Identification and Management of an Acute Allergic Reaction�in the School Setting

Allergies occur when your immune system becomes unusually sensitive and overreacts to common substances such as pollen, mould, dust or food.

When these substances cause an allergic reaction, they are called allergens.

Allergens enter the body through:

The Mouth

The Nose

Touch

Injection

Anaphylaxis is a sudden, severe, potentially life-threatening allergic reaction that may involve the skin, respiratory tract, gastrointestinal tract and/or cardiovascular system.

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Common Causes of�Anaphylaxis

Food

Medications

Insect Venom

Latex

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EpiPen

Allergic reactions can �occur in the:

• upper respiratory system
• lower respiratory system
• skin
• digestive system
• as a generalized reaction called anaphylaxis

Symptoms of An�Anaphylactic Reaction

The most distinctive symptoms include:

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• hives
• swelling of the throat, lips, tongue or around the eyes
• difficulty breathing or

swallowing

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* Hives may be entirely absent, especially in severe or near-fatal cases of anaphylaxis.

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Children may describe their symptoms as

• “My tongue is hot”
• “My tongue and mouth itch”
• “There’s something stuck in my throat”
• “My food is too spicy”

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Symptoms of An�Anaphylactic Reaction�

Other common symptoms include:

• a metallic taste or tingling in the mouth
• flushing, itching, or redness of the skin
• nausea, vomiting, or diarrhea
• dizziness or lightheadedness
• increased heart rate
• feelings of fear or panic
• loss of consciousness

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Remember…

It can take only 1 to 2 minutes for a mild allergic reaction to escalate to anaphylaxis

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When is anaphylaxis most likely to occur?

• New situations
• Normal daily routines are interrupted eg. birthday parties and school trips
• During teenage years

(increasing independence,

relaxed precautions,

reluctance to carry

medication)

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Preventing Anaphylaxis

1. Awareness

2. Avoidance

• Do not let student come in contact with allergen
• Check ingredients every time
• if unsure, do not let student eat it
• offer students an alternative choice in food
• Do not let students share lunches, snacks, containers or utensils
• Avoid bulk foods
• Monitor foods used in class parties/Assure supplies for arts and crafts are safe
• Be aware of cross-contamination - wash surfaces with board approved solutions

3. Action

• Administer EpiPen & Call 911

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Have An Emergency Plan

• A child with a life-threatening allergy should have immediate access to an EpiPen at all times!!

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• It is important to have one EpiPen available for every 5-10 minutes if symptoms return or persist.

What is an EpiPen?

An EpiPen is a disposable drug delivery system with a spring-activated, concealed needle designed for emergency administration.

EpiPens are available in 2 strengths:

• EpiPen Jr Smaller amount of epinephrine

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• EpiPen Larger amount of epinephrine

What is in an EpiPen?

• EpiPens are an effective way to administer a drug called Epinephrine (Adrenaline)
• Epinephrine by injection is the treatment of choice for anaphylactic reactions.
• Epinephrine works quickly to:
• constrict blood vessels
• relax smooth muscles in the

lungs to improve breathing

• stimulate the heart beat
• reverse hives and swelling

around the face and lips.

After the Administration of the EpiPen

• Seek emergency medical attention as EpiPen is being administered
• If symptoms return or there is no improvement in 10-20 minutes a second dose may be required.
• Side effects of Epinephrine include:
• Nervousness
• Increased heart rate
• Sweating
• Nausea / Vomiting
• Headache
• Dizziness

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Special Tips About Using �EpiPens

If you suspect an anaphylactic emergency, administer the EpiPen and call 911

The effects of epinephrine when not needed:

• Increased Heart Rate
• Nervousness

The possible effect of not administering epinephrine in anaphylaxis:

• Death

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*Always seek medical attention

after the administration of an EpiPen

Questions?

References:

• Anaphylaxis: An ExtremeAllergic Emergency; Meridian Medical Technology/DEY
• Managing Allergies and Anaphylaxis at School by Sandra Montgomery
• The Food Allergy and Anaphylaxis Network

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