Allergy to: Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No For a suspected or active food allergy reaction:
|
|
- Benedict Sutton
- 5 years ago
- Views:
Transcription
1 Name: D.O.B.: Allergy to: Weight: lbs. Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No For a suspected or active food allergy reaction: PLACE STudent s Picture here SEVERE SYMPTOMS [ ] if checked, give epinephrine immediately if the allergen was definitely eaten, even if there are no symptoms. NOTE: WHEN IN DOUBT, GIVE EPINEPHRINE. mild SYMPTOMS [ ] if checked, give epinephrine immediately for ANY symptoms if the allergen was likely eaten. LUNG Short of breath, wheezing, repetitive cough HEART Pale, blue, faint, weak pulse, dizzy THROAT Tight, hoarse, trouble breathing/ swallowing MOUTH Significant swelling of the tongue and/or lips NOSE Itchy/runny nose, sneezing MOUTH Itchy mouth SKIN Many hives over body, widespread redness 1. INJECT EPINEPHRINE IMMEDIATELY. 2. Call 911. Request ambulance with epinephrine. Consider giving additional medications (following or with the epinephrine):»» Antihistamine GUT Repetitive vomiting or severe diarrhea»» Inhaler (bronchodilator) if asthma Lay the student flat and raise legs. If breathing is difficult or they are vomiting, let them sit up or lie on their side. If symptoms do not improve, or symptoms return, more doses of epinephrine can be given about 5 minutes or more after the last dose. Alert emergency contacts. OTHER Feeling something bad is about to happen, anxiety, confusion Or a combination of mild or severe symptoms from different body areas. NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction. Use Epinephrine. ò ò ò Transport student to ER even if symptoms resolve. Student should remain in ER for 4+ hours because symptoms may return. SKIN A few hives, mild itch ò ò ò GUT Mild nausea/discomfort 1. Give Antihistamines, If Ordered By Physician 2. Stay with student; alert emergency contacts. 3. Watch student closely for changes. If symptoms worsen, GIVE EPINEPHRINE. MEDICATIONS/DOSES Epinephrine Brand: Epinephrine Dose: [ ] 0.15 mg IM [ ] 0.3 mg IM Antihistamine Brand or Generic: Antihistamine Dose: Other (e.g., inhaler-bronchodilator if asthmatic): Parent/Guardian Authorization Signature Date Physician/HCP Authorization Signature Date Form provided courtesy of Food Allergy Research & Education (FARE) ( 8/2013
2 EpiPen (epinephrine) Auto-Injector Directions 1. Remove the EpiPen Auto-Injector from the plastic carrying case. 2. Pull off the blue safety release cap. 3. Swing and firmly push orange tip against mid-outer thigh. 4. Hold for approximately 10 seconds. 5. Remove and massage the area for 10 seconds. 2 4 Auvi-Q TM (epinephrine injection, USP) Directions 1. Remove the outer case of Auvi-Q. This will automatically activate the voice instructions. 2. Pull off red safety guard. 3. Place black end against mid-outer thigh. 4. Press firmly and hold for 5 seconds. 5. Remove from thigh. 2 3 Adrenaclick /AdrenaclicK Generic Directions 1. Remove the outer case. 2. Remove grey caps labeled 1 and Place red rounded tip against mid-outer thigh. 4. Press down hard until needle penetrates. 5. Hold for 10 seconds. Remove from thigh OTHER DIRECTIONS/INFORMATION (may self-carry epinephrine, may self-administer epinephrine, etc.): Treat student before calling Emergency Contacts. The first signs of a reaction can be mild, but symptoms can get worse quickly. Emergency Contacts call 911 Rescue Squad: Doctor: Phone: Parent/Guardian: Phone: Other Emergency Contacts Name/Relationship: Phone: Name/Relationship: Phone: Parent/Guardian Authorization Signature Date Form provided courtesy of Food Allergy Research & Education (FARE) ( 8/2013
3
4 Bee Sting Allergy Action Plan Student s Name: D.O.B: Grade/Class ALLERGY TO: Asthmatic Yes* No *Higher risk for severe reaction Place Child s Picture Here STEP 1: TREATMENT Symptoms: Give Checked Medication**: **(To be determined by physician authorizing treatment) If child has been stung, but no symptoms: Epinephrine Antihistamine Mouth Itching, tingling, or swelling of lips, tongue, mouth Epinephrine Antihistamine Skin Hives, itchy rash, swelling of the face or extremities Epinephrine Antihistamine Gut Nausea, abdominal cramps, vomiting, diarrhea Epinephrine Antihistamine Throat Tightening of throat, hoarseness, hacking cough Epinephrine Antihistamine Lung Shortness of breath, repetitive coughing, wheezing Epinephrine Antihistamine Heart Thready pulse, low blood pressure, fainting, pale, blueness Epinephrine Antihistamine Other Epinephrine Antihistamine If reaction is progressing (several of the above areas affected), give Epinephrine Antihistamine The severity of symptoms can quickly change. Potentially life-threatening. DOSAGE Epinephrine: inject intramuscularly (circle one) EpiPen EpiPen Jr. Twinject 0.3 mg Twinject 0.15 mg (see reverse side for instructions) Antihistamine: give Other: give IMPORTANT: Asthma inhalers and/or antihistamines cannot be depended on to replace epinephrine in anaphylaxis. STEP 2: EMERGENCY CALLS 1. Call 911 (or Rescue Squad: ). State that an allergic reaction has been treated, and additional epinephrine may be needed. 2. Dr. at 3. Emergency contacts: Name/Relationship Phone Number(s) a. 1.) 2.) b. 1.) 2.) c. 1.) 2.) EVEN IF PARENT/GUARDIAN CANNOT BE REACHED, DO NOT HESITATE TO MEDICATE OR TAKE CHILD TO MEDICAL FACILITY! Parent/Guardian Signature Date
5 TRAINED STAFF MEMBERS 1. Room 2. Room 3. Room EpiPen and EpiPen Jr. Directions Pull off gray activation cap. Twinject 0.3 mg and Twinject 0.15 mg Directions Hold black tip near outer thigh (always apply to thigh). Pull off green end cap, then red end cap. Put gray cap against outer thigh, press down firmly until needle penetrates. Hold for 10 seconds, then remove. Swing and jab firmly into outer thigh until Auto-Injector mechanism functions. Hold in place and count to 10. Remove the EpiPen unit and massage the injection area for 10 seconds. SECOND DOSE ADMINISTRATION: If symptoms don t improve after 10 minutes, administer second dose: Unscrew gray cap and pull syringe from barrel by holding blue collar at needle base. Slide yellow or orange collar off plunger. Put needle into thigh through skin, push plunger down all the way, and remove. Once EpiPen or Twinject is used, call the Rescue Squad. Take the used unit with you to the Emergency Room. Plan to stay for observation at the Emergency Room for at least 4 hours. For children with multiple food allergies, consider providing separate Action Plans for different foods. **Medication checklist adapted from the Authorization of Emergency Treatment form developed by the Mount Sinai School of Medicine. Used with permission.
6 Food Allergy Action Plan Student s Name: D.O.B: Teacher: ALLERGY TO: Asthmatic Yes* No *Higher risk for severe reaction Place Child s Picture Here STEP 1: TREATMENT Symptoms: Give Checked Medication**: **(To be determined by physician authorizing treatment) If a food allergen has been ingested, but no symptoms: Epinephrine Antihistamine Mouth Itching, tingling, or swelling of lips, tongue, mouth Epinephrine Antihistamine Skin Hives, itchy rash, swelling of the face or extremities Epinephrine Antihistamine Gut Nausea, abdominal cramps, vomiting, diarrhea Epinephrine Antihistamine Throat Tightening of throat, hoarseness, hacking cough Epinephrine Antihistamine Lung Shortness of breath, repetitive coughing, wheezing Epinephrine Antihistamine Heart Thready pulse, low blood pressure, fainting, pale, blueness Epinephrine Antihistamine Other Epinephrine Antihistamine If reaction is progressing (several of the above areas affected), give Epinephrine Antihistamine The severity of symptoms can quickly change. Potentially life-threatening. DOSAGE Epinephrine: inject intramuscularly (circle one) EpiPen EpiPen Jr. Twinject 0.3 mg Twinject 0.15 mg (see reverse side for instructions) Antihistamine: give Other: give IMPORTANT: Asthma inhalers and/or antihistamines cannot be depended on to replace epinephrine in anaphylaxis. STEP 2: EMERGENCY CALLS 1. Call 911 (or Rescue Squad: ). State that an allergic reaction has been treated, and additional epinephrine may be needed. 2. Dr. at 3. Emergency contacts: Name/Relationship Phone Number(s) a. 1.) 2.) b. 1.) 2.) c. 1.) 2.) EVEN IF PARENT/GUARDIAN CANNOT BE REACHED, DO NOT HESITATE TO MEDICATE OR TAKE CHILD TO MEDICAL FACILITY! Parent/Guardian Signature Doctor s Signature (Required) Date Date
7 TRAINED STAFF MEMBERS 1. Room 2. Room 3. Room EpiPen and EpiPen Jr. Directions Pull off gray activation cap. Twinject 0.3 mg and Twinject 0.15 mg Directions Hold black tip near outer thigh (always apply to thigh). Pull off green end cap, then red end cap. Put gray cap against outer thigh, press down firmly until needle penetrates. Hold for 10 seconds, then remove. Swing and jab firmly into outer thigh until Auto-Injector mechanism functions. Hold in place and count to 10. Remove the EpiPen unit and massage the injection area for 10 seconds. SECOND DOSE ADMINISTRATION: If symptoms don t improve after 10 minutes, administer second dose: Unscrew gray cap and pull syringe from barrel by holding blue collar at needle base. Slide yellow or orange collar off plunger. Put needle into thigh through skin, push plunger down all the way, and remove. Once EpiPen or Twinject is used, call the Rescue Squad. Take the used unit with you to the Emergency Room. Plan to stay for observation at the Emergency Room for at least 4 hours. For children with multiple food allergies, consider providing separate Action Plans for different foods. **Medication checklist adapted from the Authorization of Emergency Treatment form developed by the Mount Sinai School of Medicine. Used with permission.
Allergy to: NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction. USE EPINEPHRINE.
Name: D.O.B.: Allergy to: PLACE PICTURE HERE Weight: lbs. Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe
More informationPERRYSBURG EXEMPTED VILLAGE SCHOOL DISTRICT
5330 F1/page 1 of 5 PERRYSBURG EXEMPTED VILLAGE SCHOOL DISTRICT MEDICATION IN SCHOOL Before the student will be permitted to take medication during school hours or to use a self-administer medication and
More informationAllergy to: NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction. USE EPINEPHRINE.
Name: D.O.B.: Allergy to: PLACE PICTURE HERE Weight: lbs. Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe
More informationEpinephrine Auto Injector Self-Administration Authorization Packet for Anaphylaxis (A new packet must be completed yearly)
Epinephrine Auto Injector Self-Administration Authorization Packet for Anaphylaxis (A new packet must be completed yearly) Packet Contents: 1. Anaphylaxis Medication Self-Administration Form (requires
More informationNOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction. USE EPINEPHRINE.
Name: Allergy to: Weight: D.O.B.: lbs. Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No PICTURE NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction.
More informationCommonwealth of Massachusetts Department of Early Education and Care
Commonwealth of Massachusetts Department of Early Education and Care MEDICATION CONSENT FORM 606 CMR 7.11(2)(b) Name of child: Name of medication: Please one of the following: Prescription: Oral/Non-Prescription:
More informationREQUIREMENTS FOR DEVELOPING AN INDIVIDUALIZED HEALTHCARE PLAN FOR STUDENTS WITH FOOD AND LIFE THREATENING ALLERGIES
REQUIREMENTS FOR DEVELOPING AN INDIVIDUALIZED HEALTHCARE PLAN FOR STUDENTS WITH FOOD AND LIFE THREATENING ALLERGIES Parent/ Guardian: Notify the appropriate school personnel of all student allergies and
More informationSt. Andrew Apostle Family Handbook Acknowledgement
11602 Silver Spring, MD 20902 (301) 649-3555 fax (301) 649 2352 www.standrewapostle.org 2018-2019 Apostle Family Handbook Acknowledgement *The Principal reserves the right to amend the Family Handbook
More informationAllergy Awareness & EpiPen Administration
Allergy Awareness & EpiPen Administration 2017-18 Common Allergens in Children! Shellfish! Milk! Egg! Peanut! Tree Nuts! Fish! Soy! Latex! Insect Stings! Exercise What is an allergy? * An allergy is an
More informationYou need to know that we will administer the epi-pen if your child is experiencing ANY of the following symptoms:
MEDICATION ADMINISTRATION AND FOOD ALLERGY POLICY We want to make you aware of the steps Silver Spring Day School (SSDS) is taking to assure the safety of children with serious allergies or a medical condition.
More informationFood Allergy Awareness Protocol
Food Allergy Awareness Protocol 745 Jeffco Blvd. Arnold, MO 63010 p 636.296.8000 f 636.282.5170 www.fox.k12.mo.us I. Introduction This document will provide guidelines for Fox C-6 parents and schools regarding
More informationLinton Hall School Allergy Action Plan
Linton Hall School Allergy Action Plan Dear Parent or Guardian, Please provide the information requested below to help us care for your child s life-threatening allergy while at school. Instructions for
More informationEpiPen Training Module:
EpiPen Training Module: Managing Life Threatening Allergies Chelmsford Public Schools September, 2016 Purpose To provide basic knowledge and skill to unlicensed school personnel to administer epinephrine
More informationSEVERE ALLERGY/ANAPHYLAXIS ACTION PLAN & TREATMENT AUTHORIZATION Appendix F-4A
PART I - TO BE COMPLETED BY PARENT Student Date of Birth Teacher/Grade Allergy Route of Exposure Contact Ingestion Weight lbs. Inhalation Sting Asthmatic Yes* No *Higher risk for severe reaction Parent
More informationSchool Year SEVERE ALLERGY Medical Action Plan (MAP) Student s Name. Date of Birth CONTACT INFORMATION ALLERGIC HISTORY
Bus Transportation Office Use ONLY if Needed Bus # Driver Route # Medical File 9758 E Highland Rd. Howell, MI 48843 810-632-2200 phone 810-632-2201 fax School Year SEVERE ALLERGY Medical Action Plan (MAP)
More informationEmergency Preparedness for Anaphylaxis in School
10/19/2017 Emergency Preparedness for Anaphylaxis in School Michael Corjulo APRN, CPNP, AE-C ASNC April 20, 2017 Objectives Review a brief overview of anaphylaxis related to the school environment Demonstrate
More informationWALNUT RIDGE PRIMARY SCHOOL 625 Route 517 P.O. Box 190 Vernon, NJ Voice (973) Fax (973)
WALNUT RIDGE PRIMARY SCHOOL 625 Route 517 P.O. Box 190 Vernon, NJ 07462 Voice (973) 764-2801 Fax (973) 764-0066 www.vtsd.com Rosemary Gebhardt Principal rgebhardt@vtsd.com Dear Parent/Guardian, The State
More informationAnaphylaxis Emergency Plan (individual)
Appendix D Anaphylaxis Emergency Plan (individual) Recommendation In schools and other child care settings, each child at risk of anaphylaxis should have an Anaphylaxis Emergency Plan. (See following page.)
More informationLAST NAME FIRST NAME MIDDLE NAME HOME TELEPHONE NUMBER PARENTS CELL NUMBER DATE OF BIRTH
To the Parents or Guardians: Please return this physical examination report or proof of physical examination received during the school year on registration day. No student will be admitted to Sacred Heart
More informationManagement of ANAPHYLAXIS in the School Setting. Updated September 2010
Management of ANAPHYLAXIS in the School Setting Updated September 2010 What is an Allergy? Allergies occur when the immune system becomes unusually sensitive and over reacts to common substance that are
More informationGET TRAINED. A program for school nurses to train school staff to administer epinephrine using an auto-injector
GET TRAINED 2015 A program for school nurses to train school staff to administer epinephrine using an auto-injector Get Trained 2016 Updates Information in this presentation was reviewed and updated in
More informationANAPHYLAXIS AND EPIPEN ADMINISTRATION
ANAPHYLAXIS AND EPIPEN ADMINISTRATION EpiPen Administration This program has been designed for the school staff member who will administer an EpiPen in the event that a student has a life-threatening allergic
More informationEpiPen Administration. For Hingham Public School Staff
EpiPen Administration For Hingham Public School Staff EpiPen Administration This program has been designed for the school staff member who is willing to administer an EpiPen in the event that a student
More informationfirst aid information
first aid information FIRST AID TREATMENT FOR ANAPHYLAXIS Anaphylaxis is a severe allergic reaction and potentially life threatening. It should always be treated as a medical emergency, requiring immediate
More informationFaith Lutheran College, Redlands Faith in Christ prepared for life A I ANAPHYLAXIS POLICY T H. Last updated June 2017
F Faith Lutheran College, Redlands Faith in Christ prepared for life A I ANAPHYLAXIS POLICY T H Last updated June 2017 Food Allergy Policy and Procedures Rationale: Within the general community, there
More informationGET TRAINED. What Would You Do? You have moments to react. Bianca 1/15/2014 GET TRAINED
GET TRAINED It s time to GET TRAINED to administer an epinephrine auto-injector in an emergency! What Would You Do? Bianca has a bee sting allergy She is playing in the garden at her friends house She
More informationRecognize Anaphylaxis Symptoms
Recognize Anaphylaxis Symptoms File: JHCD-F1 Recognize the Common Anaphylaxis Symptoms Sudden difficulty breathing, wheezing Hives, generalized flushing, itching, or redness of the skin, Swelling of the
More informationTREATMENT OF ANAPHYLACTIC REACTION WITH EPINEPHRINE
TREATMENT OF ANAPHYLACTIC REACTION WITH EPINEPHRINE FILE: JGCDC Background: The Bibb County School System recognizes the growing concern with severe life-threatening allergic reactions to food items, latex,
More informationFirst Aid Information
ISSUED May 2018 First Aid Information First Aid Kits Are Located: First Aid Kits Are Managed By: First Aid Kits Are Accessible By: Church Staff Ministry Volunteer Leaders Ministry Volunteer Team Members
More informationACTION PLAN FOR. Difficult/noisy breathing Swelling of tongue Swelling/tightness in throat Wheeze or persistent cough ACTION FOR ANAPHYLAXIS
www.allergy.org.au Name: Date of birth: Photo Confirmed allergens: Family/emergency contact name(s): ACTION PLAN FOR Anaphylaxis SIGNS OF MILD TO MODERATE ALLERGIC REACTION Swelling of lips, face, eyes
More informationAn allergic reaction is an exaggerated response by the immune system to a foreign substance
ALLERGIC REACTION An allergic reaction is an exaggerated response by the immune system to a foreign substance Anaphylaxis is an unusual or exaggerated allergic reaction; is a life threatening emergency
More informationINDIVIDUAL CARE REGISTRATION MATERIALS
INDIVIDUAL CARE REGISTRATION MATERIALS Individual Care Plan Medication Treatment Form Emergency & Allergy Action Plans Food Allergy/Intolerance Health Care Provider Statement YMCA OF SNOHOMISH COUNTY ymca-snoco.org
More informationShelley Westwood, RN, BSN
Shelley Westwood, RN, BSN The body requires a constant supply of oxygen for survival. AMERICAN RED CROSS FIRST AID RESPONDING TO EMERGENCIES FOURTH EDITION Copyright 2006 by The American National Red Cross
More informationSt. Joseph s Primary School Numurkah
St. Joseph s Primary School Numurkah Anaphylaxis Procedure March 2014 Basic Beliefs: Our school community nurtures the development of the whole child. Our School is built on respect and an appreciation
More informationShould you have questions or concerns, please contact the Program Supervisor at the location your child is registered.
Community Services Department, Recreation Division 201 City Centre Drive MISSISSAUGA ON L5B 2T4 mississauga.ca/recreation Dear Parent/Guardian, We are excited to have you join us for camps this season!
More informationAllergy Management Policy
Allergy Management Policy Food Allergy People with allergies have over-reactive immune systems that target otherwise harmless elements of our diet and environment. During an allergic reaction to food,
More informationAs you begin this build-up phase there are several factors to keep in mind concerning your treatment:
SLIT IMMUNOTHERAPY INSTRUCTIONS David R. Scott, M.D./William A. Scott, M.D. Congratulations on beginning your new sublingual immunotherapy (SLIT) prescription! The initial 30 doses are advancement doses.
More informationCCSD School Nurses. Support of Students with Life Threatening Allergies
CCSD School Nurses Support of Students with Life Threatening Allergies The Clark County School District is committed to provide a safe, supportive environment in which all students can learn and achieve.
More informationManaging Allergies and Anaphylaxis at School: Training for School Personnel
Managing Allergies and Anaphylaxis at School: Training for School Personnel Recognizing Severe Allergic Response Use of Epinephrine Auto-Injectors The resources for this presentation were created by the
More informationPATIENT INFORMATION. Auvi-Q (epinephrine injection) Auto-Injector For allergic emergencies (anaphylaxis)
PATIENT INFORMATION Auvi-Q (epinephrine injection) Auto-Injector For allergic emergencies (anaphylaxis) Read this Patient Information Leaflet before you have to use Auvi-Q and each time you get a refill.
More informationAnaphylaxis Policy. Rationale. What is anaphylaxis?
Anaphylaxis Policy Rationale Allergic reactions are common in children. However, severe life threatening allergic reactions are uncommon and deaths are rare. Protecting our community from the effects of
More informationALLERGY AWARENESS POLICY
ALLERGY AWARENESS POLICY 1. RATIONALE Allergies are very common and increasing in Australia and New Zealand, affecting around 1 in 5 people at some time in their lives. There are many different causes
More informationEMT OPTIONAL SKILL. Cell Phones and Pagers. Epinephrine Auto-injector. Course Outline 9/2017
EMT OPTIONAL SKILL Epinephrine Auto-injector Cell Phones and Pagers Be courteous to your classmates! Please set your cell phones and/or pagers to silent or turn them off. Course Outline Introduction and
More informationAllergic Reactions and Envenomations. Chapter 16
Allergic Reactions and Envenomations Chapter 16 Allergic Reactions Allergic reaction Exaggerated immune response to any substance Histamines and leukotrienes Chemicals released by the immune system Anaphylaxis
More informationEpinephrine Auto-Injector (MAT EPI) Course Handouts. 12/31/17 Version
Epinephrine Auto-Injector (MAT EPI) Course Handouts 12/31/17 Version Epinephrine Auto-Injector (EPI) Course Overview EPI Handout 1.1 The Epinephrine Auto-Injector (EPI) course is approved by the Board
More informationShould a pupil show signs of a mild- moderate allergic reaction:
Guidelines for pupils with a severe allergy who carry an auto- injector JEXT EPI-PEN EMERADE When in school pupils are expected to carry their auto-injector at all times. A pupil with a severe allergy
More informationEczema: also called atopic dermatitis; a chronic, itchy, scaly rash not due to a particular substance exposure
Allergy is a condition in which the immune system causes sneezing, itching, rashes, and wheezing, or sometimes even life-threatening allergic reactions. The more you know about allergies, the better prepared
More informationPARENT/ GUARDIAN ANAPHYLAXIS PACKAGE ELEMENTARY/SECONDARY
PARENT/ GUARDIAN ANAPHYLAXIS PACKAGE ELEMENTARY/SECONDARY 2006 PARENT/GUARDIAN INFORMATION & RESPONSIBILITIES: The Board and its schools endeavor to provide a safe environment for children with life threatening
More informationIntroduction to Emergency Medical Care 1
Introduction to Emergency Medical Care 1 OBJECTIVES 22.1 Define key terms introduced in this chapter. Slides 10, 14, 19, 37, 39 22.2 Differentiate between the signs and symptoms of an allergic reaction
More informationANAPHYLAXIS MANAGEMENT POLICY
ANAPHYLAXIS MANAGEMENT POLICY PHILOSOPHY The management of Anaphylaxis, a severe, rapidly progressive allergic reaction that is potentially life threatening, is an essential component of Mount Waverley
More informationVACCINE-RELATED ALLERGIC REACTIONS
VACCINE-RELATED ALLERGIC REACTIONS Management of Anaphylaxis Public Health Immunization Program June 2018 VACCINE-RELATED ADVERSE EVENTS Local reactions pain, edema, erythema Systemic reactions fever,
More informationManaging Allergies and Anaphylaxis at School EPI-PEN TRAINING FOR SCHOOL PERSONNEL
Managing Allergies and Anaphylaxis at School EPI-PEN TRAINING FOR SCHOOL PERSONNEL Objective: Attendees will be able to: Increase their knowledge about allergies to food and other allergens. Describe the
More informationEpiPen Administration. by Susan Reiss RN, NCSN
EpiPen Administration by Susan Reiss RN, NCSN EpiPen Administration This program has been designed for the school staff member who is willing to administer an EpiPen in the event that a student has a life-threatening
More informationFAUQUIER COUNTY PUBLIC SCHOOLS Policy: Adopted: 04/10/2012 Revised: 07/23/12, 7/08/13, 08/11/14, 08/14/17 ADMINISTERING MEDICINES TO STUDENTS
ACCOMPANYING REGULATION REGULATION 7-5.3(B): ADMINISTRATION OF EPINEPHRINE (Severe Allergic Reaction) 1. Generally 1.1. Fauquier County Public Schools Public Schools ( FCPS) anaphylaxis regulation is developed
More informationQueen City Independent School District Stock Epinephrine Policy/Protocol
Queen City Independent School District Stock Epinephrine Policy/Protocol In accordance with Texas SB 66 as well as Chapter 38 of the Education Code Subchapter E, and the NASN guidelines for stock Epinephrine
More informationPOLICY MANUAL Section 5 NO: Anaphylaxis/Life Threatening Medical Conditions -POLICY-
Anaphylaxis/Life Threatening Medical Conditions -POLICY- The Board of Education is committed to the principle of providing a safe learning environment for its students. This includes a safe environment
More informationADMINISTRATIVE CHECKLIST FOR ANAPHYLAXIS
Appendix 317A ADMINISTRATIVE CHECKLIST FOR ANAPHYLAXIS Information gathering: Physician s information sheet completed Parent consent to give medical treatment form signed Student Care Plan readily available
More informationAnaphylaxis Management Policy
Anaphylaxis Management Policy Purpose: To fully comply with Ministerial Order 706 and the associated Guidelines published and amended by the Victorian Government, Department of Education from time to time.
More informationHealthy Colts Initiative - Emergency Protocols
Healthy Colts Initiative - Emergency Protocols Severe Allergic Reactions and Anaphylaxis A potentially deadly allergic reaction that is rapid in onset, most often triggered by foods, medications and insect
More informationStaff Training for Acute & Chronic Illnesses
Staff Training for Acute & Chronic Illnesses Anaphylaxis/Severe Allergies Level I Staff Training Asthma Diabetes Level I Staff Training Seizure Disorder Migraine Headaches Mild Allergies & Other Illnesses
More informationANAPHYLAXIS POLICY & PROCEDURES
PHOENIX P-12 COMMUNITY COLLEGE ANAPHYLAXIS POLICY & PROCEDURES Policy Statement Anaphylaxis is a severe, rapidly progressive allergic reaction that involves various areas of the body simultaneously and
More informationAsthma With a Slight Chance of Anaphylaxis
Asthma With a Slight Chance of Anaphylaxis An Update for Alberta Oral Health Professionals Sept 25/13 Presented by Val Olson CRE Community Pediatric Asthma Service Air passes through the: Nose or mouth
More informationHoliday Program BOOKING FORM
Holiday Program BOOKING FORM January 2016 PRICES EFFECTIVE FROM 1 JANUARY 2016 RISK MANAGEMENT ASSESSMENT IS AVAILABLE AT OUR WEB SITE www.bathurstgoldfields.com.au Please return by email: info@bathurstgoldfields.com.au
More informationPROCEDURE ANAPHYLAXIS PROCEDURE
PROCEDURE ANAPHYLAXIS PROCEDURE Anaphylaxis- sometimes called allergic shock or generalized allergic reaction - is a severe allergic reaction that can lead to rapid death, if untreated. Like less severe
More informationvenue Infant School MEDICINES PROTOCOL DOB: Insert photograph of child: This means..must avoid ALL substances which contain or may contain
The venue Infant School MEDICINES PROTOCOL Name of Child: Address: Age of Child: DOB: Insert photograph of child: Parent/Carers name and contact numbers: Additional contacts: GP contact details: ALLERGY
More informationMurrayville Community College Anaphylaxis Policy
PURPOSE To explain to Murrayville Community College parents, carers, staff and students the processes and procedures in place to support students diagnosed as being at risk of suffering from anaphylaxis.
More informationELWOOD COLLEGE PROGRAM: ANAPHYLAXIS MANAGEMENT POLICY NO: 4 DATE: 09/02/10
ELWOOD COLLEGE Glenhuntly Rd, Elwood, 3184, Telephone 9531 9566 PROGRAM: ANAPHYLAXIS MANAGEMENT POLICY NO: 4 DATE: 09/02/10 PURPOSE: 1. To provide, as far as practicable, a safe school environment in which
More informationManaging Illness 8/9/2010 1
Managing Illness 1 Fainting Caused by a temporary drop in blood pressure thus causing a reduction in oxygen to the brain. Insufficient oxygen causes casualty to black out and fall. Consciousness normally
More informationLEARN ABOUT ANOTHER WAY TO TREAT YOUR ALLERGIES
LEARN ABOUT ANOTHER WAY TO TREAT YOUR ALLERGIES WHAT ARE ALLERGIES? It s probably not something that you think about, but every time you open your mouth or inhale, tiny particles from the environment that
More informationALLERGIC/ANAPHYLACTIC REACTION POLICY
Child Care Early Years Act Policies & Procedures Binder ALLERGIC/ANAPHYLACTIC REACTION POLICY MLCP endeaours to offer an enironment supportie of allergic and or anaphylactic students. The school promotes
More informationLesson 17: Allergies & Anaphylaxis. Emergency Reference Guide p
Lesson 17: Allergies & Anaphylaxis Emergency Reference Guide p. 25-30 Objectives Describe basics of allergic reactions & treatment Define anaphylaxis List signs & symptoms of anaphylaxis Describe conditions
More informationVACCINE-RELATED ALLERGIC REACTIONS
VACCINE-RELATED ALLERGIC REACTIONS Management of Anaphylaxis IERHA Immunization Program September 2016 VACCINE-RELATED ADVERSE EVENTS Local reactions pain, edema, erythema Systemic reactions fever, lymphadenopathy
More informationSCHOOL DISTRICT NO. 51 (BOUNDARY) P O L I C Y
SCHOOL DISTRICT NO. 51 (BOUNDARY) P O L I C Y SECTION TITLE NO. 4020 HEALTH/SAFETY Anaphylaxis (Severe Allergic Reaction) DATE ADOPTED: May 13, 2008 DATE AMENDED: Anaphylaxis is a sudden and severe allergic
More informationRecognition and Treatment of Anaphylaxis in the School Setting
Recognition and Treatment of Anaphylaxis in the School Setting Background for Authorization House Bill 1107/Senate Bill 656 enacted by the 2012 General Assembly required local school boards to adopt and
More informationChapter 8. Learning Objectives. Learning Objectives 9/11/2012. Anaphylaxis. List symptoms of anaphylactic shock
Chapter 8 Anaphylaxis Learning Objectives List symptoms of anaphylactic shock Discuss role of immune system in fighting antigens Define allergic response Learning Objectives Describe body s response to
More informationEPI PEN TRAINING KAREN, RN, BSN FARGO SOUTH SCHOOL NURSE
EPI PEN TRAINING KAREN, RN, BSN FARGO SOUTH SCHOOL NURSE Why use an Epipen? Anaphylaxis Anaphylaxis is a severe, potentially lifethreatening allergic reaction caused by contact with certain triggers CAUSES
More informationPATIENT INFORMATION RELENZA
PATIENT INFORMATION RELENZA (ruh-lens-uh) (zanamivir inhalation powder) for oral inhalation use What is RELENZA? RELENZA is a prescription medicine used to: treat the flu (influenza A and B virus) in people
More informationWESTBROOK PUBLIC SCHOOLS
WESTBROOK PUBLIC SCHOOLS ANNUAL MEDICATION ADMINISTRATION TRAINING MANUAL FOR NON-LICENSED SCHOOL PERSONNEL REVISED 2017 Tina Bennett, RN CONFIDENTIALITY AND PRIVACY Confidentiality is a very important
More informationTREATING ALLERGIES THROUGH EDUCATION
World allergy week: Allergies and Anaphylaxis Dr Mike Levin Paediatric Asthma and Allergy Division University of Cape Town Red Cross Hospital Agenda Introduction: Allergies in general Food allergies and
More informationPhysical Examination Form
Physical Examination Form Applicant s Name: Date: Date of Birth: Age at Exam: Gender: Male Female Primary Diagnosis: _ Secondary Diagnosis: HEALTH HISTORY: *Parents/Guardians please complete the following
More informationMANAGING COMMON PRESENTATIONS OF ALLERGY IN PRIMARY CARE. Helen Bourne Consultant Immunologist
MANAGING COMMON PRESENTATIONS OF ALLERGY IN PRIMARY CARE Helen Bourne Consultant Immunologist AIMS Presentation of Allergic Disease in Adults Rhinitis/ Rhinoconjuctivitis Urticaria and Angioedema Food
More informationNew Patient Questionnaire
- - Toda y 's Date: Primary Care Provider's Name: Was a consultation recommended? Primary Clinic: Referring provider's name (if different): Please answer the following questions to facilitate the diagnosis
More informationShock Video Shock (3)
CHAPTER 9 Shock Video Shock (3) Lesson Objectives 1. Explain what happens inside the body with severe blood loss. 2. List common causes of shock. 3. Describe first aid steps for a victim in shock. 4. Describe
More informationCLINICAL TOOLKIT. For interactive versions, v isit our website: AllergyEducation.co.uk. Job code: TFSUK1665. Date of preparation: June 2016.
CLINICAL TOOLKIT For interactive versions, v isit our website: AllergyEducation.co.uk Job code: TFSUK1665. Date of preparation: June 2016. DIAGNOSING ALLERGY - 1,2,3 Step 1: Take a history Diagnosing allergy
More informationPolicy for the Treatment of Anaphylaxis in Adults and Children
Policy for the Treatment of Anaphylaxis in Adults and Children June 2008 Policy Title: Policy for the Treatment of Anaphylaxis in Adults or Children Policy Reference Number: PrimCare08/17 Implementation
More informationAnaphylaxis Management
Williamstown Primary School Anaphylaxis Management 1. BACKGROUND Anaphylaxis is a serious health issue for a percentage of the population and the Department recognises the key to preventing an anaphylactic
More informationFood Allergy , The Patient Education Institute, Inc. imf10101 Last reviewed: 10/15/2017 1
Food Allergy Introduction A food allergy is an abnormal response to a food. It is triggered by your body's immune system. An allergic reaction to a food can sometimes cause severe illness or death. Tree
More informationS:\Admin Staff\100 Administration\2010\109 Policy\Operational Plans\Anaphylaxis Policy.doc
Growing Together Principal: Mr Paul Andrijich Deputy Principal: Mr Paul Westcott Registrar: Mrs Kerry Vine 65 Coast Road West Swan WA 6055 Telephone: 9250 2711 Mobile: 0434734390 Fax: 9250 2416 EDUCATE
More informationNEW ZEALAND CONSUMER MEDICINE INFORMATION. other allergens, possibly unidentified.
NEW ZEALAND CONSUMER MEDICINE INFORMATION EPIPEN Adrenaline (epinephrine)* 300 µg/0.3 ml Auto-Injector * In some countries, adrenaline is known as epinephrine What is in this leaflet This leaflet answers
More informationSierra Sacramento Valley EMS Agency
Sierra Sacramento Valley EMS Agency BLS AUTO-INJECTOR EPINEPHRINE ADMINISTRATION OPTIONAL SKILL (UPDATED 08/2017) In order for PSFA, EMR or EMT personnel to administer auto-injector epinephrine, they must:
More informationAppendix 1. Care Plan Templates. Supporting pupils with medical conditions
Appendix 1 Care Plan Templates Supporting pupils with medical conditions March 2018 Contents page Model process for developing individual health care plans Template 1 Individual health care plan (IHCP)
More informationNursing Services Fall 2011
Nursing Services Fall 2011 RCW 28A.210.320 states life-threatening condition means a health condition that will put the child in danger of death during the school day. Medical Orders Staff Education Student
More informationSTEP-BY-STEP GUIDE TO SELF-INFUSION. Subcutaneous Administration of GAMMAGARD LIQUID
STEP-BY-STEP GUIDE TO SELF-INFUSION Subcutaneous Administration of GAMMAGARD LIQUID This handy guide will help you manage your subcutaneous administration of GAMMAGARD LIQUID. If you have questions on
More informationHealth Point: Understanding Allergic Reactions
Health Point: Understanding Allergic Reactions What are allergies? Every person s body is different. People s bodies can react differently to the same things. For example, you may like to eat fish, but
More informationSAN JOAQUIN COUNTY EMERGENCY MEDICAL SERVICES AGENCY. Administration of Epinephrine Auto-Injector Training
SAN JOAQUIN COUNTY EMERGENCY MEDICAL SERVICES AGENCY Administration of Epinephrine Auto-Injector Training Disclaimer: Authorization - EMT Optional Skills Only authorized Emergency Medical Technicians (EMT)
More informationEpiPen Jr : Unidose 0.15 mg epinephrine auto-injector
PART III: CONSUMER INFORMATION EpiPen Sterile epinephrine injection, USP Unidose 0.3 mg epinephrine Auto-injector EpiPen Jr Sterile epinephrine injection, USP Unidose 0.15 mg epinephrine Auto-injector
More informationCHAPTER 9. Shock National Safety Council
CHAPTER 9 Shock Shock Dangerous condition: Not enough oxygen-rich blood reaching vital organs, such as brain and heart Caused by anything that significantly reduces blood flow Life-threatening emergency
More informationWelcome to Cleveland Hill!
Welcome to Cleveland Hill! We are so glad you are here! This is some important information from the health office: An updated immunization record is required by the start of school. This may be obtained
More informationPATIENT AUTHORIZATION AND NOTICE OF RELEASE OF INFORMATION (PAN)
XOLAIR Access Solutions is a free program for you from Genentech. We work to help you pay for your XOLAIR (omalizumab) for subcutaneous use. We can help in many different ways. We assist people who have
More informationSTUDENT HEALTH FORM. Name of Student Birth Date Sex (MM/DD/YY) Entrance Date (MM/DD/YY) Siblings in the School (names and grades)
STUDENT HEALTH FORM If you are a new student enrolling at AISC, please attach a copy of the immunization records & proof of physical exam in the last 12 months & submit the complete form to: Sanja Ilic,
More information