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1 TREATMENT OF SEVERE ALLERGIC REACTION Protocol for Training PowerPoint  Presentation Based on “Treatment of Severe Allergic Reaction, A Protocol for.

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Presentation on theme: "1 TREATMENT OF SEVERE ALLERGIC REACTION Protocol for Training PowerPoint  Presentation Based on “Treatment of Severe Allergic Reaction, A Protocol for."— Presentation transcript:

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2 1 TREATMENT OF SEVERE ALLERGIC REACTION Protocol for Training PowerPoint  Presentation Based on “Treatment of Severe Allergic Reaction, A Protocol for Training” revised January 2008

3 2 zThe Oregon Department of Human Services and the Oregon Department of Education gratefully acknowledge Multnomah Education Service District Department of Health and Social Services for their assistance in the development of this training material. zThese materials may not be reproduced for profit. Copyright. All rights reserved.

4 3 Introduction zAnaphylaxis is a sudden severe allergic reaction zSensitive individuals can experience reactions from: yFood yMedication yInsect stings yExercise yOther

5 4 Introduction, cont’d. zIn the US each year there are: yApproximately 50 deaths due to insect stings yApproximately 100 deaths related to food allergies

6 5 Introduction, cont’d. Immediate injection of epinephrine is the single factor most likely to save a life during anaphylaxis!

7 6 Introduction zLegislation passed in authorized trained individuals to administer epinephrine to people suffering severe reactions to insect stings. zLegislation expanded in 1989, to include reactions to other allergens. zIntended for situations where medical help is not immediately available: yschools ycamps yforests yrecreational areas

8 7 Explanation of Laws zPerson must meet qualifications for training yBe 21 years of age or older yReasonable expectation to come into contact with sensitive individuals yComplete approved training program

9 8 Who Should Be Trained? zPublic or private school employees zCamp counselors or employees zYouth organization staff or volunteers zForest rangers zForemen of forest workers zAny person with exposure to risk

10 9 Who Should Be Trained? zAdditional training yThese persons are strongly encouraged to obtain and maintain current training in approved First Aid and CPR course

11 10 Once Training is Complete zQualified individuals receive a signed certificate zThe certificate can be used as a prescription for pre-measured doses of epinephrine (1 adult dose and 1 child dose) zPrescription can be filled up to four times zThe prescription is issued in the name of the trained person (this is not a personal prescription) zCertificates expire 3 years after issuance zUse limited to situations where a licensed health care professional is not immediately available

12 11 Training Overview zWhat can trigger anaphylaxis? yInsect stings, food, medication, other zFor each allergen: yLikely culprits yAvoidance measures zIdentifying the sensitive individual; steps to take ahead of time

13 12 Training Overview, continued zRecognizing Anaphylaxis zTreatment for Anaphylaxis yBasic information about epinephrine yHow to give epinephrine ySequence of steps for responding to anaphylaxis zQuiz

14 13 What is ANAPHYLAXIS? zAnaphylaxis is a generalized, immediate life-threatening reaction to a foreign protein or allergen yInsect’s venom yFood yMedication yPollen yOther

15 14 What is Anaphylaxis? zSevere life-threatening allergic reactions are rare zImmediate administration of epinephrine is vital zPerson may be unable to self-administer zPerson may have no history of allergic response

16 15 What is Anaphylaxis? The 2 key steps in saving a life are: 1.Recognition of anaphylaxis when it occurs; and 2.Swift administration of epinephrine

17 16 Recognizing Anaphylaxis zThere are many possible symptoms zThere may be only one symptom, or there may be many! zWhat symptoms has the person experienced before zReactions vary from person to person

18 17 Recognizing Anaphylaxis zAnaphylaxis usually occurs quickly yReaction can start within seconds yDeath can occur within minutes yDelayed reactions are also possible

19 18 Symptoms Of Anaphylaxis (slide 1 of 3) zSneezing, wheezing, or coughing zShortness of breath / Difficulty breathing zTightness in chest zDifficulty swallowing zHoarseness zSwelling of eyes, lips, face, tongue or elsewhere

20 19 Symptoms Of Anaphylaxis (slide 2 of 3) zSweating and anxiety zNausea, abdominal pain, vomiting and diarrhea zDizziness and/or fainting zLoss of bowel or bladder control zSense of impending doom or death zRapid or weak pulse

21 20 Symptoms Of Anaphylaxis (slide 3 of 3) zFlushed skin or extreme pallor zItching, with or without hives zRaised red rash in any area of the body zBurning sensation, especially in face or chest zBlueness around lips, inside lips, or eyelids zLoss of consciousness

22 21 Possible Allergens - Insects zIt is estimated that 8 in every 1,000 people are allergic to insect stings zStinging insects account for 40 to 100 deaths per year in the U.S.

23 22 Possible Allergens - Insects zBees, wasps, hornets and yellow jackets cause most fatal reactions zYellow jackets are most common in the Pacific Northwest zInsects are more likely to sting during the late summer and fall zBees are more likely to sting on warm, bright days

24 23 Insect Identification zIf possible, it is important to identify stinging insects, but this should never delay treatment! zOnly the honey bee leaves a “stinger”

25 24 How to Avoid Insect Stings zStinging insects are attracted to: yLight yellow and blue colors ySweet drinks (soft drinks, juice, beer) yCosmetics, lotions, perfumes, and hair spray yPaint fumes yFood odors yHeat given off by dark colors

26 25 Increased Risk of Insect Stings Associated With: zPicnics, cooking / eating outdoors zAreas of trash / garbage zAreas of insect habitat zFlowers zBright colored clothing zFragrant perfumes / cosmetics zExposed skin zBecoming excited

27 26 How To Avoid Insect Stings zSensitive or suspected sensitive person should wear: ySmooth, hard finish white or tan clothing yHats yLong sleeved shirts and slacks ySocks and shoes zGently brush insects away - don’t swat

28 27 What is not an anaphylactic reaction to insect sting? Normal Reactions zProduce localized, sharp pain at sting site yRedness, heat and swelling occur ySwelling about the size of a quarter xUsually lasts about 24 hours zMedical attention usually not needed zStings around eyes, nose or throat may be more serious yShould seek medical care

29 28 Intervention Steps For Normal Reactions zRemove stinger as soon as possible zCleanse sting site zApply ice pack zElevate limb zReassure and calm the person zObserve for at least 30 minutes

30 29 What is not an anaphylactic reaction to insect sting? Localized Reactions To Insect Stings zAllergic reaction to allergen zInvolves pain, itching and swelling yLarger area of swelling than normal reaction ySwelling extends and crosses major joint line ySwelling does not involve other areas of body zMay be delayed zSymptoms may last up to one week or more

31 30 Intervention Steps For Localized Reactions zRemove stinger zCleanse sting site zApply ice pack zElevate limb zReassure and calm person zGive antihistamine (Follow school policies) zKeep person quiet zObserve for at least one hour

32 31 Toxic Reactions To Stings zSystemic reaction results from multiple stings (usually 10 or more) zSymptoms may include: yGastrointestinal, diarrhea, vomiting yDrowsiness, fainting, or unconsciousness yGeneralized swelling yHeadache and fever yMuscle spasms or convulsions

33 32 Intervention Steps For Toxic Reactions zStay with person - delegate call to zObserve for symptoms of anaphylaxis zGive epinephrine if necessary zRemove stingers promptly zReassure and calm person zHave person transported for medical help

34 33 Possible Allergens-Foods yNearly any food can trigger an allergic reaction at any age yFood allergies are most common in children and appear to be increasing in frequency yApproximately 4 percent of US children have a food allergy

35 34 Possible Allergens - Foods Foods most often associated with anaphylaxis: zPeanuts yMost common cause of anaphylaxis in children yThe food most frequently causing fatal reactions zFish and shellfish yShellfish are the food most frequently causing anaphylaxis in adults zTree Nuts zEggs zSoy zMilk zWheat

36 35 Food Avoidance zAvoid exposure to known allergens zInform food preparation personnel of known allergies zLunch swapping or sharing should be avoided zRead labels on food & skin-care products zAvoid cross-contamination

37 36 Possible Allergens - Medications zA person may experience reactions to any medication at any time zMost common medications to cause reactions: yPenicillin yAspirin yAllergy injections

38 37 Other Possible Allergens zPollens zLatex yGloves, balloons, rubber bands, yace wraps, first aid tape, erasers, bungee cords, et cetera! zExercise zUnknown substances

39 38 Identifying the sensitive individual Steps to take BEFOREHAND: zWho in your group has a history of severe allergic reactions? zGet signed consent for emergency treatment- **Do not delay treatment if not available! zKnow how to get emergency help yWhere is the nearest hospital? EMT unit? yDetermine ahead of time how to call for help

40 39 EMERGENCY PLAN zPrepare for identified and unidentified individuals zKnow where the epinephrine is kept zWho is trained to give epinephrine zWho is 1 st aid/CPR trained zReview the plan yearly

41 40 Treatment For Anaphylaxis zAdminister epinephrine at the first sign of a systemic reaction zTiming is essential zThe sooner that epinephrine is given, the greater the chance for survival

42 41 Treatment For Anaphylaxis zWe will first go over detailed information on epinephrine and how to give it; z Then we will go over the entire sequence of steps for responding to anaphylaxis.

43 42 Epinephrine zPowerful drug used for treatment of anaphylaxis zMust be obtained by prescription zMost immediate and effective treatment available zCan only be injected into fatty area under the skin, usually the lateral thigh zMay have side effects

44 43 How Epinephrine Acts On The Body zConstricts blood vessels zRaises blood pressure zRelaxes bronchial muscles zReduces tissue swelling

45 44 Possible Side Effects/Risks Of Epinephrine zRapid heart rate zNervousness or anxiety zNausea zVomiting z Sweating z Pallor z Tremors z Headache

46 45 Storage And Handling Of Epinephrine zStore in dark place at room temperature yDo not allow syringe to freeze zKeep away from sunlight zCheck medication for discoloration ySolution should be clear zCheck expiration date

47 46 EpiPen  zAdvantages yAuto-Injector system delivers pre-measured dose of epinephrine yNo preparation needed Note: No other device may currently be used by persons completing this training.

48 47 EpiPen  Administration *Don’t delay to weigh!!!

49 48 EpiPen JR  Administration ** Although the EpiPen JR is not recommended for use with small children (infants and toddlers), the risks of death from true anaphylaxis are greater than the risk for administering epinephrine to this age group.

50 49 Responding to Anaphylaxis: How to Give Epinephrine zGiven via pre-measured injection zInjected into the subcutaneous tissue (fatty area under the skin) zUsually given in lateral thigh zAuto-injector can be given through clothing

51 50 Responding to Anaphylaxis: How to Give Epinephrine, cont’d. zDetermine proper dosage zUnscrew the yellow or green cap off of the EPIPEN® carrying case and remove the auto-injector from its storage tube. zGrasp the unit with the black tip pointing downward. zWith your other hand, pull off the gray safety cap.

52 51 Responding to Anaphylaxis: How to Give Epinephrine, cont’d. zPlace black tip of EPIPEN® near outer thigh, at right angle to leg. zIf thigh cannot be used, use thickest part of upper arm. zThe injection can be given through clothing if necessary. zSwing and jab firmly at 90 degree angle into outer thigh until the auto-injector clicks.

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54 53 Responding to Anaphylaxis: How to Give Epinephrine, cont’d. zHold the EPIPEN® firmly against the thigh for approximately 10 seconds. (The injection is now complete, and the window on the EPIPEN® will show red.) zThe EPIPEN® auto-injector may then be removed; massage the injection area for 10 seconds.

55 54 Responding to Anaphylaxis: How to Give Epinephrine, cont’d. zCarefully place the used EPIPEN®, needle-end first, into the storage tube of the carrying case, using one hand only to avoid a needle stick. zScrew the cap of the storage tube back on completely. zIf possible, write the time that the medication was given on the carrying case; this can be given to the emergency medical personnel when they arrive.

56 55 Intervention Steps For Anaphylaxis 1.Determine if the person is suffering an anaphylactic reaction. It is safer to give the epinephrine than to delay treatment. This is a life-and-death decision. 2.Do not move the person, unless the location poses a safety threat. 3.Have the person sit or lie down.

57 56 Intervention Steps For Anaphylaxis, cont’d. 4.Determine proper dosage and administer epinephrine from pre- measured syringe. 5.Have someone call for emergency medical assistance (9-1-1). 6.Remove stinger if one is present 7.Reassure and calm person if possible.

58 57 Intervention Steps For Anaphylaxis, cont’d. 8.Check for and maintain open airway by listening and observing person’s breathing. 9.Administer CPR if needed. 10.If the person experiencing an anaphylactic reaction is also asthmatic, you can assist the person in the use of his or her own inhaler if desired, after epinephrine is given.

59 58 Intervention Steps For Anaphylaxis, cont’d. 11.Always relinquish care to EMS/911 when they arrive on scene. A person who has been given treatment for a severe allergic reaction must receive immediate and continuing medical attention

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