Transcript Anaphylaxis “Using an Epipen”

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)
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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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MOST DANGEROUS SYMPTOMS

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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Anaphylactic Reaction
Normal Appearance
Hives and Swelling of face
Important: Not all reactions have hives
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Swelling of the
lips/faces and hives
may occur
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WHY ARE TEENS AT HIGHER RISK?

Increased independence

Increased risk taking
 Eating
unsafe food and eating out
 Not carrying auto injector

Not telling friends

Not wearing a medical alert ID
Reference: Allergy Safe Communities (2013)
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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
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WHAT SHOULD I DO?
1.
2.
3.
4.
5.
Administer single dose auto-injector
Call 911
Notify parent/guardian
Administer second auto-injector in
5 to 15 minutes after first dose is given IF
symptoms do not improve or if symptoms recur
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 AUTOINJECTOR?



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®
TM
 Allerject
 Twinject®
*Please note that Twinject® is currently not available
on the market.
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WHAT IS AN EPIPEN®?
A disposable, pre-filled automatic
injection device that administers
a single dose of epinephrine
Reference: www.epipen.ca
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HOW TO USE EPIPEN®?




Hold firmly with ORANGE tip pointing downward
Remove BLUE safety cap by pulling straight up
Swing and push ORANGE tip firmly into midouter thigh until you hear a “click”
Hold on thigh for several seconds
Built-in needle protection
When EpiPen® is removed, the ORANGE
needle cover automatically extends to cover
the injection needle
Reference: www.epipen.ca
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TM
WHAT IS ALLERJECT ?

A disposable, pre-filled
automatic injection
device that administers a
single dose of
epinephrine

Talks users through each
step
Reference: www.allerject.ca
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TM
HOW TO USE ALLERJECT ?
•Pull Allerject™ from the outer case
•Pull off RED safety guard
•Do not touch the BLACK base of the autoinjector, 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
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Reference: www.allerject.ca
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)
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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
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Reference: www.twinject.ca
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)
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CONCLUSION:
FOLLOW THE THREE A’S

Awareness



Avoidance


Know the triggers
Know the emergency plan and how to administer
epinephrine via the auto-injector
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.)
TM
 www.allerject.ca (Allerject )
 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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