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Anaphylaxis Powered By Docstoc

       Education for a Life
   Threatening Allergic Reaction
                   Natasha Paul BSc,BScN, RN
                   Public Health Services
   Identify participant at risk
   Define anaphylaxis
   Describe the signs and symptoms
   Identify triggers for anaphylaxis
   Discuss treatment of anaphylaxis
   Discuss avoidance strategies
   Be able to use an epinephrine auto-injector
Goal for Recreational Programs
   To create an “allergy-safe” environment
   Prevention of an allergic emergency
       Education
       Awareness
       Training
Identify the Participants at
   Recognize Particpants
       Picture
       MedicAlert® bracelet
       Anaphylaxis emergency plan
   Know the symptoms
Anaphylaxis Emergency Plan
What is Anaphylaxis?
   Medical Emergency
   A severe life threatening allergic
   Death can occur within minutes
   Can involve more than one body system
What are the Signs and
   hives
   swelling
   itching
   redness
   sneezing          trouble speaking
   cough             trouble
   shortness of       swallowing
    breath            throat tightness
   wheeze            chest
   hoarse voice       pain/tightness
   lightheadedness
   dizzy
   unsteady
   feeling faint
   drowsy
   nausea
   vomiting
   diarrhea
   stomach pain
   anxiety
   feeling something bad is going to
   “impending doom”
Key Messages
   Unpredictable
   Never ignore early symptoms
   Antihistamines do not prevent
   Asthma medicine do not prevent
   Assistance may be required to use the
Triggers for Anaphylaxis
   Food
     peanut            wheat
     tree nuts         soy

     milk

     egg

     fish/shellfish
Triggers for Anaphylaxis

   Insect Stings

   Medication

   Latex
Factors that increase the risk
of a severe allergic reaction

   Asthma

   No or delayed use of epinephrine
Treatment of Anaphylaxis

   Hormone that is produced naturally in
    the body
   “fright & flight”
   Drug of choice to treat anaphylaxis
   No contraindications
   Will not cause harm if given
When to give Epinephrine
   Known exposure
   Any inside symptoms
   Generalized hives or swelling
   If in doubt, give epinephrine
Managing Anaphylaxis
   Administer epinephrine (note expiry
   Lie the person on his/her side
   Call 911
   Call parents
   If reaction continues or worsens, a
    second dose of epinephrine may be
    given in 10-20 minutes
Location of the Epinephrine
   Places that are easily accessible
   Check expiry date located on Epi
   NOT in locked cupboards or drawers
   Individuals should carry their own auto-
   Extra auto-injectors in emergency first-
    aid kits (if possible)
Avoidance Strategies
(Food Allergens)

   Do not eat the allergic food
   Supervision of young children while
   No trading or sharing of food, utensils,
    or containers
   Wash hands before and after eating
   Disposal of food items after eating
Avoidance Strategies
   Table surfaces cleaned after eating
   Ingredient list for food purchased
   “No Eating” rule on buses
   Non-food items or special activity to reward
    or celebrate participants
   Communication or Reminders - “It is that
    time of year again…”via Community
    Center/HRM using bulletins and newsletters
    outlining the program’s anaphylaxis
Avoidance Strategies
(Insect Stings)

   Eat in designated areas inside the
   Carry epinephrine auto-injector
   Cover and empty garbage bins
   Replace or repair broken screens on
   Epi pens should not be expired or close
    to expiration date. Inform parents if
    they are.

   If you overhear a child say he has an
    allergy but you are unaware of this fact
    – follow it up.
       (Providing Treatment)

   Volunteer Services Act:
    Chapter 497 (Revised status 1989, amended 1992
                    An Act Respecting the
                  Protection of Persons Who
                      Render Services or
     (Providing Treatment)
   Volunteer Services Act:                          Chapter 497 (Revised
    status 1989, amended 1992 C34)

        Emergency assistance to person
             Where, in respect of a person who is ill, injured or
              unconscious as a result of an accident or other
              emergency, a volunteer renders services or
              assistance at any place, the volunteer is not liable for
              damages for injuries to or the death of that person
              alleged to have been caused by an act or omission on
              the part of the volunteer while rendering services or
              assistance, unless it is established that the injuries or
              death were caused by gross negligence on the part of
              the volunteer, and no proceeding shall be
              commenced against a volunteer which is not based
              upon his alleged gross negligence. R.S., c. 497, s. 3.

Canadian Charter of Rights and Freedoms
 provides: (s.15)
“15. (1) Every individual is equal before and under the
  law and has the right to the equal protection and
  equal benefit of the law without discrimination and,
  in particular, without discrimination based on race,
  national or ethnic origin, colour, religion, sex, age or
  mental or physical disability. individual is equal
  before and under the law and has the right to equal
  protection and equal benefit of the law without
  discrimination and in particular, without
  discrimination based on …physical disability.”

Canadian Charter of Rights and
 Freedoms provides: (s.15)
(2) Subsection (1) does not preclude any law, program
  or activity that has as its object the amelioration of
  conditions of disadvantaged individuals or groups
  including those that are disadvantaged because of
  race, national or ethnic origin, colour, religion, sex,
  age or mental or physical disability.
      How to use the EpiPen®
   Remove EpiPen Auto-Injector from carrier tube
   Hold firmly with orange tip pointing downward
   Remove blue safety release (cap)
   Push Orange tip firmly into mid-outer thigh until
    you hear a “click”
   Hold on thigh for several seconds (count to 10)
   Built in needle protection (orange needle protector
    extends to cover needle to protect you from a
    needle stick injury)
   Remove and return to storage container
   Bring to hospital for disposal
How to use the EpiPen®

How to use the Twinject™
   Pull of Green cap #1 to see a red tip
   Pull of Green cap #2
   Press GREY tip against mid outer thigh
    until a click is heard
   Hold in place for a count of 10
   Remove
How to use the Twinject™
   Suggestion: Start taking Second dose
    apart now and make it available.
   Once Ambulance arrives, place Second
    Dose or unused Epinephrine in case and
    give to Ambulance Attendants.
How to use the Twinject™
Website Resources
Anaphylaxis in Schools & Other Settings
                        (2nd Edition, 2009)
     Can be purchased for $15 (plus applicable taxes and
         shipping and handling) from any of the following
   Allergy/Asthma Information Association (AAIA)
   Anaphylaxis Canada
   Association québécoise des allergies alimentaires (AQAA)
   Canadian Society of Allergy and Clinical Immunology

The proceeds from the sale of this document will help these
  non-profit organizations continue their work in
  anaphylaxis education, support, and research.

    HRM Recreational Policy 2005

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