CONFIDENTIALAllergy

For use by designated caregiver(s)Procedure for Combined Allergic & Asthmatic Response

Student: / DOB:
Procedure Written on:
By:
Reviewed on:
By:
Reviewed on:
By:

COMBINED ALLEGIC & ASTHMATIC RESPONSE

MD ORDERS SHOULD BE ATTACHED TO THIS PROCEDURE

Student is allergic to:

Insect stings ______

Ingestion of ______

Exposure to ______

Severe Allergic Reaction Symptoms (Anaphylaxis) include:

Shortness of breath or tightness of chest
Difficulty in or absence of breathing
Continuous sneezing, wheezing, or coughing
Difficulty swallowing
Swelling of eyes, lips, face, tongue, or elsewhere
Dizziness and/or fainting
Rapid or weak pulse
Blueness around lips, inside lips, eyelids
Sweating and anxiety / Itching, with or without hives; raised red rash on any area of the body
Skin flushing or extreme pallor
Hoarseness
Sense of impending disaster or approaching death
Involuntary bowel or bladder action
Nausea, abdominal pain, vomiting, and diarrhea
Burning sensation, especially face or chest
Loss of consciousness

For Severe Allergic Reaction (Anaphylaxis):

  1. DO NOT move person with these serious symptoms. Bring delegated caregivers and equipment to the scene, unless area is hazardous.
  2. Have the person sit or lie down.
  3. Immediately delegate calls to:
  1. EMS/9-1-1
  2. Nurse if in building
  3. Parent
  1. Remove the stinger if present using a gentle brushing motion.
  2. Administer Epi-Pen, per MD Order.
  1. Refer to Procedure for Administering Epi-Pen Injection
  2. Note – Only staff trained to administer Epi-Pen injection can perform this step

Student’s who have asthma in addition to anaphylaxis may have more severe symptoms.

Symptoms of Asthma include:

  • Tightness in chest
  • Shortness of breath
  • Coughing for prolonged periods
  • Audible wheeze or unusual sounds
  • Coughing that causes choking, bluish color, or vomiting.
  • Bluish discoloration to lips, nails, gums, eyelids
  • Inability to speak in full sentences without taking a breath or only able to whisper
  • Need to lean over at the waist
  • Anxious appearance
  • Decreased level of consciousness
  1. Administer Albuterol Metered Dose Inhaler, per MD Order
  2. Refer to Procedure for Administering Albuterol Metered Dose Inhaler
  3. Review 5 R’s to ensure that student is taking the correct medication:

Right Student
Right Medication
Right Dose
Right Time
Right Route

Check medication upon receipt and monthly. Advise parent immediately to

replace medication two weeks before expiration date. In emergency, use expired

medication.

  1. Monitor for absent breathing/pulse. If trained, begin CPR for absent breathing/pulse. Reassure and calm the person if possible.
  2. Defer care to EMS

Mild Symptoms include:

  • Small localized rash or redness
  • Mild itching at area of contact
  • Eye irritation; watering, red eyes
  • Nasal drip or congestion
  • Intermittent sneezing

For Mild Symptoms…

  1. For skin contact with allergen, wash/rinse affected area thoroughly with running water.

For insect sting, scrape stinger away immediately and apply ice to sting site.

  1. Administer antihistamine, per MD order
  2. Refer to Procedure for Administration of Oral Allergy Medication
  3. If symptoms worsen or any signs of anaphylaxis are present refer to the above response for a severe allergic reaction (anaphylaxis).
  4. Monitor student for signs of anaphylaxis under direct observation for 60 minutes. If mild symptoms subside, student may return to class. If mild symptoms persist, or student becomes somnolent, have parent pick-up student.
  5. Advise parent of incident before returning student to class.

References

Oregon Department of Human Services, Pubic Health Division. (2013). Treatment of Severe Allergic Reaction: A Protocol for Training

Multnomah Education Service District.(2007). Procedure for Anticipated Allergic Response.

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