Allergies & Allergies & AnaphylaxisAnaphylaxisAllergies & Allergies & AnaphylaxisAnaphylaxis

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What is an Allergy?What is an Allergy?Allergies occur when the immune system becomesunusually sensitive and overreacts to commonsubstances 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 What is Anaphylaxis?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-Why is this life-threatening?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 Prevention = Having a PlanPlan

• 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 Mild or Early AnaphylaxisAnaphylaxis

• 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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Mild to Moderate Anaphylaxis : Hives and Swelling of face

Before giving Epinephrine After giving Epinephrine

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Moderate or Severe Moderate or Severe AnaphylaxisAnaphylaxis

• 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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Anaphylaxis: What should I do?

1. Administer single dose epinephrine auto-injector 2. Call 9113. Notify Parent/Guardian4. Administer second auto-injector in 10 to 15 minutes,

or sooner IF symptoms do not improve or if symptoms recur

5. 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, What is a Single Dose, Epinephrine Auto-Epinephrine Auto-

injector?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 What is in an EpiPen®?EpiPen®?

Single dose of epinephrine

www.healthofstudentren.com

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Using the EpiPen® Using the EpiPen® Auto-InjectorAuto-Injector

1. Remove the device from the plastic protective container

2. Remove the GREY GREY capcap from device

3. Press BLACK tip to thigh until a loud “click” is heard

4. Hold in place for 10-15 seconds

www.allergycapital.com.au

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Using the EpiPen® Using the EpiPen® Auto-InjectorAuto-Injector

5. Remove the pen from the thigh6. The needle can now be seen, place auto-

injector back in protective case7. Apply pressure to injection site with a

tissue or bandage if there is bleeding8. Follow Standard Precautions for your

safety

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What is a What is a Twinject®?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

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Using the Twinject® Auto-Injector

1. Pull off GREEN end cap labeled “1”

2. Pull off RED end cap labeled “2”

3. Press GREY cap into outer thigh until unit activates

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Using the Twinject® Auto-Injector

4. Hold Twinject® in place for 10 seconds

5. Apply pressure to injection site with a tissue or bandage if there is bleeding

6. 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

• Don’t give anything to drink

• Send auto-injector with student to hospital

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Conclusion:Conclusion:Follow the three A’sFollow the three A’s

• 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. – Don’t delay!

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ResourcesResources

• 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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ReferencesReferences

• 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?Any Questions?