ANAPHYLAXIS

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, tree nuts, seafood, wheat, soy, sesame seeds, sulphites and mustard

Insect bites – bees, wasps, hornets and some ants

Medications – penicillin, sulfa drugs

Exercise

Latex – gloves/medical devices

Reference: Anaphylaxis Canada (2013)

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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)3

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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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

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Swelling of the lips/faces and hives may occur

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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

Not telling friends

Not wearing a medical alert IDReference: 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 ground activities

Encourage students to wear medical alert identification 11

WHAT SHOULD I DO?

1. Administer single dose auto-injector2. Call 9113. Notify parent/guardian4. 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, call 911 after administering auto-injector

Reference: BC Anaphylactic and Child Safety Framework (2007)

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WHAT SHOULD I DO?

When in doubt, administer epinephrine. Symptoms of anaphylaxis can be as simple as redness 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: EpiPen®

AllerjectTM

Twinject®

*Please note that Twinject® is currently not available on the market.

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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

Swing and push ORANGE tip firmly into mid-outer thigh until you hear a “click”

Hold on thigh for several seconds

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Built-in needle protectionWhen EpiPen® is removed, the ORANGE needle cover automatically extends to cover the injection needle

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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• Pull Allerject™ from the outer case

• Pull off RED safety guard• 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

• 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

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 10 seconds

20Reference: www.twinject.ca

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WHAT TO DO AFTER GIVING EPINEPHERINE

• Have students lie still on their backs with their feet higher than their heads

• If vomiting, have the students lie on their sides to prevent choking

• If breathing is difficult, have the students sit up

• Loosen tight clothing and cover students with blanket

• Don’t give anything to drink

• Send auto-injector with students to hospital

Reference: Anaphylaxis Canada (2013)

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 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) www.aaia.ca (Allergy/Asthma Information Assoc.) www.allerject.ca (AllerjectTM) www.epipen.ca (EpiPen®) www.twinject.ca (Twinject®) www.medicalert.ca www.bchealthguide.org/healthfiles

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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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