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Slide 1
By Dana Ashe, RN, CCHC Jackson County Health Department
Slide 2
Severe Allergic Reaction Training Pre-Test Please fill in the
blanks with F (false) and T (True) 1. _____ Anaphylaxis is a mild
reaction to a substance you are allergic to. 2. _____ The Epi-Pen
and Epi-Pen Jr. can be used interchangeably. 3. _____If you have
never had an allergic reaction, you will probably never have one.
4._____After administering the Epi-Pen, I should only call 911 if
the parents want me to. 5._____An Epi-Pen must always be kept in a
locked container. 6._____The Epi-Pen is a quick and painless way to
administer epinephrine and save a childs life. 7. The body systems
that are affected in an allergic reaction are: (Please Circle One)
A. The Skin B. The Respiratory System C. The Gastrointestinal
System D. The Sympathetic Nervous System E. A and B F. All of the
above
Slide 3
Objectives The trainee will: Learn what anaphylaxis is Causes
of anaphylaxis Signs and symptoms Treatment (antihistamine vs.
EpiPen) Learn how to use the EpiPen auto injector Storage When to
implement an Individualized Emergency Care Plan. When to call
911
Slide 4
Definition Anaphylaxis is a potentially life- threatening
allergic reaction caused by exposure to specific allergen triggers.
Rapid, severe, symptoms can be fatal within minutes or can take two
hours or more.
Slide 5
Anyone can have an Anaphylactic reaction! After: ingestion
Inhalation Skin Contact Or: injection of an allergen Allergens are
substances that cause an overreaction of the bodys defense
mechanism.
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What do I look for? Mild reactions are usually more localized.
The child will be able to participate in normal activities. But!
Always keep in mind: It only takes 1-2 minutes for a mild reaction
to escalate to severe anaphylaxis!
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Physical Changes Itching of the skin/eyes (tears) Raised rash
(hives) flushing Headache Nausea & Vomiting Abdominal Cramps
Hoarseness Cough-Wheezing Shortness of Breath
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Hives
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Physical Changes Swelling of the tissues of the lips, throat,
tongue, hands and feet. Problem swallowing, Metallic taste Anxiety
Sense of impending doom Hypotension, dizziness or loss of
consciousness
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Swelling of the lips
Slide 12
Angioedema Angio prefix that relates to blood vessels Edema The
presence of abnormally large amounts of fluid in the intercellular
tissue spaces (between the cells). Severe allergic reactions cause
angioedema deep in the soft tissue of the throat and neck causing
the throat to swell shut, cutting off the persons ability to
breathe.
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What Causes Anaphylaxis??? Foods (leading cause outside
hospital) Some insect venoms (bee stings are common cause)
Medications Latex Allergy Exercise Idiopathic
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Foods These 6 common foods account for 90% of reactions. Milk
Eggs Peanuts Tree Nuts Soy Wheat
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Other food triggers may include: Legumes Cheese Fruits Unknown?
(Idiopathic)
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Insects Bees Wasp Yellow Jackets Hornets Fire Ants
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Medications Antibiotics *Penicillin, Cephalosporins, etc.
Aspirin, NSAIDS Chemotherapeutic Agents Biological (Vaccines) Radio
Contrast Media
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Latex Allergy Proteins in natural rubber latex Rubber bands
Elastic (undergarments) Hospital and dental equipment !!!Latex
dipped products are biggest culprits --- Baloons, gloves, bandages,
water bottles, etc.
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Exercise Exercise induced anaphylaxis is a form of physical
allergy. Although the mechanism of action is unknown, it may be
related to ingestion of some medications or foods before exercise.
Rare
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Idiopathic Idiopathic anaphylaxis is a life threatening
allergic reaction that occurs in the absence of any known allergen.
IN OTHER WORDS, Nobody really knows what causes Idiopathic
Anaphylaxis.
Slide 22
Remember Common symptoms or a reaction can range from mild to
severe. The severe or life threatening reactions are called
anaphylaxis. No predictable pattern. The time between exposurue to
allergen and symptoms can vary depending on the allergen, exposure
and sesnitivity.
Slide 23
Treatment Remove child from allergen contact. Refer to care
plan and provide medications and treatments as indicated. Mild s/s
may indicate need for antihistamine or decongestants. Severe s/s
may indicate need for epipen.
Slide 24
Treatment Use epipen if required (per care plan instructions)
used for emergency symptoms as indicated. After epipen ---Call
911!!! Dont delay, the EpiPen is only effective for 15-20 minutes.
Call parents
Slide 25
Treatment Child should be lying on back with feet elevated.
Keep child warm and loosed tight clothing. Dont give anything to
drink. Comfort child Monitor signs and symptoms Do not leave child
unattended.
Slide 26
Demonstration EpiPen
Slide 27
EpiPen Jr. Used for children delivers one dose of 0.15mg.
Epiniphrine intramuscularly.
Slide 28
EpiPen Should be labeled with childs name and stored with a
copy of the care plan. Store unlocked and out of reach of children.
Store away from direct sunlight. Do not refrigerate. Check
expiration date monthly. Check = replace if cloudy or
discolored.
Slide 29
EpiPen If EpiPen is expired, it is better to give it in an
emergency than to give nothing at all!!
Slide 30
Anaphylactic Prevention Screen people at risk See MD for proper
diagnosis and treatment. Wear Medic-alert* accidental exposures are
never planned/be prepared! Education on avoidance of
allergens.
Slide 31
As many as 35% of people who have an anaphylactic reaction will
experience a recurrence in the hours following the beginning of the
reaction and will require further treatment, including addition
epinephrine injections.
Slide 32
Management Identify children with allergies (review medical
form and talk to parents). Identify specific allergen. Remove as
many allergens from environment as possible. Post allergies
(helpful = childs picture)
Slide 33
Management Read labels monitor ingredients Obtain written MD
instructions Team approach to develop care plan Learn to recognize
s/s of mild to severe allergic reactions.
Slide 34
Management Learn to administer emergency medications safely and
appropriately. Know when and how to give meds (specific individual
instructions on care plan). Develop policies for safe storage and
accessibility of emergency meds. Call for help and stay calm!!
Slide 35
Post - Test Please fill in the blanks with F (false) and T
(True) 1. ___F__ Anaphylaxis is a mild reaction to a substance you
are allergic to. 2. ___F__ The Epi-Pen and Epi-Pen Jr. can be used
interchangeably. 3. ___F__If you have never had an allergic
reaction, you will probably never have one. 4.___F__After
administering the Epi-Pen, I should only call 911 if the parents
want me to. 5.___F__An Epi-Pen must always be kept in a locked
container. 6.___T__The Epi-Pen is a quick and painless way to
administer epinephrine and save a childs life. 7. The body systems
that are affected in an allergic reaction are: (Please Circle One)
A. The Skin B. The Respiratory System C. The Gastrointestinal
System D. The Sympathetic Nervous System E. A and B F. All of the
above
Slide 36
References Refer to Caring For Our Children Standard 4.010