Transcript Insect Sting Emergency Treatment

Epi-Pen Anaphylaxis
Protocol for Emergency
Treatment of Allergic
Reactions
Pre-service Training
For CCHD Nursing & MD Staff
Edition: April 2006
Definition of Anaphylaxis
“An allergic hypersensitivity reaction to
a foreign protein or drug
Affects the respiratory and circulatory
system and can result in shock
May cause increased irritability,
shortness of breath, blue color to the
skin and sometimes convulsions,
unconsciousness and death” (Taber’s)
Agents
Insect Stings
 Bees, wasps, hornets, yellow jackets,
fire ants, others
Foods
 Peanuts, nuts, milk, eggs, shellfish,
whitefish, food additives
 1/80 persons have nut allergy
Other Agents
Medications
 Antibiotics (most commonly penicillin),
as well as seizure medications, muscle
relaxants, aspirin, non-steroidal antiinflammatory agents
 Radio-opaque contrast dyes
Exercise
Signs and Symptoms
Symptoms occur quickly after exposure

Rebound any time within 24 hours
Shortness of breath
Localized skin redness
Rash (Hive like wheals)
Itching
Apprehension (“something’s wrong”)
Other Signs & Symptoms
Sneezing
Runny nose
Coughing
Tightness in chest
Wheezing
Swelling around face
Labored breathing
Further Signs &
Symptoms
Decreased level of consciousness, due
to:
lowered oxygen content in blood
 lowered blood pressure

Seizure
Cardiac Arrest
Death
Emergency Treatment
CALL 911!
Maintain open airway, assist ventilation, place
victim in position of comfort
Treat for shock
Initiate CPR if necessary
Check expiration date and color of EpiPen
(do not use if expired or liquid is brown color)
Inject Epi-Pen (adult or peds) as appropriate
Using the EpiPen
Inject epinephrine into upper outer side
of the front thigh muscle– NOT INTO
BUTTOCK OR INTRAVENOUSLY
Repeat injections if possible:
every 5 minutes if worse, for total 3 doses
 or every 15 minutes if better, for total of 3
doses, while awaiting emergency transport

Initiate Evacuation
Even if the person responds to the initial
injection, symptoms may re-occur
The antigenic substance is still in the
body (we have treated only the
immediate effects)
The person MUST get emergency
attention as soon as possible
How to Use the Epi-Pen
Pull off the gray safety cap
Place black tip on the outer thigh
Push Epi-Pen against the thigh (into
muscle, not fat) until a click is heard
Hold in place for 10-15 seconds as vial
is emptied
Can be administered through clothes
Discard unit (not reusable)
How to Use the Epi-Pen
Do not store Epi-Pen in refrigerator or in
extreme heat (not in cars or sunlight)
Do not use if brown or date has expired
Pharmacology
Actions:
Epinephrine is adrenaline
 Improves breathing by reducing the
swelling of the airways
 Stimulates heartbeat and circulation
 Works to reverse hives and swelling
around the face and lips (angioedema)
 Works quickly but short duration of action

Pharmacology
Dosing:
ADULT & OLDER CHILDREN (over 33
lbs): Yellow Epi-Pen, 0.3 mg epinephrine
1:1000.
 PEDIATRIC (younger children under 33
lbs): White Epi-Pen-Jr., 0.15 mg
epinephrine 1:2000.


Both may be repeated every 5-15 minutes
for maximum 3 doses
Personal Liability
Florida Statute 768.13 FS (Good
Samaritan Act):

“Any person who gratuitously and in good
faith renders emergency care or treatment
at the scene of an emergency… without
the objection of the injured victim shall not
be held liable for any civil damages…
where the person acts as an ordinary
reasonably prudent man would have acted
under the same, or similar circumstances.”
Certification
Persons attending an approved training
meet the requirements of law to
administer the Epi-Pen.
Biennial re-certification (every 2 years)
Child Specific orientation is needed for
each child prescribed with an Epi-Pen.
Employee Statement
I (print name), _________________________,
have read through this training material. I will
use the Epi-Pen as detailed in this presentation,
as needed for emergency treatment of allergic
reactions during work activities assigned by my
supervisor of the Collier County Health Dept.
(Employee Signature & Date)
______________________________________
(Supervisor Signature & Date)
______________________________________