Transcript MLHU Anaphylaxis Presentation

Anaphylaxis in Schools
2016-2017 School Year
Overview
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Sabrina’s Law
Expectations for School Staff
Definition of Anaphylaxis
Recognition
Action
How to use an Auto-injector
Sabrina’s Law
• Legislation: Bill 3 (January 1, 2006)
• Mandates publicly funded School
Boards to establish and maintain an
anaphylaxis policy
• Intended to educate school
communities and prevent anaphylactic
incidents
• It does not create allergen-free schools
Anaphylaxis Policy
Requirements
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Strategies to reduce risk of exposure
Communication plan
Regular training
Individual emergency plan
Request information from parents
Maintain file for each anaphylactic
student
Required for Individual Plan
• Type of allergy, monitoring, avoidance
strategies and appropriate treatment
• Individualized and readily accessible
emergency procedure with emergency
contact information
• Storage of epinephrine auto-injector
Sabrina’s Law states:
No action for damages shall be
instituted respecting any act done
in good faith or for neglect or
default in good faith in response to
an anaphylactic reaction, unless
damages are result of gross
negligence.
Expectations for School Staff
• Know emergency plan (copy of plan should
be in your day planner)
• Know the location of emergency medication
• Administer epinephrine auto-injector
Expectations for School Staff
• Written consent to administer autoinjector is required
• In case of emergency, if written consent
is not yet received, the auto-injector can
be given to pupil it is prescribed to
Key Recommendations
• Epinephrine is the first line medication
• Antihistamines and asthma
medications must not be used first for
anaphylaxis
• After receiving epinephrine, the person
must go to hospital
Key Recommendations
• A second dose can be given 5 to 15
minutes after first dose if symptoms
have not improved or they return
• Expect that you will be required to
administer the auto-injector
What is anaphylaxis?
• Severe systemic allergic reaction
• Can cause death
• Requires immediate action i.e. give the
auto-injector and dial emergency
medical services (911)
Triggers
Most Common
• Foods - milk, egg, peanut, tree nuts,
seafood (fish, crustaceans and
shellfish), mustard, sulphites, soy,
sesame, wheat
• Insect stings
Triggers (cont’d)
Other potential triggers:
• medications
• latex
• exercise-induced
• unknown (idiopathic)
Common Symptoms
F.A.S.T.
F: Face - itchiness, redness, swelling of
face or tongue, metallic taste in mouth
A: Airway - trouble breathing, swallowing
or speaking
S: Stomach - pain, vomiting, diarrhea
T: Total – rash, itchiness, swelling,
weakness, paleness, sense of doom, loss
of consciousness, uterine cramps
Characteristics of Symptoms
• Symptoms do not appear in any order
• May appear immediately or hours after
contact with the allergen
• Symptoms may vary or become more
severe with each exposure to allergen
Characteristics of Symptoms
• These can also be symptoms of other
conditions. If they appear in a person
diagnosed with anaphylaxis after
potential exposure, ACT!
• Look for your Anaphylaxis Resource Kit
for copies of the ‘think F.A.S.T.’ poster
Action
• Identify the individual (should wear MedicAlert bracelet/necklace)
• Get the person to the ground where they are
• If experiencing breathing problems, keep in
an upright position
• If dizzy or fainting, place person on their back
with legs raised above heart level
• If vomiting, place on their side with head
down
• If getting worse, (but conscious and not
vomiting) place on their back
Action (cont’d)
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Remain with the student
Send someone for auto-injector(s)
Have someone else dial 911
Inject Auto-injector and record the time
Remain with student. If breathing improves,
lay the student down, cover, tilt head back
and elevate feet
• Have someone else notify emergency contact
• Be prepared to give a second dose in 5 to 15
minutes if the reaction continues, progresses
or returns
What else?
• In doubt? Give Auto-injector to student for
whom it is prescribed
• Used Auto-injector goes to hospital
• Dosage is weight related, so make sure you
get the right auto-injector for the right student
EPI-PEN
Junior has green label 15-30 kg
Adult has yellow label 30 kg and over
EpiPen®
For adults and children weighing 30 kg (66 lbs) or more
The orange cover extends to fully
cover the needle after use.
EpiPen® Jr
For children weighing 15–30 kg (33–66 lbs)
Questions and Answers
Can I use an expired Auto-injector?
• The companies cannot recommend the use of
expired auto-injector, however, if it is all that is
available and the medication is not discoloured,
use it.
• Encourage parents to register on www.epipen.ca
for reminders of expiration
Questions and Answers
Do I have to take the auto-injector to field
trips, cross country meets and sports
events etc.?
• Yes. The auto-injector must go everywhere
the student goes.
What should I do if I accidentally inject
myself?
• You must go to the hospital
Questions and Answers
Where should an auto-injector be kept?
• Auto-injectors must be accessible. Do not
keep them locked up or in backpacks.
Backpacks may not be easily identified in
an emergency
Click on Auto-Injector for
Demonstration Video
Two Step Epipen Administration Procedure
‘Blue Sky, Orange Thigh’
Hold firmly with orange tip
pointing downward.
Remove blue safety cap
by pulling straight up.
Do not bend or twist.
Swing and push orange tip
firmly into mid-outer thigh
until you hear a “click.”
Hold on thigh for 10 seconds.
Regarding Allerject Recall
• If family has Allerject auto-injectors:
– Allerject auto-injectors (expiry date
between October 2015 – December 2016)
are to be returned to local pharmacy where
they can be exchanged for an alternative
auto-injector at no cost to the patient
Key Points to Remember
• You do not need to contact parents for consent to
give an auto-injector to the individual it is
prescribed for
• Antihistamines (e.g. Benadryl) can be given after
the auto-injector, not before
• Ensure that you use the correct person’s autoinjector (dose is based on weight)
• Do not put your thumb on either end of the
Epipen auto-injector
Resources
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foodallergycanada.ca
epipen.ca
aaia.ca
eworkshop.on.ca/allergies
csaci.ca/patient-school-resources