Anaphylaxis in Schools 2017-2018 School Year
Overview Sabrina s Law Expectations for School Staff Definition of Anaphylaxis Recognition Action How to use an Auto-injector
Sabrina s Law Legislation: Bill 3 (January 1, 2006) Mandates publicly funded School Boards to establish and maintain an anaphylaxis policy Intended to educate school communities and prevent anaphylactic incidents It does not create allergen-free schools
Anaphylaxis Policy Requirements Strategies to reduce risk of exposure Communication plan Regular training Individual emergency plan Request information from parents Maintain file for each anaphylactic student
Required for Individual Plan Type of allergy, monitoring, avoidance strategies and appropriate treatment Individualized and readily accessible emergency procedure with emergency contact information Storage of epinephrine auto-injector
Sabrina s Law states: No action for damages shall be instituted respecting any act done in good faith or for neglect or default in good faith in response to an anaphylactic reaction, unless damages are result of gross negligence.
Expectations for School Staff Know emergency plan (copy of plan should be in your day planner) Know the location of emergency medication Administer epinephrine auto-injector
Expectations for School Staff Written consent to administer autoinjector is required In case of emergency, if written consent is not yet received, the auto-injector can be given to pupil it is prescribed to
Key Recommendations Epinephrine is the first line medication Antihistamines and asthma medications must not be used first for anaphylaxis After receiving epinephrine, the person must go to hospital
Key Recommendations A second dose can be given 5 to 15 minutes after first dose if symptoms have not improved or they return Expect that you will be required to administer the auto-injector
What is anaphylaxis? Severe systemic allergic reaction Can cause death Requires immediate action i.e. give the auto-injector and dial emergency medical services (911)
Most Common Triggers Foods - milk, egg, peanut, tree nuts, seafood (fish, crustaceans and shellfish), mustard, sulphites, soy, sesame, wheat Insect stings
Triggers (cont d) Other potential triggers: medications latex exercise-induced unknown (idiopathic)
Common Symptoms F.A.S.T. F: Face - itchiness, redness, swelling of face or tongue, metallic taste in mouth A: Airway - trouble breathing, swallowing or speaking S: Stomach - pain, vomiting, diarrhea T: Total rash, itchiness, swelling, weakness, paleness, sense of doom, loss of consciousness, uterine cramps
Characteristics of Symptoms Symptoms do not appear in any order May appear immediately or hours after contact with the allergen Symptoms may vary or become more severe with each exposure to allergen
Characteristics of Symptoms These can also be symptoms of other conditions. If they appear in a person diagnosed with anaphylaxis after potential exposure, ACT! Look for your Anaphylaxis Resource Kit for copies of the think F.A.S.T. poster
Action Identify the individual (should wear Medic- Alert bracelet/necklace) Get the person to the ground where they are If experiencing breathing problems, keep in an upright position If dizzy or fainting, place person on their back with legs raised above heart level If vomiting, place on their side with head down If getting worse, (but conscious and not vomiting) place on their back
Action (cont d) Remain with the student Send someone for auto-injector(s) Have someone else dial 911 Inject Auto-injector and record the time Remain with student. If breathing improves, lay the student down, cover, tilt head back and elevate feet Have someone else notify emergency contact Be prepared to give a second dose in 5 to 15 minutes if the reaction continues, progresses or returns
What else? In doubt? Give Auto-injector to student for whom it is prescribed Used Auto-injector goes to hospital Dosage is weight related, so make sure you get the right auto-injector for the right student EPI-PEN Junior has green label 15-30 kg Adult has yellow label 30 kg and over
EpiPen For adults and children weighing 30 kg (66 lbs) or more The orange cover extends to fully cover the needle after use. EpiPen Jr For children weighing 15 30 kg (33 66 lbs)
Questions and Answers Can I use an expired Auto-injector? The companies cannot recommend the use of expired auto-injector, however, if it is all that is available and the medication is not discoloured, use it. Encourage parents to register on www.epipen.ca for reminders of expiration
Questions and Answers Do I have to take the auto-injector to field trips, cross country meets and sports events etc.? Yes. The auto-injector must go everywhere the student goes. What should I do if I accidentally inject myself? You must go to the hospital
Questions and Answers Where should an auto-injector be kept? Auto-injectors must be accessible. Do not keep them locked up or in backpacks. Backpacks may not be easily identified in an emergency
Click on Auto-Injector for Demonstration Video
Two Step Epipen Administration Procedure Blue Sky, Orange Thigh Hold firmly with orange tip pointing downward. Remove blue safety cap by pulling straight up. Do not bend or twist. Swing and push orange tip firmly into mid-outer thigh until you hear a click. Hold on thigh for 10 seconds.
Key Points to Remember You do not need to contact parents for consent to give an auto-injector to the individual it is prescribed for Antihistamines (e.g. Benadryl) can be given after the auto-injector, not before Ensure that you use the correct person s autoinjector (dose is based on weight) Do not put your thumb on either end of the Epipen auto-injector
Resources foodallergycanada.ca epipen.ca aaia.ca eworkshop.on.ca/allergies csaci.ca/patient-school-resources