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Anaphylaxis

Asthma Action Plan

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Anaphylaxis Links

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Format for Printing Anaphylaxis Info for Patients, Families & Schools

"Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death." 

Important anaphylaxis facts:

  • Anaphylaxis can be effectively treated if early signs are recognized by our patients, their families and other supervising adults, and by aggressive early intervention with epinephrine
  • Each year in the United States, there are estimated to be about 100,000 cases of anaphylaxis, and almost 1% are fatal. 
  • Rates of food allergy have doubled in the past ten years, now estimated at 4% of the US population. 
  • About 90 percent of all food reactions are due to eight main triggers: milk, eggs, soy, wheat, peanuts, tree nuts, fish and shellfish.
  • Other triggers include stings and bites, latex, radiology-contrast media, cold temperature exposure or even exercise.  20 percent or more of anaphylaxis cases do not have a known cause.
  • 2011 – Children’s Physician Network assembles workgroup
    • Goal: Create a single Anaphylaxis Action Plan to be used community-wide
    • Actions: Plan developed, distributed; education provided to key constituents
    • Feedback: Supported by School Nurse Organization of Minnesota ( SNOM), used in schools across metro
  • 2013 – Minor revisions 
    • Addition of Auvi-Q (new to market)
    • Removal of Twinject (off market) 
  • 2016-Major Revisions by Children’s Health Network (CHN)Work-Group
    • Workgroup convened with representation from:
      • Allergists (2)
      • Pediatricians (2)
      • Nurse Practitioner/Certified Asthma Educator (1)
      • School Nurse (1)
      • Early Childhood/School-Aged Consultant/Licensed Trainer (1)
      • CHN Nursing staff
  • 2016 Revision Updates
    • Visual emphasis on epinephrine as #1 treatment for anaphylaxis
      • Enhanced display
      • Bold arrows delineate pathways to epinephrine  
    • Simplified criteria for use of epinephrine
      • Special circumstances/high-risk patient (optional)
      • Known/suspected exposure to allergen and severe symptom(s)
      • Unknown exposure and multiple organ systems affected
    • Detailed instructions for post-epinephrine treatment plan
    • Clarification of circumstances regarding use of antihistamines
      • Pathway delineated using small open arrow    
    • Updated FDA information for EpiPen® epinephrine autoinjector 
      • Hold time on anterolateral thigh decreased from 10 to 3 seconds
    • Updated FDA information for all epinephrine autoinjectors 
      • Hold thigh firmly to prevent movement during injection (especially in young children)
      • Do not administer epinephrine to other areas of the body 
      • Seek medical care if skin changes occur after injection 
    • Clarified available medications
      • Epinephrine = injection; Antihistamine = oral medication
      • Auvi-Q removed (off market)
    • Clarified language regarding “allergy response kit” for schools
      • Supplied by parent or guardian
    • Provided additional lines for parent/guardian contact info 
  • What did Not Change
    • Epinephrine dosing (2010 NIAID guidelines)
      • Epinephrine, IM; auto-injector or 1:1,000 solution
        • Weight 10-25 kg: 0.15 mg epinephrine autoinjector, IM (anterior-lateral thigh)
        • Weight >25 kg: 0.3 mg epinephrine autoinjector, IM (anterior-lateral thigh)
    • Epinephrine doses may need to be repeated every 5-15 minutes
    • Epinephrine is the first-line treatment in all cases of anaphylaxis. 
    • Commitment to the use of ONE form across the community

RESOURCES: