1. EpiPen Module

2. Senate Bill 25 FN
Approximately 5 months ago, Senate Bill 25 FN was passed, allowing schools to have EpiPens available to any student showing signs or symptoms of anaphylaxis, and for the school nurse to train school personnel on the administration of EpiPens.
The training module should include how to recognize signs and symptoms of severe allergic reactions, standards for the storage and administration of EpiPens, follow-up procedures, and a certificate of completion.

3. Mylan Corporation
Between 2009 and 2016, Mylan raised the price of EpiPens by 400%, although the cost of the actual medication inside the pen costs only a few dollars.
It costs $600 to buy a two-pack of EpiPens, and they expire within a year.
To combat this issue, Mylan hosts the EpiPen4Schools program, which supplies four free EpiPen or EpiPen Jr. auto-injectors in the form of two EpiPen “2 Pak” cartons to schools in the program each year.
(Mylan Corporation, 2016)

4. What is an EpiPen?
The EpiPen 0.3 mg and EpiPen Jr. 0.15mg are for people who have a history of life-threatening allergic reactions (anaphylaxis).
These devices are self-injectable devices that contain epinephrine. According to the National Food Allergy Guidelines, epinephrine is the first-line treatment for life-threatening allergic reactions
This is what epinephrine looks like when it is not in Epipen form.
This is an EpiPen set.

5. What is Anaphylaxis?
Anaphylaxis is a potentially life-threatening reaction to an allergen.
Examples of allergens include: Bee stings, Certain foods, Peanut butter etc.

6. How to recognize Anaphylaxis?

7. Signs and Symptoms of Anaphylaxis:

8. Early S/S: Runny nose Skin rash (Itchiness) A “strange feeling”
(Anaphylaxis, 2014).

9. Serious S/S: Trouble breathing Hives/Swelling Tightness of the throat
Hoarse voice
Nausea/Vomiting/Diarrhea
Dizziness
“Feeling of Doom”
(Anaphylaxis, 2014)

10. Anaphylaxis Action Plan
An anaphylaxis action plan is necessary for those who are at an increased risk of anaphylaxis.
A plan must be placed to avoid known allergens.
It is crucial to be prepared in case exposure to an allergen occurs.
At Risk Situations
Dining out
Traveling
School and camp
Field Trips
Holidays

11. An Action Plan should include 4 basic steps:
1- Avoiding known allergens
2- Recognizing signs and symptoms of known allergens
3- Having immediate access to two EpiPens at all times
4- Seeking immediate medical care should anaphylaxis occur
Details such as a list of known allergens, emergency contact information, current medications, and your healthcare professional’s contact information may be helpful to add to the action plan.

12. Administration: Hold the EpiPen and pull off the blue activation cap
Place the orange tip against the thigh and push firmly, you should hear a click once the needle enters the thigh, hold for several seconds
Remove the EpiPen and massage injected area for several seconds
Check that the orange needle cover automatically covers the injection needle
Prepare for side effects: anxiety, paranoia, uncontrollable shaking
Call 911
How to Give an EpiPen or EpiPen Junior

13. Administration Video EpiPen Administration Video

14. Quiz
Give this post-test quiz to participants to test their EpiPen knowledge:
Quiz
Answers are in the notes section of this PowerPoint!
1-D
2-A,B,C
3-D
4-D
5-B
6-B
7-B
8-D
9-A,B,D
10-D

15. Checklist
The school nurse will complete this checklist for each participant in order to evaluate his or her knowledge on EpiPen administration
Checklist

16. We want your feedback!
To evaluate this module, we ask that the school nurse complete this evaluation on the module:
Evaluation Form

17. Optional Certificate of Completion

18. References
Anaphylaxis. (2014). Retrieved October 06, 2016, from
How to Give an EpiPen or EpiPen Junior [Administration Steps]. (n.d.). Retrieved November 18, 2016, from ive_EpiPen.png
Mylan Corporation: EpiPen4Schools (2016). Retrieved October 13, 2016, from
New Hampshire SENATE BILL 25-FN, 2016 SESSION (2016). Retrieved from General Court State of New Hampshire Database. id=103&txtFormat=html