1. Anaphylaxis Caring for Children in a Community Program 2013-04-02

2. Allergies Excessive reaction to a normally harmless substance (allergen) Immune system creates IgE antibodies in response to allergen When exposed to allergen, IgE antibodies cause symptoms Vary from mild to life- threatening

3. Anaphylaxis Severe allergic reaction Extreme total body reaction Can result in death due to airway obstruction or a severe drop in blood pressure Can be triggered by minute amounts of an allergen

4. Allergens FOOD Peanuts Nuts Milk Eggs Fish Shellfish Wheat Sesame Soy OTHER Insect stings Medication Latex

5. Risk Reduction Avoidance of allergens is the only way to prevent an anaphylactic reaction Greatest risk of exposure to food allergens occurs in new situations What risk reduction strategies are implemented in your community program?

6. Establishing an allergen aware policy Supervision of young children while eating No trading or sharing of food or utensils Hand washing before and after eating Cleaning surfaces Common Risk Reduction Strategies

7. Signs of Anaphylaxis (Think F.A.S.T) Stomach severe vomiting severe diarrhea severe cramps Total body swelling hives itchiness sense of doom change in behavior pale or bluish skin dizziness fainting loss of consciousness Face red watery eyes runny nose itchiness redness swelling hives Airway throat tightness change of voice difficulty swallowing difficulty breathing coughing wheezing

8. Epinephrine Constricts blood vessels, relaxes airway muscles, reduces swelling, reduces release of chemicals that cause allergic reaction, stimulates heart Side effects include rapid heart rate, paleness, dizziness, weakness, tremors, headache Anti-histamines are not used If ANY combination of signs is present and there is reason to suspect anaphylaxis, give epinephrine If in doubt, TREAT!

9. Anaphylaxis & Asthma Children are at higher risk for severe allergic reactions if they also have asthma If uncertain if child is having anaphylactic reaction or asthma episode, give epinephrine first

10. Adrenaline Auto-injectors Spring-loaded syringe with concealed needle EpiPen®, Twinject®, Allerject™ 2 dosages (0.15 mg, 0.3 mg) Stored at room temperature Has expiry date Should be kept with child Twinject® has 2 nd dose that cannot be administered by community program

11. How to Use Adrenaline Auto-injector 1.Secure child`s leg. 2.Identify injection area on outer middle thigh. 3.Grasp adrenaline auto- injector in your fist. 4.Remove safety cap(s). 5. Firmly press tip into thigh at 90° angle until you hear a click. 6. Hold in place for a slow count of 5. 7. Discard adrenaline auto- injector safely or give to EMS personnel.

12. 1.Inject adrenaline auto-injector. 2.Activate 911/EMS. 3.Notify parent/guardian. 4.If signs persist or recur, give backup adrenaline auto-injector (if available) every 5 to 15 minutes. 5.Stay with child until EMS personnel arrive. How to Respond to an Anaphylactic Reaction

13. Child Specific Information It is important to be aware of the children with anaphylaxis in your care AND: their life threatening allergen(s) the location of their adrenaline auto-injector This information is included in the child’s Anaphylaxis Health Care Plan