Allergy Awareness & EpiPen Administration

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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 abnormal response to a normal substance. This is the body s attempt to defend itself against substances that are perceived by the body to be harmful (an Allergen). * Symptoms can occur up to 72 hours or more after exposure to the allergen and can last up to several days. Symptoms may or may not be life threatening.

What is Anaphylaxis? * Anaphylaxis is the life threatening form of an allergic reaction. * It is a sudden, severe allergic response that usually produces breathing difficulties, cardio vascular collapse and possible death. * Usually occurs 1-15 minutes after exposure, rarely after 2 hours. * Symptoms in two or more body systems is considered ANAPHYLAXIS. * Requires immediate action Epi Pen

Symptoms that can occur during an Allergic or Anaphylactic Reaction * Skin: Hives, swelling, itchy red rash * Gut: Cramps, nausea, vomiting, diarrhea, gas * Neuro: Weakness, impending doom feeling * Respiratory: Itchy, watery eyes; runny nose; stuffy nose; sneezing; cough; itching or swelling of lips, tongue or throat; changes in voice; difficulty swallowing; tightness in chest; wheezing; shortness of breath; repetitive throat clearing. * Cardiovascular: reduced blood pressure, increased heart rate, shock, pale and sweaty.

Recognize Anaphylactic Reactions * Be aware of the students in your classroom/school that have life threatening allergies. * Know what the student is allergic to * Recognize the signs and symptoms of an Anaphylactic Reaction. * Know where student s Epi pen is located. ASK!!! * RESPOND to those symptoms * Do Not Ignore or send to office alone

Emergency Procedure if an Anaphylactic Reaction occurs in your Classroom * Identify the student and known allergy, determine if allergen was ingested. * If student does NOT have a known allergy or does NOT have a Health plan and exhibits symptoms in two or more body systems administer stock Epi Pen. * Locate Epi Pen: Ask the student if they have their Epi Pen on their person or call front office for Epi Pen. * Administer Epi Pen * Call 911/ Stay with student * DO NOT send a student who you suspect of having an allergic reaction to the Office. Request epi pen to be brought to your location if not carried by student. * Contact parents immediately.

How does Epinephrine work? * Quickly constricts blood vessels * Relaxes smooth muscles in the lungs to improve breathing * Stimulates heartbeat * Works to reverse hives and swelling around the face and lips * Wears off in 10-20 minutes, sometimes requires a second dose, critical that 911 is called and student transported to emergency room or directives of parent.

Procedure for Epi Pen Injection Check if Fluid is Clear Do Not Inject if Fluid is Brown

Activate Syringe * Remove from protective container, then: * Pull off Blue safety cap * Blue to the Sky, Orange to the thigh

Injection Procedure " Hold syringe firmly in hand, Orange to thigh, Blue to Sky. " 90 degree angle to thigh " Use thigh opposite of an insect bite " Press hard into thigh through clothes " Hold in place and count 3 seconds " Remove pen " Massage area " Call 911, give used epi pen to emergency responders

Auvi-Q Epinephrine Auto Injector

Talking Directions to Administer: Remove cover, place on side of thigh, push with command and count 5 (follow verbal commands)

Epinephrine Auto Injector Videos * How To Administer Epipen * Generic Mylan Epi Pen video * How to Administer an Auvi-Q * Generic Impax Epinephrine Auto Injector

School Stock Epinephrine Cabinet * To be used by trained school staff for students experiencing a severe anaphylactic reaction * Green for less than 60 lbs: Yellow for 60 lbs and greater * Always use the student s Epi pen first if possible * Located In front office in bright yellow cabinet

Allergy Action/ Emergency Care Plan # Individual specific to the student # Should go to all staff involved with student # Information should be treated 2/10/17 with care FAAN, 2012 ALLERGY & ANAPHYLAXIS - EMERGENCY ACTION PLAN School Year: Picture Allergy Medication Authorization & Epinephrine Auto-Injector Authorization (EAI) Self-Administration Form In Accordance with UCA 26-41-104 Utah Department of Health STUDENT INFORMATION Asthma: Yes (if yes, high risk for severe reaction, please also complete IHP101.1 form) No Student: DOB: School: Grade: Parent: Phone: Email: Physician: Phone: Fax or email: School Nurse: School Phone: Fax or email: EXTREMELY REACTIVE TO THE FOLLOWING: Allergen(s): If checked, give epinephrine immediately if the allergen was LIKELY eaten, for ANY symptoms. If checked, give epinephrine immediately if the allergen was DEFINITELY eaten, even if no symptoms are apparent. peanuts tree nuts soy fish shellfish wheat eggs (safe to have in baked goods) dairy (safe to have in baked goods) dairy (NOT safe to have in baked goods) eggs (NOT safe to have baked goods ) latex animals medication insect stings (list) other ACTIONS FOR MILD TO MODERATE ALLERGIC REACTION For MILD SYMPTOMS from A SINGLE SYSTEM area, follow the directions below: MILD Symptoms Antihistamines may be given, if ordered by a healthcare provider. Nose itchy/runny nose Stay with the person; alert emergency contacts. Mouth- Itchy mouth Watch closely for changes. If symptoms worsen, give epinephrine. Skin A few hives, mild itch Gut Mild nausea/discomfort, one episode of mild vomiting (not repetitive) ACTION FOR SEVERE ALLERGIC REACTION (ANAPHYLAXIS) SEVERE Symptoms Lung-short of breath, wheezing, repetitive cough Heart-pale, blue, faint, weak pulse, dizzy Throat-tight, hoarse, trouble breathing or swallowing Mouth-significant swelling of the tongue and/or lips Skin-Many hives over body, widespread redness Gut-Repetitive vomiting, severe diarrhea Other-Feeling something bad is about to happen, anxiety, confusion For MILD SYMPTOMS from MORE THAN ONE system area, GIVE EPINEPHRINE 1. INJECT EPINEPHRINE IMMEDIATELY. 2. Call 911. Tell them the child is having anaphylaxis and may need epinephrine when they arrive. 3. Consider giving additional medications following epinephrine Antihistamine Inhaler (bronchodilator) if wheezing 4. Lay the person flat, raise legs and keep warm. If breathing is difficult or they are vomiting, let them sit up or lie on their side. 5. If symptoms do not improve, or symptoms return, more doses of epinephrine can be given about 5 minutes or more after the last dose. 6. Alert emergency contacts. 7. Transport them to emergency department even if symptoms resolve. Person should remain in ED for at least 4 hours because symptoms may return. MEDICATION Epinephrine (EAI) Brand: Epinephrine Dose: 0.15 mg IM 0.3 mg IM Side Effects: Antihistamine Name: Dose: Side Effects: Other: (e.g., inhaler-bronchodilator if wheezing) Other Dose: Side Effects: Location of epinephrine: Student Carries Backpack In Classroom Health Office Front Office Other: PRESCRIBER TO COMPLETE The above named student is under my care. The above reflects my plan of care for the above named student. It is medically appropriate for the student to self-carry Epinephrine Auto Injector (EAI) medication. The student should be in possession of EAI medication and supplies at all times. Student can self-carry and self-administer EAI if needed, when able and appropriate. Student can self-carry, but not self-administer EAI. It is not medically appropriate to carry and self-administer this EAI medication. Please have the appropriate/designated school personnel maintain this student s medication for use in an emergency. Healthcare Provider (print): Signature: Date: UDOH IHP104.1 Page 1 of 2

Health Plan Book in Health Room Cabinet This Red Notebook has all student Health Care Plans and is located in the Health room cabinet. Please check this notebook to confirm you have a student s plan.

Red Caduceus in Power School This red caduceus symbol appears above a name in Power School or Power Teacher when medical information is in the Medical Alert box. This information is listed by year. ** A student with a Health Care Plan will have information in this alert box.

How to reduce allergens in your classroom * Read all ingredients each and every time * Check all ingredients of items used for projects: soils, glues, paints, make up products can have allergens. * Encourage good hand washing hygiene for all students especially after lunch or snack * Safest to have a no food rule in class if have severe allergic student. School Administrator to set food guidelines. * Sub folders must have a copy of health plans

Field Trip Requirements * Notify School Nurse of all Field Trip dates * Ensure your allergic students have Epi pen/inhaler before leaving the school. * Bring copy of Allergy Action Plan and parent phone numbers. * Contact parent with 504 to discuss field trip, cannot request parent to go because of allergy. * If medication kept in health office check out and carry for student, form to sign in medication book out/in.

Now let s Get Trained!! The Good Samaritan Law protects all individuals who administer an Epi Pen from liability.! All staff members will need to review the A Shot to Live module on PCSD website under Health Services.! Demonstrate Epinephrine Auto injector skills with your school nurse once completed watching the video.