Anaphylaxis is an acute, potentially life-threatening syndrome that affects the lungs, heart, throat, skin, and gut. Treatment for severe anaphylaxis is epinephrine.
Milk, eggs, wheat, and soy (MEWS) as a group are the most common food allergens; however, peanuts and fish are among the most potent. In fact, children can develop anaphylaxis from the fumes of cooking fish or residual peanut in a candy bar. In children, foods can be a significant trigger for immunoglobulin E (IgE)-mediated anaphylaxis.
or ANY of the following SEVERE SYMPTOMS after suspected or known ingestion or exposure:
One or more of the following:
- LUNG: Short of breath, wheezing, repetitive cough HEART: Pale, blue, faint, weak pulse, dizzy, confused THROAT: Tight, hoarse, trouble breathing/swallowing MOUTH: Significant swelling of tongue and/or lips SKIN: Many hives over body, widespread redness
- GUT: Repetitive vomiting, severe diarrhea, abdominal pain
- OTHER: Feeling something bad is about to happen, anxiety
- Or a combination of symptoms from different body areas.
- INJECT EPINEPHRINE IMMEDIATELY.
- Call 911. Tell them the child is having anaphylaxis and may need epinephrine when they arrive.
- Begin monitoring (see box below)
- Consider giving additional medications after epinephrine*:
- Inhaler (bronchodilator) if asthma
*Antihistamines & inhalers/bronchodilators are not to be depended upon to treat a severe reaction (anaphylaxis).
USE EPINEPHRINE FOR ANAPHYLAXIS
For ANY of the following MILD SYMPTOMS: NOSE: Itchy/runny nose, sneezing
- MOUTH: Itchy mouth
- SKIN: A few hives (often around mouth/face,) mild itch
- GUT: Mild nausea/discomfort
1A. IF MILD SYMPTOMS FROM MORE THAN ONE BODY AREA, INJECT EPINEPHRINE IMMEDIATELY & call 911 (see box above).
1B. IF MILD SYMPTOMS FROM ONLY ONE BODY AREA, GIVE ANTIHISTAMINE (see below).
MONITOR CLOSELY (see monitoring instructions below)
If symptoms worsen, INJECT EPINEPHRINE IMMEDIATELY & call 911 (see box above).
Stay with student; alert healthcare professionals and parents. Tell 911 operator that epinephrine was given & request an ambulance with epinephrine. Note time when epinephrine was administered. A second dose of epinephrine can be given 5 minutes or more after first if symptoms persist or recur. For a severe reaction, consider keeping patient lying on back with legs raised. Treat even if parents cannot be reached. See back/attached for auto-injection technique.
Anaphylaxis (severe allergic reaction) Response Kit
An Anaphylaxis (severe allergic reaction) Response Kit should contain at least two doses of injectable epinephrine, other medications recommended by the patient’s physician, and a copy of this Anaphylaxis Action Plan.
EpiPen® Instructions (www.epipen.com/-/media/files/epipen/patient%20information.pdf):
- Remove from clear carrier tube.
- Pull off the BLUE safety release.
- Hold EpiPen in closed fist with thumb away from end.
- Firmly push orange tip against outer thigh so it clicks AND HOLD in place for 10 seconds.
Auvi-Q™ Instructions (www.auvi-q.com/Media/pdf/Trainer-Instructions.pdf):
- Activate the voice instructions by removing the outer case.
- Pull off the RED safety guard.
- Place the black end against the outer thigh, then press firmly and hold for 5 seconds.
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