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Massachusetts Department of Public Health School Health Unit


Latex. Bee stings. Allergic Response. People with allergies have over-reactive immune systems ... system recognizes an allergen (food, medication, latex etc) ... – PowerPoint PPT presentation

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Title: Massachusetts Department of Public Health School Health Unit

Massachusetts Department of Public Health -
School Health Unit
  • Program for Unlicensed School Personnel to
    Administer Epinephrine by Autoinjector in
    Life-Threatening Situations

By Elizabeth Gartman, RN August, 2007
Terms to Learn
  • Allergen
  • Immune system
  • Epipen
  • Autoinjector
  • Anaphylaxis
  • Epipen Jr
  • Histamine
  • Chemical mediators

Common Causes of Allergic Emergencies
  • Food
  • Medication
  • Latex
  • Bee stings

Allergic Response
  • People with allergies have over-reactive immune
    systems that target otherwise harmless elements
    of our diet and environment. During an allergic
    reaction the immune system recognizes an allergen
    (food, medication, latex etc). This initiates a
    sequence of events in the cells of the immune
    system resulting in release of chemical mediators
    such as histamine . These chemicals trigger
    inflammatory reactions in the skin, the
    respiratory system, the gastrointestinal system,
    and the cardiovascular system.

What Happens in an Allergic Response?
What is Anaphylaxis ?
  • Anaphylaxis is the widespread and systemic
    reaction of chemical mediators affecting the
    skin, respiratory, GI, and cardiovascular
  • This is a life-threatening emergency!!

What are the Symptoms of Anaphylaxis ?
  • Itching, tingling, swelling of lips, tongue
  • Hives, itchy rash swelling of face or extremities
  • Nausea, vomiting, abdominal cramps, diarrhea
  • Tightening of throat, hoarseness, hacking cough
  • Shortness of breath, wheezing
  • Thready pulse, low blood pressure, fainting, pale

Treatment of Anaphylaxis
  • Anaphylaxis must be treated with an Epipen. This
    is injected into the thigh and works to constrict
    blood vessels and dilate or relax smooth muscles
    in the lungs to improve breathing, stimulates the
    heartbeat, and works to reduce the hives and
    swelling around the face and lips.

Administration of Epinephrine
  • Right patient
  • Right medication
  • Right dose
  • Right route
  • Right time

Epinephrine Dosages
  • Epinephrine is available in 2 strengths
  • Epipen Jr 0.15 mg (use in children up to 60
  • Epipen 0.30 mg over 60 pounds.

How is Epinephrine Stored?
  • Epinephrine is available in what is called an
    autoinjector. It is stored at room temperature
    and should not be subjected to any extremes in
    temperature. The solution is clear and colorless
    and should be replaced if it is not.

How to Administer an Epipen
  • Remove autoinjector from box or cylindrical
    container after making sure the name on the label
    is for the correct student.
  • Pull off gray activation cap.
  • Hold black tip near outer thigh.
  • Swing and jab firmly into outer thigh until
    autoinjector mechanism functions.
  • Hold in place and count to 10. Remove the
    Epipen and massage the injection area for 10

Important Information
  • After injecting the Epipen and removing from the
    student, carefully place the Epipen in its
    original container. If an accidental needle
    stick occurs, medical care should be sought.
  • Send Epipen container to the hospital with the

  • If in doubt about the need to administer
    Epinephrine then go ahead and give it.
  • Most deaths from allergic reactions occur because
    epinephrine was not administered!!!

Protocol for Handling Life Threatening Emergency
  • Observe student
  • Recognize symptoms of anaphylaxis
  • Administer Epipen
  • Call 911
  • Call parents
  • Notify physician

Field Trips
  • All trips out of the school building, even those
    to schools within our district, must be reported
    to school nurse 2 weeks prior to the trip. If
    there is a student with an Epipen, the nurse will
    then send home a permission to delegate form to
    the students parent to sign. The nurse must be
    able to delegate to one person whose name will be
    on that form. The nurse can delegate to staff
    members only!!!

Epipen Video
  • To view a short video on treating an anaphylactic
    reaction with an Epipen go to