Emergency Response Form for Life-Threatening Asthma or Allergic Reactions

DEFINITION: Life-threatening asthma consists of an acute episode of worsening airflow obstruction. Immediate action and monitoring are necessary.

A systemic allergic reaction (anaphylaxis) is a severe response resulting in cardiovascular collapse (shock) after the injection of an antigen (for example, bee or other insect sting), ingestion of a food or medication, or exposure to other allergens, such as animal fur, chemical irritants, pollens or molds, among others. The blood pressure falls, the pulse becomes weak, AND DEATH CAN OCCUR. Immediate allergic reactions may require emergency treatment and medications.

LIFE-THREATENING ASTHMA SYMPTOMS: Any of these symptoms may occur:

• Chest tightness
• Wheezing
• Severe shortness of breath
• Retractions (chest or neck "sucked in")
• Cyanosis (lips and nail beds exhibit a grayish or bluish color)
• Change in mental status, such as agitation, anxiety, or lethargy
• A hunched-over position
• Breathlessness causing speech in one-to-two word phrases or complete inability to speak

ANAPHYLACTIC SYMPTOMS OF BODY SYSTEM: Any of the symptoms may occur within seconds. The more immediate the reactions, the more severe the reaction may become. Any of the symptoms present requires several hours of monitoring.

• Skin: warmth, itching, and/or tingling of underarms/groin, flushing, hives
• Abdominal: pain, nausea and vomiting, diarrhea
• Oral/Respiratory: sneezing, swelling of face (lips, mouth, tongue, throat), lump or tightness in the throat, hoarseness, difficulty inhaling, shortness of breath, decrease in peak flow meter reading, wheezing reactions
• Cardiovascular: headache, low blood pressure (shock), lightheadedness, fainting, loss of consciousness, rapid heart rate, ventricular fibrillation (no pulse)
• Mental status: apprehension, anxiety, restlessness, irritability
  

EMERGENCY NURSING PROTOCOL:

1. CALL 911
2. Summon school nurse if available. If not, summon designated trained, non-medical staff to implement emergency nursing protocol
3. Check airway patency, breathing, respiratory rate, and pulse
4. Administer medications (EpiPen, and/or albuterol) per standing order
5. Determine cause as quickly as possible
6. Monitor vital signs (pulse, respiration, et cetera.)
7. Contact parents immediately and physician as soon as possible
8. Any individual treated for symptoms with epinephrine at school will be transferred to medical facility

STANDING ORDERS FOR RESPONSE TO LIFE-THREATENING ASTHMA OR ANAPHYLAXIS:

The order of medication administration is dependent upon the severity of symptoms:

• Administer an IM EpiPen-Jr. for a child less than 50 pounds or an adult EpiPen for any individual over 50 pounds

AND/OR

• Follow with nebulized albuterol (premixed) while awaiting EMS unit. If not better, may repeat times two, back-to-back.
  
  
• Administer CPR (Cardiopulmonary Resuscitation), if indicated.
  
  

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