1. Severe Allergic Reactions PLSD Staff August 2011 Sharon Schmitz, RN,MSN Health Program Coordinator

2. Symptoms of Severe Allergic Reaction (Anaphylaxis) Flushed face Dizziness Seizures Confusion Weakness Paleness Hives all over body Blueness around mouth, eyes Difficulty breathing Drooling or difficulty swallowing Loss of consciousness

3. Possible Causes of Allergic Reaction Insect stings (bees) Medication Foods Sometimes unknown

4. Food Allergy Basics Symptoms may occur within minutes to two hours after ingestion Almost any food can cause a reaction There is no cure for food allergy Complete and strict avoidance is the only way to prevent a reaction

5. Eight foods cause 90% of allergic reactions in the US Milk Eggs Peanuts Tree nuts Wheat Soy Fish Shellfish

6. Food Allergy Basics Foods that cause the majority of severe or anaphylactic reactions: –Peanuts –Tree nuts –Fish –Shellfish

7. What does it mean to have a Food Allergy? Strict avoidance of that food Constant vigilance Tasting just a tiny bit can be deadly.

8. Causes of Accidental Exposures Not reading ingredient label to be sure food is allergen-free Food trading Inaccurate labeling Contamination from other foods from improperly cleaned utensils and table surfaces

9. Cleaning Cleaning is essential to prevent accidental exposure Hand washing is important. Use soap and water.

10. There is no way to know how serious a reaction will become, so it is important to treat all reactions quickly

11. Food Allergy Facts The same food can cause different symptoms from one student to another Not all children have severe reactions to a food Some mild reactions may become severe A food allergy management plan is needed for all students with severe food allergy and may include the need to administer emergency medication

12. Managing food allergies in schools requires teamwork between staff, parents, and students.

13. Allergen Avoidance Provide information for substitute teachers in a prominent place. Inform parent/guardians of allergic student in advance of any in-class event where food will be present Encourage hand washing before & after eating

14. Encourage Non food rewards Pencils, pens Stickers Bookmarks Yo yo Slinkies Silly Putty Crazy straws Extra recess Certificate Pat on the back Verbal praise Special seat First in line Listen to music

15. Allergen Avoidance Be cautious of cross contamination of surfaces where the substance may have touched. Tables, desks, countertops, etc. must be thoroughly cleaned to remove any debris.

16. Immediately initiate the allergy action plan if a student reports symptoms of an allergic reaction.

17. Allergic Reaction Symptoms Respiratory Tract: –Itchy, watery eyes, running or stuffy nose, cough, itching or swelling of the lips, wheezing GI Tract: –Abdominal cramps, nausea, vomiting, diarrhea Skin –Hives, eczema, itchy, red rash, swelling Symptoms may progress rapidly to severe reactions

18. Anaphylaxis Severe Allergic Reaction Potentially life-threatening reaction Requires immediate medical attention Effects multiple body systems –Breathing difficulties –Drop in blood pressure –Shock Avoidance of the allergen is the only way to prevent allergic reaction

19. In the event of suspected reaction: Call 911 Refer to student’s plan. Administer doctor and parent approved medication (epinephrine) as indicated Call parent

20. How to Administer an EpiPen Copy and paste the link below to view video on the proper administration of an EpiPen. http://www.epipen.com/how-to-use- epipen

21. Epi-pen Administration Epi-pen is an Epinephrine Autoinjector Remove from plastic cylinder Remove grey cap Place black tip against student’s outer thigh Press firmly into outer thigh - hear click Hold in place for 10 seconds Remove device and massage gently for 10 seconds Save device for EMT Continue to monitor while waiting for squad Student does not remain at school. Transported by squad or parent

22. PLSD School Nurses 2011-12 Rhonda Carmel, RN –Central –Diley Marni Dreher, RN –North Kim Hively, RN –Toll Gate Middle –Toll Gate Elementary –Heritage Sharon Schmitz, RN Harmon Fairfield Marcia Stewart, RN Ridgeview Sycamore Creek Violet Tami Tackett, RN Lakeview Pickerington Tussing