Swansea School Department

Health Services

Procedure Title:

Administration of Epinephrine via Epi-Pen. The drug of choice in the treatment of anaphylaxis is epinephrine.

Purpose:

To counteract the effects of exposure to an IgE mediated allergen.

To provide immediate care in the case of a potentially life threatening allergic reaction.

To vasoconstrict and relax smooth muscle associated with the lungs and bronchioles to improve the work of breathing.

To reverse hives and swelling around the face and lips.

Equipment:

Epi-Pen or Epi-Pen Jr. 0.3mg. Auto-injector (Epinephrine Injection 1:2000)

Policy:

Registered Nurses who have been instructed in accordance with the Administration of Epinephrine via Epi-Pen policy, by the Health Services Director and have been granted such privileges may administer Epinephrine. The administration of epinephrine via Epi-Pen must follow the standing order protocols.

This policy is not intended to replace the physician’s orders for those individuals who are known to produce a hypersensitive IgE reaction to insect venom or food products.

Procedure/Protocol:

1. Assess the patient for symptoms of severe allergic/anaphylactic reaction.

Symptoms may include but are not limited to the following: whelps on the skin, swelling of the eyes, mouth, lips, throat, wheezing, respiratory distress, gagging, chocking and or feeling faint, feeling of impending doom.

2. Assess vital signs for signs of shock: respirations wheezy, labored, or absent;

B/P hypotensive, palpable; pulse weak, rapid, thready.

3. Assess level of consciousness; restless, anxious, lethargic, unresponsive.

4. Monitor ABCs ,and initiate CPR if necessary.

5. Check the printed expiration on the Epi-Pen Auto-injector and administer promptly.

6. Activate Emergency Medical Services (Call 8-911)

7. Continue to monitor and assess patient for response to the epinephrine; patient’s condition is expected to improve rapidly. Epinephrine may cause feelings of heart racing and may produce feelings of nausea. If the patient is lying down turn him/her to the side to prevent aspiration of gastric contents. Some individuals may experience severe pounding headaches.

8. Notify patient’s parent/guardian of emergency actions initiated.

Storage:

1. Epi-Pen Auto-injectors may be stored in the emergency medical kit and carried exclusively by Registered Nurses, employed by the Swansea School Department on a permanent or temporary basis, during the course of the school day.

2. Epi-Pens should not be refrigerated or exposed to extreme heat.

3. Epi-Pens should not be exposed to direct sunlight.

4. Epi-Pens should periodically be checked to make certain the solution is clear and colorless. If the solution has iodized and turned brown from exposure it must be replaced immediately.

Policy submitted by Swansea Health Services Department

February 6, 2004

Reviewed and approved by:

________________________

Mark Ringiewicz, M.D.