Transcript Managing Allergies & Anaphylaxis At School

Managing Allergies &
Anaphylaxis At School
Sandra Montgomery
Superintendent of Special Services
ANAPHYLAXIS
PROTOCOL & GUIDELINES
2006
Sabrina’s Law
 Sabrina Shannon had a severe
allergy to dairy products
 She died after eating french fries at
school
 Bill 3 is intended to protect
students with deadly food allergies
January 1st 2006 legislation
What does Bill 3 mean for
school boards?
 Create anaphylaxis policy
 Educate students and parents on cross
contamination
 Implement plans to reduce the risk of exposure to
allergens ie. thorough hand washing is a key to
risk reduction
 Creating allergen aware environments and
individual student plans
 It is about expectations for parents, students,
principals, staff and volunteers
 It is NOT about banning products
Bill 3 - Liability
 Section c.7 s.3 (4)
 Ensures that no damages will be
instituted with respect to any act
done in good faith in response to an
anaphylactic reaction (Unless
damages are the result of gross
negligence)
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
Allergic reactions can
occur in the:
 upper respiratory system
 lower respiratory system
 skin
 digestive system
 as a generalized reaction called
anaphylaxis
Anaphylaxis is a sudden, severe,
potentially life-threatening allergic
reaction that may involve the skin,
respiratory tract, gastrointestinal tract
and/or cardiovascular system.
Common Causes of
Anaphylaxis
Food
Medications
Insect Venom
Exercise
Latex
EpiPen
Symptoms of An
Anaphylactic Reaction
The most distinctive symptoms
include:
 hives
 swelling of the throat, lips, tongue
or around the eyes
 difficulty breathing or
swallowing
* Hives may be entirely absent, especially in severe or near-fatal cases of anaphylaxis.
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
Remember…
It takes only 1 to 2
minutes for a mild
allergic reaction
to escalate to
anaphylaxis
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)
Preventing Anaphylaxis
1. Awareness


Know causes and triggers
Know emergency plan
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
Be aware of cross-contamination - wash
surfaces with board approved solutions
3. Action

Administer EpiPen & Call 911
Have An Emergency Plan
 A child with a life-threatening allergy
should carry an EpiPen at all times.
 An additional EpiPen(s) should be easily
accessible
 It is important to have one EpiPen
available for every 10 -20 minutes
Have An Emergency Plan
 Display “At Risk” posters in high traffic
areas
 Keep student’s medical information
with their EpiPen.
 Ensure student has
Medic Alert identification
that indicates their specific
allergens.
The EpiPen
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
 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.
Who can I give the EpiPen to?
 It is expected that parents would provide
proprietary medication with appropriate
consent
 Under the new legislation an
emergency EpiPen should
be on site
Using an Epi-Pen
 Grasp EpiPen with the black tip
pointing down( 911 is being
called at same time)
 With your other hand
pull off the gray safety cap.
Using an Epi-Pen
 Hold the black tip near the outer
thigh.
 Swing and jab firmly into the outer
thigh.
Using an Epi-Pen
 Hold firmly in thigh for approx. 10
seconds (Count to 10).
 Remove Epi-Pen and massage
injection area.
Check the Tip
 If the needle is exposed, you have given
the dose.
 There may be a kick back effect so make
sure your grip is firm
 Bend the needle back against a hard
surface after administration.
 Carefully put the unit (needle first) back
into the carrying tube.
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
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
*Always seek medical attention
after the administration of an EpiPen
Special Tips About Using
EpiPens
 Never put fingers over the black tip when removing
the safety cap, or after the safety cap has been
removed.
 Periodically check the expiry date and condition of
stored EpiPens.
 Keep EpiPens at room temperature. Do not expose
them to extreme cold, heat or direct sunlight.
 Place the EpiPen on bare skin
if possible. In an emergency,
the EpiPen can be used directly
through clothing.
Executive Summary
Now a policy of TCDSB
Immunity is enshrined in the
legislation
Updated committee list
Executive Summary
Revised School Responsibilities
Creating allergen aware
environments
Minimizing risk
Ensure thorough hand washing
Store medication in a readily
accessible, organized manner
A generic EpiPen can now be used
Executive Summary
Parent/Student Responsibilities
Parent to alert school
Student to carry EpiPen on their
person at all times
Executive Summary
Staff Inservices
Semi annually or as required for all
staff who may be new to the school
Copy of sign in sheets for in-service
to be forwarded to the school
superintendent
Books and videos are now available
for loan
References
Anaphylaxis Canada
416 Moore Ave., Suite 306, Toronto, Ontario
M4G 1C9
Telephone: 416-85-566
E-mail: [email protected]
www.gosafe.ca
Canadian Society of Allergy & Clinical
Immunology
774 Echo Dr., Ottawa, Ontario
K1S 5N8
Telephone: 613-730-8177
E-mail: [email protected]
Canadian School Boards Association
The Hospital for Sick Children
130 Slater Street, Suite 350, Ottawa, Ontario
K1P 6E2
Telephone: 613-235-3724
E-mail: admin@cds\nsba.org
555 University Ave, Toronto, Ontario
Telephone: 416-813-5300
E-mail: www.sickkids.on.ca
Allergy Asthma Information
Association
Collins Consulting
(National Office)
P.O. Box 100, Etobicoke, Ontario
M4K 5K9
Telephone: 416-679-9521
E-mail: [email protected], www.aaia.ca
Toronto Catholic District School Board
E-mail: [email protected]
Superintendent of Special Services
Telephone: 416-222-8282 ext. 2486
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