Emergency Supply of Epinephrine Auto Injectors on School Property An online training for all school staff (Revised August 2017)

Objectives Understand the Law (GS115C-375.2A). Know your role: Recognize signs and symptoms of anaphylaxis. Know what to do in the event of an anaphylactic reaction

GS 115C-375.2A School Supply of Epinephrine Auto-injectors Effective November 1, 2014 Schools shall supply emergency epinephrine For use by trained school personnel To provide emergency medical aid to persons suffering from anaphylaxis (severe life threatening allergic reaction) Minimum of two epinephrine auto-injectors in secure, but unlocked, easily accessible location on each school campus Epinephrine auto-injector – disposable drug delivery system, spring activated, injection designed for emergency administration of epinephrine to provide rapid, convenient first aid for anaphylaxis

Law (Continued) Training of designated personnel Initial and annual training required Emergency auto-injectors not to be used as sole medication supply for students with known severe allergies who are authorized to have their own epinephrine at school School system and employees shall not be liable in civil damages (Good Samaritan Act)

Anaphylaxis is a severe or potentially life-threatening allergic reaction that occurs very QUICKLY It must be treated IMMEDIATELY The drug of choice is epinephrine What is Anaphylaxis? Many choices for epinephrine: epi pen, epi pen jr., adrenaclick, and auvi q

Most Common Allergens Food Allergies: (8 foods are responsible for 90% of ALL food related anaphylactic episodes) Milk (milk containing products) Egg Peanut Tree nuts (walnuts, cashews, pecans, almonds, etc.) Fish Shellfish Soy Wheat Insect Stings Latex or latex containing items (gloves)

Mild Symptoms NOSE: Itchy/runny nose/sneezing MOUTH: Itchy mouth SKIN: Few hives/mild itch ABDOMINAL AREA/STOMACH: Mild nausea/discomfort MILD SYMPTOMS can progress QUICKLY to SEVERE SYMPTOMS >>>ANAPHYLAXIS<<<

ANAPHYLAXIS (Severe Symptoms: one or more of the following) LUNG: Short of breath/wheezing/repetitive cough HEART: Pale/blue skin/faint/weak pulse/dizzy THROAT: Tight/hoarse/trouble breathing or swallowing MOUTH: Swelling of tongue and/or lips SKIN: Widespread hives and/or redness over the body GUT: Repetitive vomiting/severe diarrhea and/or cramping OTHER: Feeling something bad is about to happen/anxiety/confusion

Emergency Epinephrine Care Plan Designated trained school personnel are authorized to use emergency epinephrine auto-injector devices to deliver emergency medical aid to any person suffering from an anaphylactic reaction during the school day or at a school sponsored event on school property. ***NEED TO GET EPI PACKAGING FOR LAST PICTORIAL*** For MILD SYMPTOMS FROM A SINGLE SYSTEM AREA, FOLLOW THE DIRECTIONS BELOW: Stay with the person; contact parent/guardian. Watch closely for changes. If symptoms worsen, give epinephrine and call 911. INJECT EPINEPHRINE IMMEDIATELY Less than 66 lbs. give EpiPen Jr. 66 lbs and greater, give EpiPen Call 911. Tell them the person is having anaphylaxis and may need epinephrine when they arrive. Lay the person flat, raise legs and keep warm. If breathing is difficult or they are vomiting, let them sit up or lie on their side. If symptoms do not improve, or symptoms return, a repeat dose of epinephrine can be given 5 minutes or more after the first dose. Contact parent/guardian.   Resources: http://www.foodallergy.org/cdc; http://www.nasn.org/ToolsResources/FoodAllergyandAnaphylaxis/GetTrained  

What Happens Next? ACT FAST Recognize signs and symptoms. Administer Epinephrine Notify trained first responders Activate EMS Never leave person alone Contact parents/guardians Follow crisis plan/emergency care plan/individualized per person and school. Document Most of these things are done simultaneously

Post Test Print, complete and submit to School Nurse Anaphylaxis training post text.docx Thank you!