Life Threatening Allergies

1. Life Threatening Allergies Julie Cacciatore RN

2. Food Allergies • Food allergies are on the rise. • 6-7 Million Americans have food allergies that can trigger anaphylaxis (Food Allergy Network). • Eight foods account for 90% of food allergies.

3. What is a Food Allergy? • An interaction between food and the immune system. • Food proteins are recognized as invaders by the immune system. • The immune system launches an attack against the invader with an antibody: IgE. • IgE antibodies fight the invader by releasing histamines and other chemicals that produce the symptoms of an allergic reaction.

4. What is a Food Intolerance? • A food intolerance is usually a more delayed reaction to a food. • Reactions often involve the digestive tract and while they cause discomfort, they are not life threatening. • Some common food intolerances include Lactose intolerance or wheat intolerance AKA Celiac Sprue Disease.

5. 8 Major Food Allergens • Cow’s milk • Eggs • Wheat • Peanuts • Tree Nuts • Soy • Fish • Shellfish

6. How Much is TOO Much? • The amount of an allergen needed to cause a reaction varies for each individual. • Some individuals can ingest small amounts of allergen without a reaction. • Other people are extremely allergic to even the most minute amount of allergen. • There is no way to predict how a reaction will develop.

7. Itching/burning/ swelling around mouth Tightness/swelling in throat Runny or stuffy nose/ itchy/watery eyes Breathing difficulties/ /wheezing/coughing Nausea/vomiting/ diarrhea abdominal pain Skin rash/hives Drop in blood pressure Increased heart rate Weakness Feeling of impending Doom Symptoms of a Food Allergy

8. Anaphylaxis • The most serious type of allergic reaction is called anaphylaxis or “shock”. • Left untreated, anaphylaxis can result in death! • For some, reactions begin slowly and gradually worsen. For others, reactions develop quickly & rapidly become life threatening. • All reactions, no matter how minor, need to be taken seriously & treated promptly.

9. Children with Known Life Threatening Allergies • Avoidance is the only way to prevent a reaction. • Precautions must be taken to prevent exposure in the classroom. • Each child with a known allergy should have a written emergency plan. • Staff should be familiar with this plan. • Emergency medications should be readily accessible to staff and never locked away!

10. School Modifications • Action/Emergency Plan created to meet needs in the school setting in collaboration with teachers, parents, physician, school nurse etc. • Posting of allergic foods in appropriate areas. • Classroom parents are made aware of the allergy & advised to send in only commercially prepared items with the ingredient labels attached. • Parent/guardians send in snacks and lunch. If the child is allowed to purchase items in the cafeteria, staff is fully informed about what items are allowed. • Shared snack is not allowed. • Education of all staff members regarding allergic reactions and the administration of emergency medications.

11. Medications used for Treatment of Allergic Reactions • Antihistamines taken by mouth • Albuteral inhaler • Epinephrine by injection, usually in the form of an Epi-Pen.

12. Epi-pens are kept in the student’s class room. Back up Epi-pens are kept in the clinic. If a child has been exposed to an allergen, call the front office for immediate assistance. Follow each child’s emergency plan. Be prepared to inject with the Epi-Pen. The emergency plan must be made available to substitute teachers. The classroom teacher and duty aids have been trained to administer the Epi-Pen. 911 must be called if an Epi-Pen is administered. Epi-Pens must accompany the child on field trips. Emergency Epi-Pens

13. How to use the Epi-Pen • Take a deep breath & breathe out. • Remove grey cap. • Hold at 90% angle against outer thigh. • Press firmly & hold for the count of ten.

14. There is one dose in each pen. There are no buttons to press; activation occurs by pressure against the leg. Store at room temperature. Fluid should be clear. An expired pen is better than none at all. Epi-Pen trainers “click”, but real pens do not. Can be injected through clothing if necessary. Arrows show direction of injection. Additional Tips About the Epi-Pen

15. Side Effects From the Epi-Pen • Restlessness • Apprehension • Headache • Tremors • Nausea/Vomiting • Increased heart rate • None of these side effects have very serious consequences. It is better to give the Epi-Pen than not to give it.

16. Summary • Know if a child has a food allergy. • Be very familiar with the Emergency Plan. • Communicate with other staff about the allergic child. • Avoidance is the first treatment for food allergy. • Make class parents aware of the food allergy and request only commercially prepared treats (with intact ingredient labels) for classroom events.

17. Summary continued • Know where the Epi-Pen is in the classroom. • Remember, it must go on field trips with the child. • If you suspect a child has come in contact with an allergen- call for help, better safe than sorry. • The responsibility for an allergic child with a history of a serious reaction can seem overwhelming at times. But common sense and planning can help prevent or minimize any emergencies.