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Anaphylaxis in Schools

Anaphylaxis in Schools. Version for 2014-2015 School Year. Overview. 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)

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Anaphylaxis in Schools

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  1. Anaphylaxis in Schools Version for 2014-2015 School Year

  2. Overview • Sabrina’s Law • Expectations for School Staff • Definition of Anaphylaxis • Recognition • Action • How to use an Auto-injector

  3. 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

  4. Anaphylaxis Policy Requirements • Strategies to reduce risk of exposure • Communication plan • Regular training • Individual emergency plan • Request information from parents • Maintain file for each anaphylactic student

  5. 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

  6. 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.

  7. 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

  8. Expectations for School Staff • Written consent to administer auto-injector 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

  9. Key Recommendations Epinephrine is the first line medication Antihistamines and asthma medications mustnot be used first for anaphylaxis After receiving epinephrine, the person must go to hospital

  10. 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

  11. 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)

  12. Triggers Most Common • Foods - milk, egg, peanut, tree nuts, fish and shellfish, mustard, sulphites, soy, sesame seeds, wheat • Insect stings

  13. Triggers (cont’d) Other potential triggers: • medications • latex • exercise-induced • unknown (idiopathic)

  14. 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 Common Symptoms

  15. 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

  16. 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

  17. Action • Identify the individual (should wear Medic-Alert bracelet/necklace) • Lay student down where they are • If experiencing breathing problems or vomiting, keep the student sitting up • Remain with the student • Send someone for auto-injector • Have someone else dial 911 • Inject Auto-injector and record the time

  18. Action (cont’d) • 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

  19. What else? • In doubt? Give Auto-injector to student it is prescribed to • Used Auto-injector goes to hospital • Dosage is weight related, so make sure you get the right auto-injector for the right student ALLERJECT Blue label 15-30 kg Orange label 30 kg and over EPI-PEN Junior has green label 15-30 kg Adult has yellow label 30 kg and over

  20. Allerject™ 0.15 mg Used for individuals weighing 15 to 30 kg (33-66 pounds) Allerject™ 0.3mg Used in individuals weighing more than 30 kg (66 pounds)

  21. The orange cover extends to fully cover the needle after use.

  22. 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 or www.allerject.ca for reminders of expiration

  23. 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

  24. 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

  25. Click on Auto-Injectors for Demonstration Videos

  26. 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.

  27. Four Step Allerject Administration Procedure • Pull Allerject™ from the outer case 2. Pull off RED safety guard 3. Place BLACK end against the middle of the outer thigh (through clothing, if necessary), then press firmly and hold in place for five seconds. 4. Seek immediate medical or hospital care.

  28. 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 auto-injector (dose is based on weight) Do not put your thumb on either end of the Epipen auto-injector

  29. Resources • www.anaphylaxis.ca • www.epipen.ca • www.allerject.ca • www.aaia.ca • www.eworkshop.on.ca/allergies • www.allergysafecommunities.ca

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