1. Save a Life with Epinephrine - EpiPen®
Rachel Gallagher, R.N., A.P.N.P.
School Nurse Consultant
Wisconsin Department of Public Instruction
125 South Webster St.
Madison, WI 53707

2. Audio Difficulties?
Make sure the volume is turned up (volume button beneath the speaker’s picture)
Make sure the volume on the computer is turned up (volume icon located on the right hand side of your computer taskbar)
Contact your IT department
If audio and visual is lost during the program, go back to: and click on the Student Services Prevention and Wellness Team link on the left, then when the SSPW Team page of archived programs appears, select the program link desired.
If problem persists contact Rachel Gallagher (608)

3. This power point, web cast and competency test will satisfy the knowledge portion of medication training.
To complete the medication training for this emergency medication, school personnel will need to have a their medication administration skill verified and documented by a school nurse, medical provider or adequately training parent by performing an independent demonstration of the skill.
Competency checklist are available at:

4. Overview What is anaphylaxis? What is the prevalence?
What are the symptoms?
What are some common allergens?
What are the treatments?
What are the delivery devices?
Demonstration
Test

5. What is Anaphylaxis?
Is a sudden and severe immune system reaction that affects the whole body
Can be life-threatening
History of asthma and eczema increases prevalence of anaphylactic reactions
Estimated that there is 30,000 episode causing 100 to 200 deaths per year.

6. What is the prevalence of anaphylaxis?
30,000 emergency room visits
2,000 hospitalizations
150 deaths
Food and Drug Administration, 2007

7. What are some of the signs of anaphylaxis?
Skin - hives, swelling, tingling and flushing of skin, sweaty skin
Respiratory - respiratory distress, wheezing, coughing
Cardiovascular - increased pulse, decreased blood pressure

8. Signs continued
Gastrointestinal – nausea, vomiting and diarrhea, drooling
Genitourinary – incontinency, cramping
Central Nervous System – confusion, loss of consciousness
Feeling of impending doom

9. Pictures
Hives
Swelling

11. What are some of the common allergens that cause anaphylaxis?
Food
Insects
Drugs
Exercise-induced anaphylaxis
Food – Although 160 foods can cause allergic reactions in people with food allergies, 90% of the food allergic reactions are caused by 8 foods including: milk, eggs, fish crustacean shellfish, tree nuts, peanuts, wheat and soybean
Insects – Bees
Drugs –
Exercise induced anaphylaxis is rare but can occur

12. What are the school responsibilities for students with anaphylaxis?
Identify students with life-threatening food allergies
Develop school policies and protocol for management of anaphylaxis
Emergency and Individual Health Care Plan
Training of staff on condition, medications, and emergency plan
Develop strategies to minimize risk of exposure
Emergency Care Plan –
Indicates plan, contact numbers and people trained in management
It also contains a student specific plan for management of anaphylaxis. The ECP is very methodically indicating if you see this do that.

13. Treatment of Students with Anaphylaxis?
Administration of Benadryl and/or Epinephrine
Call 911
Check for relapse and administer second dose of epinephrine as needed
Monitor side effects
Monitor status of anaphylaxis
Notify parents/physician
Administraton of Benadryl and Epinephrine as indicated by orders. Some physicians will have you
35% of students who receive the first dose of epinephrine will have a reoccurrence of their symptoms and require a second dose 5-10 minutes after the first dose was given.
Anaphylaxis may recur 1 to 72 hours after initial signs and symptoms apparently resolve. Reported incidence of biphasic anaphylaxis varies from 1% to 23%

14. Epinephrine dosages
.15 mg for students less than 66 pounds or 30 kilograms
.30 mg for students greater than 66 pounds or 30 kilograms
Epi-pen® - .3 mg
Epi-pen Jr.® mg

15. Delivery Devices Epi-pen® New delivery device (1/10) Old device
Two delivery devices that come in different strengths
Old device

16. Steps for administration-Epi-Pen®
Flip open the yellow cap of the Epi-Pen® or the green cap of the Epi-Pen® Jr. auto injector carrier tube.
Slide out of carrier tube.
Grasp unit with fist and orange tip down.
With other hand, pull off blue safety release cap.

17. Steps for administration-Epi-Pen® cont.
Hold orange tip near outer thigh.
Swing and push against outer thigh at a right angle or perpendicular to the leg.
Hold firm against thigh for 10 seconds to deliver the medications.
Remove tip from leg and massage injection site for 10 seconds.

18. Demonstration - EpiPen®

19. Documentation
Every dose of medication need to documented with the date, time and initials of the person administering the medication on the medication log.

20. Questions?
School Nurse
Medical Provider
Parent

21. To Download this PowerPoint Presentation, go to:

22. Any comments regarding this webcast?
Any suggestions on future school nursing topics?
Contact:
Rachel Gallagher
(608)

23. Take Test. Upon Completion, take test to nurse or administrator for scoring.