1. Epinephrine Training Today is the day that you will learn how to save a life!

2. Instructions for Viewing On-line Epinephrine Training  Epinephrine training for staff members will be completed on-line.  Please read the following document, view video and complete the quiz.  Once you have completed the above step, contact your school nurse to arrange for epinephrine skill demonstration and turn in your quiz.  If you have any questions regarding this inservice, contact your school nurse.

3. Objectives Upon completion of this in-service you will be able to:  Identify the proper documents that need to be in place prior to administering epinephrine  State the 5 Rights of medication administration  Learn the signs and symptoms of anaphylaxis  Identify common allergens  Identify treatment for anaphylaxis  Obtain skills to administer epinephrine  Identify proper documentation of medication administration

4. Prior to Dispensing Medication to Students It is extremely important that you understand your districts policy on medication administration. If you have questions on this policy or would like to review the policy, please ask your school nurse for clarification.  Prior to administering any medication to a student, the school must have on file a completed Administering Medication to Students form with the parent’s/guardian’s signature and dispensing physician’s signature.

5. Prior to Dispensing Medication to Students (cont.)  Wisconsin State Statute 118.29 states that the School District may give prescription medication to a student only with the completed directions from a physician and signed consent of the parents. Administering medication without the completed Administering Medication to Students form is a direct violation of our School District Policy and the Wisconsin Statute.  Wisconsin State Statute 118.2925 states that a school nurse or designee give epinephrine to a student with known anaphylactic allergic reactions and to those who the school nurse or designee believes in good faith is experiencing anaphylaxis. In each situation a call to 911 will be called for further assistance as soon as practical

6. Dispensing Medication to Students ALWAYS check the 5 “RIGHTS’ before administering medication to any student  Make sure you have the RIGHT student-ask name if you are unsure  Make sure you have the RIGHT medication  Make sure you have the RIGHT dose of the medication  Epinephrine Jr. is 0.15mg (33-66 lbs) and adult epinephrine is 0.3mg (over 66 lbs)  Make sure it is the RIGHT situation (time)  Make sure it is the RIGHT route of administration (epinephrine is an auto-injector)

7. Signs and Symptoms of Anaphylaxis Anaphylaxis may include one or more of the following symptoms:  Mouth: Itching and swelling of lips, tongue or mouth  Throat: Itching and/or sense of tightness or closing of the throat, hoarseness, hacking cough, difficulty swallowing  Skin: Hives, itchy rash, and/or swelling of any body part, flushed or pale skin  Gut: Nausea, abdominal cramps, vomiting and/or diarrhea  Lungs: Difficulty breathing, shortness of breath, repetitive coughing, and/or wheezing  Heart: Fainting or loss of consciousness, “thready” pulse, dizziness, change in mental status, cyanotic (bluish) lips and mouth area

8. Epinephrine Use Unknown triggers Exercise Allergy shots/desensitization Allergens:  Bee stings  Latex  Allergy shots  Food Allergies - most common allergens :

9. Treatment of Anaphylaxis Epinephrine is the drug of choice for anaphylaxis. Epinephrine Auto-injector is easy to use and should be administered PROMPTLY.  Some protocols call for epinephrine to be administered with or without symptoms A delay in treatment can have devastating results. Please click on link below to view video (10:30 min.) Double click or Right click here to select “open hyperlink” to view video Helpful tip for viewing video: If viewing presentation in the slide view mode, right click and open hyper link to view the video. If viewing in slide show mode, double click on the link to view video.

10. Types of Epinephrine Auto-Injectors

11. Epinephrine Steps to follow: If student has symptoms of anaphylaxis:  Give epinephrine without delay per provider’s orders (33- 66 lbs= 0.15 mg those that are over 66 lbs dose is 0.3 mg)  Call 911 to transport student to hospital- this is required per State Law  Activate your school’s emergency response team for support Do not leave student alone!

12. Documentation  Consult with your school nurse on proper documentation  Dependent on your school district’s policy, you might need to complete an incident report. Consult with your building administrator or school nurse.

13. Thank you for taking the time to complete this training.

14. Acknowledgement  This DPI approved epinephrine training curriculum was developed by Diana Hoffman, RN, BSN, NCSN and Toni Zastrow, RN, BSN, NCSN. Diana and Toni are part of the Fort HealthCare School Nurse Program, which serves over 12,000 students in eight school districts in southeastern Wisconsin. Diana serves as the school nurse for Whitewater Unified School District and Toni serves as the school nurse for the Lake Mills Area School District.