Presentation on theme: "OBJECTIVES OF SESSION Update your knowledge on anaphylaxis"— Presentation transcript:
1GUIDELINES FOR MANAGEMENT OF ANAPHYLAXIS IN EDUCATIONAL ESTABLISHMENTS DHSSPS /DOE 2010
2OBJECTIVES OF SESSION Update your knowledge on anaphylaxis Be aware of the emergency treatment prescribed for children with this conditionPractise the correct technique for auto-injector administrationBe aware of how to safely dispose of the auto-injector
3WHAT IS ANAPHYLAXIS?Anaphylaxis is a severe, life-threatening, generalised or systemic hypersensitivity reaction. It is characterised by rapidly developing life-threating problems involving the airway and /or breathing and /or circulation. In most cases, there are associated skin and mucosal changes
4COMMON CAUSES Peanuts Tree nuts Milk Egg Sesame Fish Shellfish Wasp BeeLatexPenicillinBlood ProductsDrugsKiwi
5TYPES OF REACTIONUni-phasic – rapidly developing severe reaction involving the airway or circulation.Bi-phasic – early oral and abdominal symptoms, then a symptom-free period of 1 – 2 hours, then increasing symptoms involving breathing and circulation.
6MINOR REACTION Feeling hot or generalised flushing of the skin Intense itching and rapid development of a nettle like rash weltsBurning sensation of lip and /or metallic taste in mouthRed, itchy, watery, swollen eyes or swollen lips or faceVomiting and diarrhoea with abdominal painItchy, runny or congested nose and / or sneezingDizziness and feeling faint/pallor – may indicate severe reaction in the very young.
7TREATMENT FOR MINOR REACTION ANTIHISTAMINE AND INHALERSFollow the child’s individual care plan. Administer the prescribed antihistamine e.g. Piriton and/or inhalerRecord the time given and stay with the childContact parent.
8SEVERE REACTIONDifficulty in breathing / noisy breathing, wheeze or stridorSwelling of mouth / tongue or feeling of tightness or lump in throatDecreased level of consciousnessCollapse, lack of breathingAbsent or very weak pulse
9TREATMENT OF SEVERE REACTION Give prescribed Auto-injector & record timeIf unconscious but breathing place in recovery positionCall paramedic ambulance 999Contact parent / carer (contact numbers given over)If no improvement within 5 minutes give auto-injector & record timeIf no signs of life commence CPR (cardiopulmonary resuscitation) and continue until professional help arrivesIF IN DOUBT GIVE AUTO-INJECTORIf Auto-injector is given the child MUST go to hospital for observation even if they have made a full recovery
14AUTOINJECTORAn Auto-injector EpiPen or Jext is prescribed according to the child’s weight to deliver a single dose of adrenaline and reverse the symptoms of anaphylaxis.Child dose 0.15mgsAdult dose 0.3mgs
15STORAGE OF EMERGENCY BOX Accessible at all times during the school day – NOT in a locked room or cupboard.Contains completed care plan with medication in dateAvoid extremes of temperature.Clearly labelled with child’s name.
16ROLES AND RESPONSIBILITIES The Child’s Parent :-Will ensure that the school are fully informed about the child’s allergy including when no longer allergic to particular foods or substancesCare plan to be completed by parent and returned to school promptlyWill accept responsibility for maintaining and replacing in school, two up to date auto injectors. If the child has been prescribed an Auto-injector device that the school has no experience of using, the school and school nurse should be immediately informed.
17It is the duty of the parent to check the expiry date of the Auto-injectors. The parent should return out of date auto-injectors to pharmacy for disposalWill discuss with the school arrangements for lunch and snacks.Will regularly remind the child of the need to refuse any food items offered by others.Will encourage their child to wear a medical identification deviceWill remove all medication at the end of the school year.
18The school :-The school principal (or designated teacher) will notify school nurse on becoming aware of a pupil requiring an adrenaline Auto-injector device e.g. EpiPen / Jext or Anapen in schoolThe principal or designated teacher will make staff aware of pupils allergic condition and who trained staff are (temporary /substitute teachers)The principal or designated teacher will identify adequate numbers of appropriate staff to attend training. Annual updated anaphylaxis centralised training will be offeredInform staff of activities which could put the pupil at riskSchool trips – school should make arrangements for safe handling and transportation of Auto-injector
19Should discuss details of care plan and child’s condition with parents. The principal will ensure that the care plan is signed appropriately. If care plan not returned or updated it is the responsibility of school to follow up with parent.Will agree with the parents and if necessary, the area catering manager on the provision of school meals/snacks.Will ensure safe storage of, and easy access to, the two auto- injectors devices together with care plan. All trained staff must be aware of where these are stored.It is the duty of the parent to check the expiry date of Auto- injectors, however schools should be aware of expiry dates on medication to ensure that they not left with out of date medication.
20The Pupil (depending on age of child) Post primary pupils may be responsible for carrying their own Auto-injectors WITH THEM AT ALL TIMES especially when away from main building e.g. sports fieldsWill be aware of the risk of food sharingAdvised to wear medical identifierReport the onset of symptoms to a responsible member of staff
21School Health Team :-Provide centralised training on the recognition and treatment of anaphylaxis in partnership with SELB and give advice and support to school staff.Participate in any debriefing session/follow up of major or minor incidentWill contact the parents and school, on an annual basis, seeking updated information and send a copy of care plan to parents for completionThe named school nurse for your school will only make 2 attempts via telephone to contact parents regarding the annual updating of Autoinjector care plan. This is the parents responsibility.If care plan not returned a letter will be sent to parents , GP and Principal stating this could place their child at risk should an emergency situation arise.School nurse along with school designated teacher will review care plan when returned by parent and sign appropriately
23Known severe allergies ___________ Name:_________Date of Birth:______Minor reactionKnown severe allergies ___________Keep calm, stay with pupil and call for helpGive prescribed medication e.g. Piritonif asthmatic give 4-6 puffs of reliever (blue) inhalerRecord medication administered and the time it is givenLocate pupil’s prescribed auto-injectorContact parent or carer
25IF IN DOUBT GIVE AUTO-INJECTOR Give prescribed Auto-injector & record time__________If unconscious but breathing place in recovery positionCall paramedic ambulance 999Contact parent / carer (contact numbers given over)If no improvement within 5 minutes give Auto-injector & record time_________________If no signs of life commence CPR (cardiopulmonary resuscitation) and continue until professional help arrivesUsed Auto-injector accompanies child to hospitalIF IN DOUBT GIVE AUTO-INJECTORForm fist around Auto-injector and pull off BLUE cap (JEXT YELLOW cap)Hold Auto-injector 10cm away from outer thigh. ORANGE (JEXT BLACK) tip should point towards outer thigh through clothing if necessary.Jab firmly into outer thigh so that autoinjector is at right angle to outer thigh until a click is heard and hold in place for 10 seconds.Remove Auto-injector and massage the injection site for 10 seconds. Used Auto-injector accompanies child to hospital
26Frequently asked questions In an emergency can I use another pupil’s Auto-injector?What do I do if a care plan is not returned by parent?Who should attend Anaphylaxis Awareness?Is prescription required from GP?
27Today you should have: Updated your knowledge Be aware of the emergency treatment prescribed for children with this conditionPractised the correct technique for auto injector administrationBe aware of how to safely dispose of the injector.
28WANT MORE INFORMATION? Contact the Anaphylaxis Campaign Tel:Schools packVideo/DVDManaging Medicines in Schools ans Early Years Settings. DH/DfES.
29Contact telephone numbers for school nursing ArmaghDungannonBanbridgeCraigavonNewryKilkeel