Managing Severe Allergies within Schools

What is Anaphylaxis? Anaphylaxis is a severe systemic allergic reaction. At the extreme end of the allergic spectrum. The whole body is affected usually within minutes of exposure to the allergen. It can take seconds or several hours.

Definition of Anaphylaxis Anaphylaxis involves one or both of two features: - Respiratory difficulty (swelling of the airway or asthma). Hypotension (fainting, collapse or unconsciousness).

What exactly is going on? An anaphylaxis reaction is caused by the sudden release of chemical substances, including histamine, from cells in the blood and tissues where they are stored.An anaphylaxis reaction is caused by the sudden release of chemical substances, including histamine, from cells in the blood and tissues where they are stored. The release is triggered by the reaction between allergic antibodies (IgE) and the allergen.The release is triggered by the reaction between allergic antibodies (IgE) and the allergen. Varying sensitivity with individualsVarying sensitivity with individuals

Common causes Peanuts Tree nuts MilkEggSesameFishShellfishWaspBeeLatexPenicillin Blood products DrugsKiwi

What are the symptoms? allergic What are the symptoms? Minor allergic reaction Feeling hot / flushing Itching “Nettle sting-like” rash / welts / hives (urticaria) Red, itchy watery eyes Itchy, runny or congested nose or sneezing Swelling: face, lips, eyes, hands Tummy pain Vomiting or diarrhoea Metallic (funny) taste in the mouth

Action allergic Action Minor allergic reaction Stay with pupil and call for help Send for emergency medication and emergency protocol Give prescribed antihistamine medication If asthmatic, give 4 – 10 puffs of reliever inhaler (blue) Contact parent or carer

What are the symptoms? anaphylactic What are the symptoms? Severe anaphylactic reactions Difficulty breathing, wheeze, breathlessness, chest tightness, persistent cough Difficulty talking, change in voice, hoarseness Swelling, tightness, itchiness of the throat Swollen tongue Impaired circulation – pale clammy skin, blue colour of lips and around mouth, decreased level of consciousness Sense of impending doom Becoming pale/floppy Absent or very weak pulse Collapse and unconsciousness

Action anaphylactic Action Severe anaphylactic reaction If child’s airway is open and child is breathing: Send for emergency medication and care plan Administer EipPen and record time Dial 999 and request paramedic ambulance Keep child in lying down position unless breathing difficulties If child has breathing difficulties then keep in sitting position If no improvement in 5 minutes give 2 nd epipen Contact parents and continue observation until professional help arrives

Types of Reaction Uni-phasic – rapidly developing severe reaction involving the airway or circulation. Bi-phasic – early oral and abdominal symptoms, then a symptom-free period of 1-2 hours, then increasing symptoms involving breathing and circulation.

Treatments Adrenaline is the mainstay of treatment:- Reverses swelling. Relieves asthma. Constricts the blood vessels. Stimulates the heartbeats. A safe drug if given correctly Antihistamines – useful for minor allergic reactions or if reaction coming on more slowly Asthma inhalers

Devices Epipen Auto injector: - Adult dose 0.3mgs Child dose 0.15mgs 2year shelf life Can be given through light clothing

Devices Anapen auto injector: - Adult dose 0.3mgs Child dose 0.15mgs 18 – 24 month shelf life

Devices Jext auto injector:- Adult dose 0.3mgs Child dose 0.15mgs Shelf life of 24 months Can be given through clothing (including denim)

Storage Accessible. Avoid extremes of temperature. Clearly labelled. In date.

Management in schools Allergen avoidance. Early recognition of symptoms. Crisis management.

Allergen avoidance Know the child, and their allergies. Be allergy aware and risk assess. Special occasions. School trips. Cookery lessons, science experiments. School pets, bird tables.

Crisis Management Alleviating fear Indemnity insurance. Individual protocols.

Who’s responsible for what? Written consent. Provide school with full information. Ensure medicine is in date.

A few things to think about! “ Will a supply teacher know who I am?” Kissing can seriously damage your health! Other training needs? e.g. Breakfast and after school clubs, school discos, sports clubs. School visitors, bus drivers/escorts. Mid-day supervisors, catering staff.

Want more information? Contact the Anaphylaxis Campaign Tel: Schools pack Video/DVD Managing Medicines in Schools and Early Years Settings. DH/DfES.