1. Anaphylaxis EpiPen Training

2. A potentially life-threatening severe allergic reaction to a substance

3.  View the powerpoint  Take test on Anaphylaxis and EpiPens and print copy.  Contact school nurse ◦ Bring completed test for review ◦ View and give return demo on EpiPen use

4.  Insects, Bees  Peanuts or Tree nuts  Latex or rubber  Medication  Foods  Unknown cause Types of life threatening allergies usually seen in students.

5.  When an allergic reaction is life threatening, it is called anaphylaxis  Students with anaphylaxis should have a health care plan prepared by the school nurse  Key personnel including health technicians, teachers of affected students and campus supervisors should be familiar with the care plan and emergency actions necessary

6.  Any respiratory system involvement  Difficulty breathing  Audible wheezing  Difficulty swallowing

7.  Hives  Itching  Swelling  Wheezing  Sense of doom  Fainting or loss of consciousness  Dizziness  Throat tightness or closing  Difficulty breathing  Stomach cramps  Change of voice  Runny nose  Vomiting  Diarrhea  Difficulty swallowing  Red, watery eyes  Change of color

8. Who can train? Who can be trained? What is required before training? How often must an individual be trained?  The school nurse  Designated school personnel who have volunteered to be trained  Current CPR certification  Annually

9.  Determine if anaphylaxis is suspected.  Anaphylaxis usually, but not always occurs right after exposure to an allergen.  Frequently anaphylaxis occurs in individuals who have a history of a previous reaction.  If there is uncertainty about the diagnosis, but there is reasonable probability that it is anaphylaxis, then treat as anaphylaxis.

10.  If anaphylaxis symptoms are present, Administer EpiPen.  Call 911 or activate the emergency medical system (EMS). Stay with the victim.  Have others notify the paramedics, school nurse, parents and school administrator immediately.  Have the victim sit or lay down. Reassure the victim and avoid moving him or her. Calming reduces distribution of allergen in the body.

11.  Know where the EpiPens are stored ◦ EpiPens are stored at room temperature ◦ Frequently check expiration dates of EpiPens  Be familiar with students who have EpiPens  Review the health care plans for students who have EpiPens  Frequently review CPR

12.  For students in second grade or below, or if less than 66 lbs., use White label EpiPen Jr. (0.15mg.)  For adults and students in third grade or above, or if more than 66lbs., use Yellow label EpiPen (0.3mg)  The EpiPen acts immediately; however the effects last only 10-15 minutes. Be sure to have someone call 911 immediately.

13.  Grasp the EpiPen and form a fist around the unit.  With the other hand, pull off the GRAY Safety cap.  Hold the black tip near the outer thigh. Never put thumb, fingers, or hand over the black tip.

14.  Swing and jab the black tip firmly into the OUTER THIGH so that the auto injector is perpendicular (at a 90 Degree angle) to the thigh. You will hear a click. (The EpiPen can be injected through the victims clothing, if necessary.)  Hold the EpiPen firmly in place for 10 seconds and then remove it from the thigh.

15.  Remove the EpiPen and massage the injection site for 10 seconds.  Check the black tip: ◦ If the needle is exposed, the dose has been given ◦ If the needle is not exposed, repeat  Return the used EpiPen to the plastic container.  Give the used EpiPen to paramedics. Watch YouTube - Using Epipen

16.  If symptoms continue and paramedics do not arrive, use a new EpiPen and re-inject 15 to 20 minutes after the initial injection.  Continue to monitor the victim’s airway and breathing.

17.  Observe the victim for signs of shock. Cover the victim with a blanket.  Monitor the victim’s airway and breathing.  Begin CPR immediately if the victim stops breathing.

18.  If the anaphylactic reaction is due to an insect sting, remove the stinger as soon as possible after administering the EpiPen. Scrape with a fingernail or plastic card, do not squeeze, push or pinch. Apply ice pack to sting area.

19.  Document the incident and complete the accident/incident report.  Include ◦ the date and time the EpiPen was administered ◦ The victim’s response ◦ Additional pertinent information  Send a copy of the report to the school nurse

20. Except for a short test!