Severe Allergies & Epi -Pen Administration

1. Severe Allergies&Epi-Pen Administration Health Services Department

2. Presentation Overview • Impact of food allergies on children • What is a food allergy? • Triggers that worsen food allergies • Mild signs & symptomsof allergies • Medical management of mild signs & symptoms • “Anaphylaxis” (severe signs & symptoms of an emergency; interventions) • Medical management of severe signs & symptoms • Preventative measures

3. Why You Have This Training • In accordance with Education Code (EC) Section 49414, legislation was enacted to develop minimum standards of training for school personnel in the administration of epinephrine auto-injectors. • It is estimated that severe allergies affect nearly 40 million Americans in all age groups and put those individuals at risk of death from anaphylaxis.

4. Impact of Food Allergies • Four out of every 100 children have a food allergy. • Food allergies are becoming more common AND hospitalizations related to food allergies are also increasing. • Children with food allergies are two to four times more likely to have other related conditions such as asthma and other allergies, compared with children without food allergies…AND are more likely to experience anaphylactic reactions to foods and be at higher risk of death.

5. What are Food Allergies? A food allergy is an abnormal response to a food triggered by the body’s immune system. • No food allergy symptoms occur on the first time a person is exposed to the food • First exposure can be: • By eating or ingesting a food allergen • Touching a food allergen • Using or eating other products with the food allergen • No cure

6. Allergy Triggers The eight major food allergens identified are: 1. Milk 2. Eggs 3. Fish (e.g., bass, flounder, cod) 4. Crustacean shellfish (e.g., crab, lobster, shrimp) 5. Tree nuts (e.g., almonds, walnuts, pecans) 6. Peanuts 7. Wheat 8. Soybeans

7. Other Severe Allergy Triggers • Common causes: • Food • Insect stings (bees, hornets, yellow jackets) • Medication (e.g. antibiotics, aspirin, and non-steroidal anti-inflammatory drugs) • Latex • Uncommon causes: • Food dependent exercise induced anaphylaxis (rare) • Idiopathic anaphylaxis

8. Food Allergies vs. Food Intolerance • Types of Food Intolerance: • - Lactose Intolerance • Food additives • Gluten Intolerance • Food poisoning • Histamine toxicity • Signs & Symptoms: • Bloating • Abdominal pain or cramping • Diarrhea • Nausea & vomiting • Food allergies are different from a food intolerance • A food intolerance is the body’s abnormal reaction to a food but DOES NOT involve the immune system • A doctor can confirm the presence or absence of a food allergy and/or food intolerance

9. Mild Signs & Symptoms Symptoms of food allergies typically appear from within a few minutes to two hours after a person has eaten the food to which he or she is allergic. Allergic reactions can include: • Hives • Flushed skin or rash • Tingling or itchy sensation in the mouth • Itching (of any part of the body) • Face, tongue, or lip swelling (or any body part) • Vomiting and/or diarrhea • Abdominal cramps • Coughing or wheezing • Dizziness and/or lightheadedness • Swelling of the throat and vocal cords • Difficulty breathing • Loss of consciousness

10. Medication Management Diphenhydramine (Benadryl) • An antihistamine • Relieves mild signs & symptoms like: • Hives • Flushed skin or rash • Tingling or itchy sensation in the mouth • Face, tongue, or lip swelling • Minor throat or airway irritation • Follow the directions labeled on the package or bottle prior to giving the medicine. • Can have side effects: • Drowsiness • Dry mouth, nose & throat • Excitement (especially in children)

11. Severe Signs and Symptoms A severe, life-threatening allergic reaction is called anaphylaxis. This can lead to: • Constricted airways in the lungs • Severe lowering of blood pressure and shock (“anaphylactic shock”) • Suffocation by swelling of the throat

12. Medication Management

13. What To Do in An Emergency • Notice the signs & symptoms • Take all reactions seriously • Try to keep calm • Initiate EPI-PEN medication treatment as prescribed by the doctor immediately • CALL FOR AN AMBULANCE THEN CALL THE PARENT(S) 1 in 4 will have a latent reaction

14. Epi-Pen Video

15. How to Prevent a Reaction • Strict avoidance of food allergens • Know mild & severe signs & symptoms of allergic reactions • Read food labels prior to consumption • If an individual is known to have severe reactions to food allergens then have an Epi-Pen prescribed by a doctor on hand • Know how and when to administer an Epi-Pen • Have an action plan

16. What You Need at School • An Emergency Care Plan • A Dietary Prescription completed by physician (for food allergies only) • A Medication Administration Authorization form • An Epi-pen • CPR training

17. Sample Emergency Care Plan

18. Sample Dietary Prescription

19. Medication Authorization Form

20. Resources Center for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA 30333, USA800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 E: cdcinfo@cdc.gov http://www.cdc.gov/asthma/ (800) 822-2762 Food Allergy and Anaphylaxis Network 11781 Lee Jackson Highway, Suite 160 Fairfax, VA 22033–3309 800–929–4040 www.foodallergy.org Food Allergy Initiative 1414 Avenue of the Americas, Suite 1804 New York, NY 10019–2514 212–207–1974 www.faiusa.org National Institute of Allergy & Infectious Diseases6610 Rockledge Drive, MSC 6612Bethesda, MD 20892-6612United States of America Phone: 301-402-1663Email: niaidnews@niaid.nih.govFax: 301-402-0120 www.niaid.nih.gov U.S. Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 Ph. 1-888-INFO-FDA (1-888-463-6332) http://www.fda.gov/

21. References • Branum, A. M., & Lukacs, S. L. U.S. DEPARTMENT OF, National Center for Health Statistics. (2008). Food allergy among U.S. children: Trends in prevalence and hospitalizations. Retrieved from Centers for Disease Control and Prevention website: http://www.cdc.gov/nchs/data/databriefs/db10.htm • Centers for Disease Control and Prevention , (2012). Food allergies in schools. Retrieved from website: http://www.cdc.gov/healthyyouth/foodallergies/ • Mondello, W. (2009, Oct/Nov). Food-allergic children and their emotional wellbeing. Living Without, Retrieved from http://www.livingwithout.com/issues/3_6/Emotional-State-Food-Allergic-Children-1022-1.html • National Center for Biotechnology Information, U.S. National Library of Medicine (2011). Diphenhydramine. Retrieved from PubMed Health website: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000704/ • National Institutes of Health, National Institute of Allergy and Infectious Diseases. (2010). Food allergy: An overview. Retrieved from NIH Publication website: http://www.niaid.nih.gov/topics/foodAllergy/Documents/foodallergy.pdf • U.S. Food and Drug Administration, Silver Spring, MD. (2010). Food allergies: What you need to know. Retrieved from website: http://www.fda.gov/downloads/Food/ResourcesForYou/Consumers/UCM220117.pdf • U.S. Food and Drug Administration. (n.d.). Food allergies: Reducing the risks (video) [Web]. Retrieved from http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm182842.htm

22. Post Test