ALLERGIES AND ANAPHYLAXIS

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ALLERGIES AND ANAPHYLAXIS

• Causes, Symptoms and Treatment

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What is Allergy?

• Exaggerated response to natural substances
• Types of possible allergens
• Inhaled pollen, dust mites, molds, latex, animal
  dander, cockroach droppings, Ingested foods and
  medicines
• Injected bee stings, fire ants, or medicine by
  needle or IV
• Absorbed (by the skin) latex, poison ivy
• Inhaled Non-natural chemical odors, smoke

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Allergy Statistics

• About 1 in every 4 adults and children have
  allergies
• Sixth leading cause of chronic disease in the
  United States
• About 50 million Americans live with hay fever or
  allergic rhinitis
• Allergic rhinitis and asthma are the 2 leading
  causes of school absenteeism
• Approximately 2.2 million school age children
  have food allergy
• One in every 17 children under age 3 has a food
  allergy

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Common Symptoms of Inhaled Allergens

• Runny nose
• Sneezing
• Congestion
• Itchiness in throat or nose
• Red, itchy, burning eyes
• Raspy voice

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Danger! Anaphylaxis

• Some allergy reactions can cause a dangerous,
  life-threatening reaction referred to as
  Anaphylaxis
• 150 people die annually from food allergies
• At least 40 deaths occur annually from reactions
  to insect stings
• Approximately 220 cases of anaphylaxis and 3
  deaths per yr are caused by latex allergy

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Types of Allergies that could lead to an
Anaphylactic response

• Ingested allergens foods medicines
• Injected allergens stings, medicines via needle
  or IV
• Absorbed allergens latex, poison ivy, oak or
  sumac

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Some may only have one or two visible symptoms

• Symptoms will usually occur within one hour of
  exposure to the allergen some may react within
  seconds or minutes
• Symptoms of food allergy, insect sting,
  medication, latex allergy are only different from
  anaphylaxis symptoms by degree
• If someone has potentially life-threatening
  allergies and they have a reaction, treat it as a
  threat

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Food Allergy is a common cause for anaphylaxis

• Food allergy is an abnormal immune system
  response to a food
• Food intolerance is sensitivity to a food
• Intolerance to a food may change over time
  reactions are usually digestive in nature
• Approximately 3 of all elementary age children
  have DIAGNOSED food allergies
• Those with true food allergy must always avoid
  their triggers or allergens

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The Most Common Allergic Foods

• Cows milk
• Hens eggs
• Peanuts, a legume
• Tree Nuts (pecan, walnut, Almond, etc)
• Soybeans, a legume
• Wheat

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Peanut Allergy

• One out of every 150 people has a peanut allergy,
  mild to severe
• Some can eat a handful of peanuts before having a
  reaction, others will have a severe reaction just
  by smelling or touching peanut residue
• Peanut allergies are unpredictable
• Schools must take steps to prevent
  cross-contamination

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What are the Symptoms of Anaphylaxis?

• Skin that turns red
• Hives
• Itching skin or mouth
• Tightness in the throat, wheezing
• Difficulty breathing
• Cardiovascular collapse with sweating
• Pale tint or blue tint to skin or nails
• Unresponsiveness

• Coughing
• Vomiting
• Diarrhea
• Behavioral changes
• Hoarseness or change in the voice
• Swelling in the face, hands, or feet
• Sense of doom
• Faintness or unconsciousness

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Quick Action Required!

• If not treated immediately, anaphylaxis can cause
  death within minutes
• The only treatment for anaphylaxis is an
  injection of adrenaline also known as epinephrine
  

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3 of 4 deaths from anaphylaxis in children occur
in school
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Identify Students With Life Threatening Allergies

• Create an action plan accessible by all
• Include a current photo, known allergens to be
  avoided, management plan and contact information
• All school personnel should know about any child
  who could have an anaphylactic reaction

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Epinephrine Auto-Injectors

• Texas law allows children to carry and
  self-administer their own epinephrine with
  physician and parental permission
• This doesnt mean the child can or will use it on
  themselves if needed
• All adults in the school environment MUST know
  how to use an auto-injector

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Emergency Procedures

• Anaphylaxis can occur in 2 stages an initial
  response and minutes or hours later, another
  response
• Watch the child for at least 4 hrs after contact
  with the suspected allergen
• Administer the auto-injector as soon as the child
  shows any of the symptoms
• Follow their emergency plan, call 911
• and get them to the hospital immediately

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If the child has asthma his physician might
recommended inhaled albuterol after using
epinephrine

• Some physicians also recommend giving an
  antihistamine after using epinephrine for some
  patients

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Steps to administer an auto-injector

• grasp the auto-injector with the hand (forming a
  fist around the unit) with the black tip facing
  downward. Immediately before use, remove the gray
  activation cap with the other hand, being careful
  not to touch the black tip, where the needle is
  located, at any time.

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Step Two

• After uncapping the auto-injector, place the
  black tip near the fleshy outer portion of the
  thigh. It is not necessary to remove any
  clothing the auto-injector is designed to work
  effectively through clothing. Do not touch the
  black tip of the auto-injector at any time.

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Step Three

• With a quick motion, swing out and jab firmly
  into the outer thigh, so that the injector is at
  a 90 degree angle to the thigh. Hold firmly in
  the thigh for several seconds. During this time,
  a spring-activated mechanism is released, and a
  dose of epinephrine is administered. Remove the
  unit and massage the injection site for an
  additional few seconds.

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Disposing of the Injector

• Once administration is complete, check the black
  tip of the auto-injector. If the needle is
  exposed, a dose of epinephrine was injected. If
  not, the above steps should be repeated. Most of
  the liquid (90) stays in the auto-injector after
  the dose is administered and cannot be reused.
• To avoid an accidental needle stick, the needle
  of the fired unit should be bent back against a
  hard surface. Carefully return the auto-injector
  to its carrying tube (NEEDLE FIRST) without
  replacing the gray safety cap. Recap the carrying
  tube and bring it to the emergency care facility
  for proper disposal.

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Younger children wont or cant verbally express
symptoms Learn Child Speak

• Might put hands in mouth
• Pull or scratch at their tongues
• Their voice may change, getting squeaky or hoarse
  or even slurring as the tongue swells

• May say their tongue feels hot, burning, like
  something is poking their tongue or it itches,
  feels funny, heavy
• May say feels like frog in throat or something is
  stuck
• May scratch ears

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Never leave the child alone

• Ideally, a second auto-injector should be
  available if needed may be administered every
  15-20 min.
• Always follow physicians directions
• Call 911, contact parents, accompany child to
  hospital till parents arrive

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The Best Action Is To Prevent Exposure to Life
Threatening Allergens

• Schools should become pro-active
• Develop school-wide plan of protection
• Exclude food allergens from schools
• Create Emergency Plans and post where visible by
  all and hold emergency drills
• These steps may save a childs life