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Anaphylaxis in Schools
Recognizing Anaphylaxis Epinephrine Auto-injector
Administration
Betsy Stoffers RN 2014
Common causes Food (most commonly – peanuts,
walnuts, pecans, shellfish, eggs, milk, soy, and wheat)
Medication Insect stings Latex
Less common causes Exercise Food-dependent exercise-induced
anaphylaxis (occurs when a person eats a specific food and exercises within 3-4 hours after eating)
Idiopathic anaphylaxis (anaphylaxis with no known apparent cause)
General symptoms of anaphylaxis Mouth: itching, tingling, or swelling
of lips, tongue, and mouth Skin: Hives, itchy rash, swelling on
the face or extremities Gut: Nausea, abdominal cramps,
vomiting, diarrhea General: Panic, sudden fatigue,
chills.
Life-threatening symptoms Throat: Tightening of the throat,
hoarseness, hacking cough Lung: Shortness of breath,
repetitive coughing, wheezing Heart: Passing out, fainting,
paleness, blueness Most dangerous symptoms are
breathing difficulties and fainting.
Anaphylaxis is likely when: Acute onset of symptoms (several
minutes to two hours after exposure) of skin/mucosal – hives, swelling, flush & breathing problems or fainting.
Any TWO of the general symptoms. ANY of the life-threatening symptoms.The severity of symptoms can change
quickly.
Bi-phasic reaction Some individuals have an
anaphylactic reaction and the symptoms go away only to return a few hours later.
This bi-phasic reaction often presents in the respiratory system, therefore -
After a severe reaction observation in a hospital setting is necessary.
Administration of Epinephrine
Steps in the Emergency Use of an Epinephrine Auto-
InjectorEpinephrine auto-injector
Steps in the Emergency Use of an Epinephrine Auto-Injector (Epinephrine auto-injector)
Determine if anaphylaxis is reasonably suspected based on symptoms present.
Do not leave the child alone – Call 911 Most severe allergic reactions in
children involve trouble breathing. Children will need to sit calmly and upright. HOWEVER if there is fainting let the child lie down with legs raised.
Administration of Epinephrine Auto-Injector
Grasp auto-injector in one hand and form a fist around the unit.
Remove gray activation cap. Hold tip near outer thigh. Swing and jab firmly into outer thigh.
Hold in place and count to 10. Remove from thigh and massage
area.
Administration of Epinephrine Auto-Injector
Check the tip. If the needle is exposed the dose was delivered. If not exposed repeat the administration. Note the time.
Remain with student. Await emergency personnel. Give auto-injector to emergency personnel and time of administration.
Emergency Medical Services*911*
After Epinephrine has been administered, emergency medical care MUST be obtained immediately because severely allergic students may need basic life support if they stop breathing.
A delayed or bi-phasic reaction may occur.
Transportation to an emergency room must occur after epinephrine is given.
Allergies can be life-threatening. Exposure to offending allergens can result in anaphylaxis.
Anaphlyaxis, however, is preventable by strict avoidance of offending allergens and treatable by auto-injection of Epinephrine (adrenaline) along with medical intervention.
Delegates should be familiar with the following information:
Epinephrine Auto-Injector
Epinephrine is most effective for controlling severe allergic reactions in children.
Through appropriate risk-reduction and allergen-avoidance procedures, the likelihood ofthe need for epinephrine administration can be minimized.
References
Training Protocols for the Emergency Administration of Epinephrine. New Jersey Department of Education. September 2008.