Responding to Allergic Reactions & Anaphylaxis

Responding to Allergic Reactions & AnaphylaxisBy Dana Ashe, RN, CCHCJackson County Health Department

Severe Allergic Reaction TrainingPre-TestPlease 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 SkinB. The Respiratory SystemC. The Gastrointestinal SystemD. The Sympathetic Nervous SystemE. A and BF. All of the above

ObjectivesThe trainee will:Learn what anaphylaxis isCauses of anaphylaxisSigns and symptomsTreatment (antihistamine vs. EpiPen)Learn how to use the EpiPen auto injectorStorageWhen to implement an Individualized Emergency Care Plan.When to call 911DefinitionAnaphylaxis 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.Anyone can have an Anaphylactic reaction!After: ingestionInhalationSkin ContactOr: injection of an allergen

Allergens are substances that cause an overreaction of the bodys defense mechanism.

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!Physical ChangesItching of the skin/eyes (tears)Raised rash (hives) flushingHeadacheNausea & Vomiting Abdominal CrampsHoarseness Cough-WheezingShortness of Breath

Hives

Physical ChangesSwelling of the tissues of the lips, throat, tongue, hands and feet.Problem swallowing, Metallic tasteAnxietySense of impending doomHypotension, dizziness or loss of consciousnessSwelling of the lips

AngioedemaAngio 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.

What Causes Anaphylaxis???Foods (leading cause outside hospital)Some insect venoms (bee stings are common cause)MedicationsLatex AllergyExerciseIdiopathic

FoodsThese 6 common foods account for 90% of reactions.

MilkEggsPeanutsTree NutsSoyWheat

Other food triggersmay include:Legumes

Cheese

Fruits

Unknown? (Idiopathic)

InsectsBees

Wasp

Yellow Jackets

Hornets

Fire Ants

MedicationsAntibiotics*Penicillin, Cephalosporins, etc.Aspirin, NSAIDSChemotherapeutic AgentsBiological (Vaccines)Radio Contrast Media Latex AllergyProteins in natural rubber latexRubber bandsElastic (undergarments)Hospital and dental equipment!!!Latex dipped products are biggest culprits --- Baloons, gloves, bandages, water bottles, etc.ExerciseExercise 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.RareIdiopathicIdiopathic 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.RememberCommon 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.TreatmentRemove 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.

TreatmentUse 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 parentsTreatmentChild should be lying on back with feet elevated. Keep child warm and loosed tight clothing.Dont give anything to drink.Comfort childMonitor signs and symptomsDo not leave child unattended.DemonstrationEpiPen

EpiPen Jr.Used for children delivers one dose of 0.15mg. Epiniphrine intramuscularly.

EpiPenShould 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.EpiPenIf EpiPen is expired, it is better to give it in an emergency than to give nothing at all!!

Anaphylactic PreventionScreen 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.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.ManagementIdentify 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)ManagementRead labels monitor ingredients

Obtain written MD instructions

Team approach to develop care plan

Learn to recognize s/s of mild to severe allergic reactions.ManagementLearn 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!!Post - TestPlease 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 SkinB. The Respiratory SystemC. The Gastrointestinal SystemD. The Sympathetic Nervous SystemE. A and BF. All of the above

ReferencesRefer to Caring For Our Children Standard 4.010??????Questions?