what is anaphylaxis?
Post on 23-Feb-2016
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What is Anaphylaxis?What is Anaphylaxis?Is this a problem at school?Is this a problem at school?
Goals for today
• Understand what anaphylaxis is and what the signs and symptoms of a reaction are
• Learn how we are going to manage anaphylaxis at school
• Practice using an EpiPen and Twinjet auto-Injector for epinephrine
Anaphylaxis is...
• An allergic reaction that can affect the entire body
• It can be fatal • It happens quickly• It often has an identifiable cause
It can affect the whole body
• Skin• Breathing• Heart• Stomach• Head
How fast is fast?• Symptoms can occur within
minutes to two hours after contact with the allergy causing substance
• In rare instances, it may occur up to four hours later
Common Causes• Food• Medication• Insect stings• Latex• Some have an unknown
cause
Who is at risk?• Anyone with a previous history• Individuals with food allergies
(Particularly allergies to shellfish, peanuts, and tree nuts)
• People with asthma are at an increased risk
Signs and symptoms• Tingling sensation• Rash...itching... burning• Metallic taste• Sensation of warmth• Breathing difficulty... Changes in
skin color• Nausea, vomiting, diarrhea, or
cramps• Anxiety, dizziness, headache• Drop in blood pressure• Loss of consciousness
Essentials of school Management…
• Written Classroom Health Care Plan developed by the school nurse and signed by the health care provider.
• Able to recognize of the signs and symptoms of anaphylaxis at school
• Prompt administration of epinephrine.• Transport to closest emergency facility
Management of Anaphylaxis at school
This is really a 4 tiered effort...• Developing a Classroom Health Care
Plan that includes the emergency plan• The Immediate phase at exposure• The phase after the initial treatments• The Prevention Plan
Developing the Classroom Health Care
PlanYour school nurse can help here.• The plan should cover the
emergency steps to follow.• It should include the necessary
trainings.• It also should cover prevention
plans as well.
Immediately• Clear and secure the airway as
needed. Observe for breathing.• Rapidly assess level of
consciousness• Consider Epinephrine... Is this
anaphylaxis?• Have someone call 911
Second Phase• If this is anaphylaxis, give the
epinephrine and/or benedryl as ordered by the Health Care Provider
• Stay with the student• Have them stay laying down.
Elevate their legs if possible.• Make sure 911 has been called
Transport… 3rd Phase
• Once epinephrine has been given, the student must have further care at the closest emergency facility
• Epinephrine lasts for only about 15-20 minutes.
• Follow the advice of the emergency responders.
What is Epinephrine?• It is a hormone produced by all of
us in the adrenal glands• It is often referred to as Adrenaline
How Does Epinephrine Work?
• Epinephrine has three major actions that are of critical importance in the treatment of anaphylaxis because it: – Constricts blood vessels and – It is a Bronchodilator – Help keeps the blood pressure stable.
Epinephrine...• Adverse reactions to epinephrine
include a fast heart rate; transient, moderate anxiety; apprehensiveness; restlessness; tremor; weakness; shakiness; dizziness; sweating; palpitations; pallor; nausea and vomiting; headache; and/or respiratory difficulties.
Epinephrine!
•EpiPen •Twinjet
Prevention of anaphylaxisis the 4th
Phase
• Medic-Alert identification• Teach appropriate avoidance measures• Be observant... watch for the signs and
symptoms of an anaphylactic reaction.
Avoidance!• What about nut free zones?• Consider a nut free table in the
cafeteria.• A nut free classroom is another
consideration
Quiz Time• What is anaphylaxis?• What are the symptoms of a
reaction?• Who is at risk for an anaphylactic
reaction?
What is an EpiPen• EpiPen® is an auto-injector that administers epinephrine (also known as adrenalin).
How to use the EpiPen
Remove the Epipen from the plastic tube
Remove the gray cap
Put the gray cap against the middle of
the outer side of the upper leg
Hold for 10 seconds
To insure the dose was given...
• Check for the red bar• Check to make sure the needle came out• Give your used EpiPen to a healthcare worker
for proper disposal. Do not throw away in a regular trash can
Let’s Practice
How to use a Twinjet1. Pull off the GREEN end cap
labeled "1." You will now see a GRAY cap. Never put your thumb, finger,or hand over the GRAY cap.
Next...2. Pull off the RED end cap labeled
"2."
Then...• 3. Put the GRAY cap against
the middle of the outerside of your thigh (upper leg) as shown. It can gothrough clothes, if necessary.
• 4. Press down firmly until the needle enters the middle ofthe outer side of your thigh through your skin. Hold it inplace while slowly counting to 10.
After 10 Seconds• Remove the Twinjet from your skin. • Check the GRAY cap; if the needle is
exposed, the dose was given. If not, repeat #3 and #4.Get ready for the second dose. Get emergency medical help right away.
Get Ready in Case You Need a Second
Dose • Unscrew and remove the GRAY
cap. Beware of theexposed needle.
• Holding the BLUE hub at the needle base, pull thesyringe from the barrel.
Then...Slide the YELLOW or ORANGE collar
off the plunger.
Decide if You Need a Second Dose
• If your symptoms have not improved within about 5 minutes since the first injection, you need a secondinjection.
• If a second dose is not needed, throw away the unused medication as directed.
Inject the Second Dose • Put the needle into your thigh
(upper leg), through your skin, as shown.
• Push the plunger down all the way.
• Remove Twinjet from your skin.
Proper Disposal • Give your used Twinjet to a
healthcare worker for proper disposal. Do not throw away in a regular trash can.
• Prepared by: Mary Clark RN, NCSN• Reviewed by: Paula Peterson APNP
Primary Children’s Hospital Salt Lake City, Utah
• JMJ Publishers• 1156 Wilson Ave.• Salt Lake City, Utah 84105• 801 467-5083
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