Kathy Stinely, RN, BSN

Booth Fickett K8 Magnet School

PRESENTATION
OBJECTIVES
The participant will understand the prevalence
and types of life threatening allergies and be
able to identify common triggers
The participant will be able to recognize the
signs and symptoms of anaphylaxis
The participant will demonstrate competency
in Epinephrine administration (EpiPen)
The participant will be able to state ways to
reduce the risk of life threatening allergic
reaction

ALLERGY STATISTICS

6-8% of U.S. school age children have identified

food allergies.
40-50% of those persons with a diagnosed food
allergy are judged to have a high risk of
anaphylaxis (a life-threatening allergic reaction).
Researchers believe that the prevalence of

food allergies is increasing and the number of

deaths from food allergy induced anaphylaxis
is growing, and children are the largest group
of the population affected by food allergies.

THE BIG 8
The Big Eight account for 90% of

food allergies.
Peanuts
Tree Nuts
Milk
Egg
Soy
Wheat
Fish
Shellfish

OTHER ALLERGENS
(TRIGGERS)
Other foods outside of the Big 8
(seeds, fruits, vegetables, meats)
Bee sting
Medication
Latex gloves, balloons, etc
Exercise induced (rare)

SO WHAT IS AN ALLERGY
An allergy is an abnormal response to a normal

substance due to an over reactive immune

system. This is the bodys attempt to defend itself
against substances that are perceived by the body
to be harmful (an allergen).
Contact with the allergen starts a series of events
in the cells of the immune system resulting in
release of chemical mediators such as histamine .
These chemicals trigger inflammatory reactions in
the skin, the respiratory system, the
gastrointestinal system, and the cardiovascular
system.

WHAT IS ANAPHYLAXIS
Anaphylaxis is the life threatening form of

an allergic reaction.
According to the American Lung
Association, it is a sudden, severe allergic
response that usually produces breathing
difficulties, collapse and possible death.
Usually occurs 1-15 minutes after exposure,
but can occur up to 2 to 4 hours later.
Life threatening emergency. Requires
immediate action EpiPen

POSSIBLE SYMPTOMS OF AN
ALLEGIC
REACTION
Skin:
Hives, itching, swelling.
COULD YOU SAVE A
LIFE?
FACE: Rash,
Think F.A.S.T.

Eye/Ear/Nose/Throat:
hives,
swelling of
Itchy/scratchy lips, tongue, mouth
lips, tongue,
and/or throat, difficulty swallowing,
eyes, face
throat tightness or closing, red,
watery eyes.
AIRWAY: Difficulty
STOMACH:
breathing,
Respiratory: Swelling, change of Abdominal
swallowing or
pain, nausea,
voice, coughing, wheezing, difficulty
talking
vomiting,
breathing, shortness of breath,.
diarrhea
Gastrointestinal: Vomiting,
stomach cramps.
TOTAL BODY:
Rash/hives, weak,
Cardiovascular: Fainting or loss of
pale, sense of doom,
consciousness, flushed, pale skin,
loss of consciousness
cyanotic (bluish) lips and mouth.
Then ACT!
Neurologic: Dizziness, change in
mental status, fainting or loss of

ALLERGY OR
ANAPHYLAXIS?
Anaphylactic
Allergic Reactions
Runny Nose
Itchy, Red, watery eyes
Hives, itchy rash
Local reaction to sting,
UNLESS known to be
allergic to venom

Allergic reactions
can progress into
full anaphylaxis

Reactions

Swelling (face, lips, tongue,

throat, upper airway)
Difficulty breathing
(chest tightness)
Vomiting, diarrhea,

cramping
Difficulty swallowing,
repeat throat clearing,
voice changes

Weakness,
paleness,
Anaphylactic
Reactions

sweating
can involve many
Feeling of impending
symptoms or just one
doom

severe symptom

HOW YOUNGER STUDENTS

MAY
DESCRIBE SYMPTOMS

My mouth or tongue is hot, burning, tingling or itching

It (my tongue) feels like there is hair on it
My mouth feels funny
Theres a frog or theres something stuck in my throat
My tongue feels full (or heavy)
My lips feel tight
It feels like there are bugs in there (to describe itchy

ears)
My throat feels thick
It feels like a bump is on the back of my tongue (throat)

BE SAFE, NOT SORRY!

Every child is different. Some students may

complain of stomach pain first, others will

start with a rash or hives, yet others will
immediately have breathing problems.
Take ALL complaints from students with a food
allergy very, very seriously.
Reactions can be unpredictable. Mild
reactions can rapidly turn into full blown
anaphylaxis.

BE PREPARED
Be able to identify your students with serious

allergies
Look for situations that may put them at risk
(students offering to share food, PB&J sandwiches
at a peanut free table, students playing where bees
are concentrated) and take action
Know the signs and symptoms of an allergic
reaction and have a plan based on the students
Allergy Action Plan

PREVENTION:
THE
FIRST
LINE
OF
DEFENSE

Be aware of the students in your classes with

life threatening allergies
Know what the student is allergic to
Be familiar with the Allergy Action Plan
Have student info in sub folder
Prohibit sharing of foods
Do not serve foods for class activities that
contain possible allergens
Have wipes and hand sanitizers/hand washing
facility available

SEVERE ALLERGY
TREATMENT
Student usually develops rash/hives.
May also see swelling, itching.
May spread, become larger or diffuse
Usually treated with Benadryl as listed in

students Allergy Action Plan.

TREATMENT OF

If possible, remove student from allergen

ANAPHYLAXIS

(remove bee stinger by brushing with ID, wash

allergen off if skin contact)
Have the student sit or lie down. Keep him
calm and quiet
Must first be treated with Epinephrine (EpiPen,
Twinjet), then may use Benadryl as per plan
Do not hesitate to use the EpiPen if you think
the student is having an allergic reaction
Most allergic reaction deaths occur
because Epinephrine was not given

WHAT TO DO IF YOUR
STUDENT
HAS AN
Call the School Nurse: give the students name
& that they are having an allergic
reaction
ANAPHYLACTIC
REACTION
DO NOT ATTEMPT TO WALK TO THE HEALTH

OFFICE
Ask if the student has an EpiPen with them and
assist/ administer if they do
Call 911 as directed by the nurse
Stay with the student
Remember the EpiPen is intended to buy time to
get to emergency care, it doesnt take its place

WHAT DOES
EPINEPHRINE
DO?
EpiPen = Epinephrine Medication

Quickly constricts blood vessels to raise blood

pressure
Relaxes smooth muscles in the lungs to
improve breathing
Stimulates heartbeat
Works to reverse hives and swelling around
the face and lips
Wears off in 10-20 minutes, sometimes
requires a second dose, so it is critical that
911 is called and student transported to
emergency room!

5 RIGHTS OF EPIPEN
ADMINISTRATION
RIGHT STUDENT: Verify that the student has a
known allergy, check allergy action plan
RIGHT MEDICATION: EpiPen, EpiPen Jr, Twinjet
RIGHT DOSE:

EpiPen for students approximately 66lbs and over

EpiPen Jr for students under 66 lbs

RIGHT ROUTE: EpiPen is to be injected into the

large outer thigh muscle

RIGHT TIME: As soon as possible after a reaction
is identified based on symptoms and the students
allergy action plan

EPIPEN VIDEOS
http://www.nationwidechildrens.org/epipen
http://www.auvi-q.com/auvi-q-demo-video

DONT FORGET:
The Good Samaritan Law protects all
individuals who administer an EpiPen
from liability.

STEPS TO REMEMBER
Remove autoinjector from box or container after

checking the name on the label to make sure it is for the

RIGHT student.
Pull off the blue activation cap.
Hold orange end near outer thigh.
Do not put
fingers over orange end.
Swing and jab firmly into outer thigh at a 90 angle until
autoinjector mechanism functions. You will hear a click.
Hold in place and count to 10. Remove device (the
needle will be covered) and massage area for 10
seconds.
Give autoinjector to nurse or paramedics.

FIELD TRIPS
You must notify the nurse at least one week before

the field trip. The nurse will identify all students

with health issues, medications and allergies.
If there is a student with an EpiPen, the nurse will
review that students Allergy Action Plan with you,
answer any questions. A copy of the plan and
student emergency contact card will accompany
the EpiPen.
You should meet with the student to explain that
you have their EpiPen and will be available
throughout the trip.

FIELD TRIPS
The EpiPen must be available at all times, it

should not be left on a bus or anywhere away

from the student.
If the student routinely carries an EpiPen of their
own, the Allergy Action Plan should still be
reviewed with the nurse and you must check to
make sure that the student has the EpiPen with
them at all times.
Remember that you must also have a cell phone
or phone access available at all times in case of
emergency.

LAST STEP
Please see Kathy with your completed quiz for

a quick hands on practice, return

demonstration and chance to get any
questions answered to complete your training.