1 of 31

������Life-Threatening Allergies & EpiPen Training

.

Wakefield Public School Nurses

​

​

2 of 31

PURPOSE

  • To provide unlicensed* school personnel with the basic knowledge and skills to administer epinephrine by auto-injection in a life-threatening situation.

​

​

*Refers to medical license

3 of 31

OBJECTIVES

  1. Identify common causes of allergic emergencies
  2. Accurately recognize general and student-specific warning signs of allergic emergency
  3. Accurately identify student for whom the epinephrine is prescribed

4 of 31

OBJECTIVES (cont.)

  1. Accurately read and interpret the emergency medication administration plan
  2. Correctly follow directions on the medication administration plan
  3. Accurately read the epinephrine label and follow directions from the label

5 of 31

OBJECTIVES (cont.)

  1. Administer epinephrine by auto-injector
  2. Safely handle epinephrine in an auto-injector
  3. Accurately describe the school’s plan for responding to emergencies
  4. Access resources appropriately, including emergency medical services, school nurse, parents and physician

6 of 31

​

​

​

​

​

WHAT ARE COMMON CAUSES OF ALLERGIC EMERGENCIES?

  • Food
  • Insect Stings
  • Medication
  • Latex
  • Exercise (uncommon)

​

​

7 of 31

FOOD

  • Peanut
  • Tree Nut (walnuts, cashew, pecan, hazelnut, almond)
  • Milk
  • Egg
  • Fish
  • Shellfish
  • Soy
  • Wheat

​

Eight Foods account for 90% of all food-allergic reactions

8 of 31

INSECT STINGS

  • Bees
  • Wasps
  • Yellow Jackets
  • Hornets
  • Fire Ants

9 of 31

MEDICATION

Antibiotics

Anesthesia

10 of 31

LATEX

Gloves

Band-Aids

Balloons

11 of 31

EXERCISE/ �TEMPERATURE EXTREMES �

​

​

  • Occurs less

frequently

12 of 31

WHAT IS ANAPHYLAXIS?

  • A potentially life-threatening medical condition occurring in allergic individuals after exposure to an allergen
  • May occur immediately (seconds) or delayed (hours)
  • Individuals with Asthma are at an increased risk of a severe reaction

​

13 of 31

WHAT ARE SYMPTOMS OF ANAPHYLAXIS?

Skin

  • Hives
  • Itchy rash
  • Swelling of

face or

extremities

Mouth

  • Itchy, tingling or swelling of mouth, tongue or lips

Throat**

  • Itchy throat
  • Tight throat
  • Hoarseness
  • Drooling

Stomach

  • Abdominal cramps
  • Nausea
  • Vomiting
  • Diarrhea

Lungs**

  • Short of

breath

  • Wheezing
  • Repetitive

cough

Heart**

  • Faint
  • Weak pulse
  • Low blood

pressure

  • Pale or blue

Other**

  • Anxiety
  • Panic
  • Itchy,

watery

red eyes

* *Potentially Life-threatening

14 of 31

HOW MIGHT A CHILD DESCRIBE A REACTION?

  • “My tongue is itching, burning or tingling”
  • “My mouth feels funny”
  • “There’s something stuck in my throat”
  • “My lips feel tight”
  • “There’s a frog in my throat”

15 of 31

WHAT IS A BIPHASIC REACTION?

​

​

  • A second wave of symptoms that may occur two to four hours later

16 of 31

WHAT IS EPINEPHRINE?

​

  • Epinephrine is the medicine of choice for treatment of anaphylaxis
  • It quickly constricts blood vessels, raising blood pressure
  • It relaxes smooth muscles in lungs to improve breathing

​

​

​

17 of 31

WHAT IS AN EPIPEN?

  • An auto-injector that administers Epinephrine
  • There are two strengths:
      • Adult 0.3mg
      • Child 0.15mg

​

Older Packaging

Newer Packaging

18 of 31

How do you administer an EpiPen?

Using the 5 Rights:

  • Right Student
  • Right Medication
  • Right Dose
  • Right Route
  • Right Time

​

Step 1

Step 2

Remove Blue

Cap

Swing & jab straight into outer thigh

19 of 31

RIGHT STUDENT

  • Identify the student with a known allergy
  • Accurately read and interpret student specific emergency health care plan
  • Accurately read the prescription label on epinephrine package

20 of 31

RIGHT MEDICATION

  • EpiPen

OR

  • EpiPen Jr.

21 of 31

RIGHT DOSE

  • Adult 0.3 mg
  • Child 0.15mg
  • Lasts approximately 15 minutes

22 of 31

RIGHT ROUTE

  • Large Outer Thigh
  • May be administered through clothing
  • Hold in place for 5-10 seconds
  • Remove carefully
  • Massage area where administered

23 of 31

RIGHT TIME

  • Student is in Anaphylaxis

24 of 31

SCHOOL PROTOCOL

  1. Call 911
  2. Specify the problem: “A student is in Anaphylaxis & was given an EpiPen”
  3. Specify entrance
  4. Note time of EpiPen administration & hand over EpiPen to EMS upon arrival
  5. Call parent to meet student at closest medical facility

​

25 of 31

EPIPEN STORAGE & HANDLING

  • Properly store at room temperature
  • Color in window will be clear
  • Avoid accidental injection to yourself or you will require immediate attention at an Emergency Room
  • Note time administered & give used EpiPen to Emergency Medical Services upon arrival

​

26 of 31

LIABILITY

  • EpiPen trained personnel are protected by the Good Samaritan Law
  • Refresher training is renewed annually

27 of 31

APPROPRIATE RESOURCES

  • School Nurse
  • School Physician
  • Parent
  • Emergency Medical Services (EMS)

28 of 31

“There is no cure for food allergies. Strict avoidance

of the offending allergen is

the key to preventing a

life-threatening reaction.”

29 of 31

REFERENCES

  • http://www.foodallergy.org
  • Managing Life Threatening Food Allergies in Schools, 2002, Massachusetts Department of Education, available at http://www.doe.mass.edu/cnp/news02/allergy.pdf
  • American Academy of Allergy, Asthma and Immunology, Anaphylaxis in Schools and Other Child-Care Settings, available at http://www.aaaai.org/media/resources/academy_statements/position_statements/ps34.asp
  • Massachusetts Department of Public Health: School Health Unit
  • http://www.epipen.com

​

​

​

​

30 of 31

COURSE COMPLETION

  1. Please take the Post-Test
  2. Then see the School Nurse to demonstrate proper EpiPen administration

with a training pen

​

Thank You!

31 of 31

  • Adapted with permission from:

Marcia Skeffington, RN, BSN, M.Ed

Woburn School Nurse

June 13, 2016