July 2013 Interior Health

Adapted from the Ministry

of Education BCSTA website

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 – peanuts, tree nuts, sesame seeds, milk

eggs, seafood, soy, wheat, sulphites and mustard

Insect bites – bees, wasps, hornets and some ants

Medications – penicillin, sulfa drugs

Exercise

Latex – gloves/medical devices

Reference: Anaphylaxis Canada (2013) 2

WHAT IS ANAPHYLAXIS?

Occurs when a person is exposed to an allergen causing a severe, life-threatening allergic response

Reactions occur within minutes or, more rarely, up to a few hours after exposure

Reference: Anaphylaxis Canada (2013)

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COMMON SYMPTOMS

Skin – hives , swelling, itching, warmth,

redness, rash

Respiratory (breathing) – wheezing, shortness

of breath, throat tightness, cough, hoarse voice,

chest pain/tightness, nasal congestion or hay

fever-like symptoms (runny itchy nose and

watery eyes, sneezing), trouble swallowing

Reference: Anaphylaxis Canada (2013)

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5

Swollen lips/face and

hives present

www.sovereign-publications.com/.../ANAPHYL.jpg

COMMON SYMPTOMS

Gastrointestinal (stomach): nausea, pain/cramps, vomiting, diarrhea

Cardiovascular (heart): pale/blue colour, weak pulse, passing out, dizzy/lightheaded, shock

Other: anxiety, feeling of “impending doom”, headache, uterine cramps in females, metallic taste

Reference: Anaphylaxis Canada (2013)

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Trouble breathing caused by airway swelling

A drop in blood pressure causing dizziness,

light-headedness, feeling faint or weak, or

passing out

Reference: Anaphylaxis Canada (2013)

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MOST DANGEROUS SYMPTOMS

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Hives and Swelling of face

Important: Not all reactions have hives

Anaphylactic Reaction Normal Appearance

www.natureshomoeo.com.au/image/student.JPG

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

Increased independence

Increased risk taking

Eating unsafe food and eating out

Not carrying auto injector,

The part of the brain that makes decisions is the

last to mature

Not telling friends, wanting to fit in http://www.allergysafecommunities.ca/challenges/

Reference: Allergy Safe Communities (2013)

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WHY ARE TEENS AT HIGHER RISK?

PREVENTION = HAVING A PLAN

Ensure the medical alert list is up-to-date and familiarize yourself with students who have medical conditions and allergies

Review emergency care plans for each student

Note where auto-injectors are stored for each student. Ensure auto-injectors are immediately available

Recognize allergy sources and triggers

Know when and how to administer the auto-injector

Prepare for outdoor and off school grounds activities

Anaphylaxis Awareness/Avoidance Strategies and Checklist 11

WHAT SHOULD I DO?

1. Administer single dose auto-injector

2. Call 911

3. Notify parent/guardian

4. Administer second auto-injector in 5 to 15 minutes after first dose is given 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. Give ASAP

**Remember, the epinephrine may only last for 15 minutes, calling 911 is very important

Reference: BC Anaphylactic and Child Safety Framework (2007) 12

WHAT SHOULD I DO?

When in doubt, administer epinephrine. Symptoms

of anaphylaxis can be as simple as tingling of the lips

or as severe as cardiac arrest.

If a person says they are having a reaction it is

important to believe them, and immediately

administer epinephrine regardless of the symptoms

present

Antihistamines and asthma medication must not be

given as first line treatment for anaphylaxis

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WHAT IS AN EPINEPHRINE AUTO-

INJECTOR?

An auto-injector is an easy way to give epinephrine to

someone having an allergic reaction

There are three auto-injectors available in BC:

AllerjectTM

EpiPen®

Twinject®

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WHAT IS AN EPIPEN®?

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Reference: www.epipen.ca

A disposable, pre-filled automatic

injection device that administers

a single dose of epinephrine

Hold firmly with ORANGE tip pointing downward.

Remove BLUE safety cap by pulling straight up.

Do not bend or twist.

Swing and push ORANGE tip firmly into mid-

outer thigh until you hear a “click.”

Hold on thigh for several seconds.

EpiPen video link

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Built-in needle protection

When EpiPen® is removed, the ORANGE

needle cover automatically extends to cover

the injection needle, ensuring the needle is

never exposed. Reference: www.epipen.ca

HOW TO USE EPIPEN®?

A disposable, pre-filled

automatic injection

device that administers a

single dose of

epinephrine

Talks users through each

step

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Reference: www.allerject.ca

WHAT IS ALLERJECTTM

?

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•youtube demonstration link

•Pull Allerject™ from the outer case

•Pull off RED safety guard

•To reduce the chance of an accidental

injection, do not touch the BLACK base of the

auto-injector, which is where the needle

comes out

•Place BLACK end against the middle of the

outer thigh, then press firmly and hold in place

for five seconds

•Do not inject into any other location

•Once the injection is complete, replace the

outer case Reference: www.allerject.ca

HOW TO USE ALLERJECTTM

?

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WHAT IS TWINJECT®?

•A disposable, pre-filled automatic

injection device that contains two

doses of epinephrine in a single device

•First dose of epinephrine is

administered by auto-injection, just like

the EpiPen® and AllerjectTM

**Remember, staff are not

recommended to give dose two

(manual intramuscular injection of

epinephrine)

Reference: www.twinject.ca

FOR INFORMATION ONLY: HOW TO

USE TWINJECT®?

Pull off GREEN end cap labeled “1”. Never put thumb, finger or hand over the RED tip.

Pull off GREEN end cap labeled “2”

Press RED cap into outer thigh until unit activates. Hold Twinject® in place for about 10 seconds

video link

20 Reference: www.twinject.ca

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WHAT TO DO AFTER GIVING

EPINEPHERINE

• • If dizzy or faint have student lie still on his or her back

with feet higher than the head

• If nauseated or vomiting, have the student lie on their

side to prevent choking

• If breathing is difficult, have the student sit up

• Loosen tight clothing and cover student with

blanket

• Don’t give anything to drink

• Send auto-injector with student to hospital

CONCLUSION:

FOLLOW THE THREE A’S

Awareness

Know the triggers

Know the emergency plan and how to administer epinephrine via the auto-injector

Avoidance

Avoid contact with allergens, make classrooms safe

Action

Give auto-injector and call 911.

Don’t delay!

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RESOURCES

For more information contact your Public Health Nurse and see:

www.bced.gov.bc.ca/health/bc_anaphylactic_child_safety.pdf (BC Anaphylactic and Child Safety Framework)

www.anaphylaxis.org (Anaphylaxis Canada)

www.whyriskit.ca/pages/en/home.php (Why Risk It- Teens)

www.aaia.ca (Allergy/Asthma Information Assoc.)

www.allerject.ca (Allerject®)

www.epipen.ca (EpiPen®)

www.twinject.ca (Twinject®)

www.medicalert.ca Medic Alert

www.bchealthguide.org/healthfiles Health files

https://dsweb.bcsta.org/docushare/dsweb/View/Collection-7655 BC Ministry of Education Core Anaphylaxis Resources

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REFERENCES

Anaphylaxis Canada (2013) http://www.anaphylaxis.org/

AAIA Anaphylaxis Reference Kit (2007) by the Allergy and Asthma Information Association, Health Canada

Anaphylaxis in Schools & Other Settings (Second Edition, 2009) by the Canadian Society of Allergy and Clinical Immunology.

Allergy Safe Communities. (2013) http://www.allergysafecommunities.ca/

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ANY QUESTIONS?

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