Allergies

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Allergies Anaphylaxis
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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 eggs, milk, peanuts/nuts, shellfish and
  some food additives
• Stings from bees, wasps, hornets and some ants
• Medications penicillin, sulfa drugs
• Exercise
• Latex (gloves/medical devices)

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What is Anaphylaxis?

• Occurs when a person is exposed to an allergen
  causing a severe, life-threatening allergic
  response
• Reactions commonly occur within 10-30 min but can
  be delayed for 2-3 hours
• Affects various organ systems including the skin,
  respiratory and cardiovascular

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Why is this life-threatening?

• Causes airway obstruction/lack of oxygen to the
  brain
• Increases risk of SHOCK, which leads to
  widespread tissue damage, organ failure and
  eventually death

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Prevention Having a Plan

• Check the School Medical Alert List to
  familiarize yourself with students in your
  school/class who have medical conditions and
  allergies
• Note all students who require single dose
  auto-injectors and where these are stored for
  each student
• Review emergency care plans for individual
  students
• Recognize allergy sources and triggers
• Know how and when to administer medication

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Mild or Early Anaphylaxis

• Itching of the lips or mouth
• Flushing or sweating
• Anxiety and/or restlessness
• Mild irritating cough or sneezing
• Hives
• Neck and Facial swelling

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Before giving Epinephrine
After giving Epinephrine
Mild to Moderate Anaphylaxis Hives and Swelling
of face
www.natureshomoeo.com.au/image/student.JPG
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Moderate or Severe Anaphylaxis

• Swelling of the throat or mouth
• Chest tightness and pain
• Wheezing or difficulty breathing
• Rapid, weak pulse
• Pallor and low blood pressure
• Dizziness or loss of consciousness

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Moderate Allergic Reaction Swollen lips/face
and hives present
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health.yahoo.com/media/healthwise/h9991075.jpg
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Anaphylaxis What should I do?

• Administer single dose epinephrine auto-injector
• Call 911
• Notify Parent/Guardian
• Administer second auto-injector in 10 to 15
  minutes, or sooner IF symptoms do not improve or
  if symptoms recur
• Have ambulance transport student to hospital
• Epinephrine is the only way to reverse the
  effects of anaphylaxis therefore needs to be
  given ASAP
• Remember, the Epinephrine may only last for 15
  minutes, calling 911 is very important

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What is a Single Dose, Epinephrine Auto-injector?

• A single dose auto-injector is an easy way to
  give epinephrine/adrenaline to someone having an
  allergic reaction
• E.g. EpiPen, Twinject

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What is in an EpiPen?
Single dose of epinephrine
www.healthofstudentren.com
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Using the EpiPen Auto-Injector

• Remove the device from the plastic protective
  container
• Remove the GREY cap from device
• Press BLACK tip to thigh until a loud click is
  heard
• Hold in place for 10-15 seconds

www.allergycapital.com.au
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Using the EpiPen Auto-Injector

• Remove the pen from the thigh
• The needle can now be seen, place auto-injector
  back in protective case
• Apply pressure to injection site with a tissue or
  bandage if there is bleeding
• Follow Standard Precautions for your safety

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What is a Twinject?

• Contains two doses of epinephrine in a single
  device
• First dose given the same way as EpiPen, the
  second dose is a manual inter-muscular injection

www.outdoored.com
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Using the Twinject Auto-Injector

• Pull off GREEN end cap labeled 1
• Pull off RED end cap labeled 2
• Press GREY cap into outer thigh until unit
  activates

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Using the Twinject Auto-Injector

• Hold Twinject in place for 10 seconds
• Apply pressure to injection site with a tissue or
  bandage if there is bleeding
• Follow Standard Precautions for your safety
• Remember, staff are not recommended to give
  dose two (manual IM injection of epinephrine)

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What to do after giving a single dose
auto-injector?

• Have student lie still on his or her back with
  feet higher than the head
• Loosen tight clothing and cover student with
  blanket
• If there is vomiting, turn student on side to
  prevent choking
• Dont give anything to drink
• Send auto-injector with student to hospital

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ConclusionFollow the three As

• Awareness
• Know the triggers
• Know the emergency plan and how to administer
  medication
• Avoidance
• Avoid contact with allergens, make classrooms
  safe
• Action
• Give single dose, single-use auto-injector and
  call 911.
• Dont delay!

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Resources

• For more information contact your Public Health
  Nurse
• www.aaia.ca (Allergy/Asthma Information Assoc.)
• www.anaphylaxis.org (Anaphylaxis Canada)
• www.epipen.ca (EpiPen)
• www.twinject.ca (Twinject)
• www.medicalert.ca
• www.bchealthguide.org/healthfiles

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References

• AAIA Anaphylaxis Reference Kit (2007) by the
  Allergy and Asthma Information Association,
  Health Canada
• Anaphylaxis in Schools Other Settings (2005) by
  the Canadian Society of Allergy and Clinical
  Immunology.

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Any Questions?