to err on the side of caution.

25 I thought I was done One More Thing: You must pass the EpiPen post test and demonstrate competency by being evaluated on the use of an EpiPen trainer by your school nurse. Please set up a time to meet with the school nurse once you have completed this training. This training is good for one year only and must be repeated annually in order to remain current.

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