1. Allergies & Anaphylaxis

2. 2 What is an Allergy? Allergies occur when the immune system becomes unusually sensitive and overreacts to common substances 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)

3. 3 What is 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

4. 4 Why is this life- 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

5. 5 Prevention = Having a Plan 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

6. 6 Mild or Early Anaphylaxis Itching of the lips or mouth Flushing or sweating Anxiety and/or restlessness Mild irritating cough or sneezing Hives Neck and Facial swelling

7. 7 Mild to Moderate Anaphylaxis : Hives and Swelling of face Before giving EpinephrineAfter giving Epinephrine www.natureshomoeo.com.au/image/student.JPG

8. 8 Moderate or Severe Anaphylaxis 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

9. 9 Moderate Allergic Reaction: Swollen lips/face and hives present www.sovereign-publications.com/.../ANAPHYL.jpg

10. 10 health.yahoo.com/media/healthwise/h9991075.jpg

11. 11 Anaphylaxis: What should I do? 1.Administer single dose epinephrine auto-injector 2.Call 911 3.Notify Parent/Guardian 4.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

12. 12 What is a Single Dose, Epinephrine Auto-injector? A single dose auto-injector is an easy way to give epinephrine/adrenaline to someone having an allergic reaction E.g. EpiPen ®, Twinject ®

13. 13 What is in an EpiPen®? Single dose of epinephrine www.healthofstudentren.com

14. 14 Using the EpiPen® Auto-Injector 1.Remove the device from the plastic protective container GREY cap 2.Remove the GREY cap 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

15. 15 Using the EpiPen® Auto-Injector 5.Remove the pen from the thigh 6.The needle can now be seen, place auto- injector back in protective case 7.Apply pressure to injection site with a tissue or bandage if there is bleeding 8.Follow Standard Precautions for your safety

16. 16 What is a 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 www.outdoored.com

17. 17 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

18. 18 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)

19. 19 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 Dont give anything to drink Send auto-injector with student to hospital

20. 20 Conclusion: Follow the three As 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. –Dont delay!

21. 21 Resources 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

22. 22 References 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.

23. 23 Any Questions?