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Managing Anaphylaxis
Now that we have a good understanding of Anaphylaxis and auto-injectors, the question is, how do we deal with anaphylaxis shock in an emergency?
Most children can inject themselves; however, if they become weak or unfit to administer the auto-injector, you will have to assist. You must also take into consideration that some children have never been injected, or they are very young.
Anaphylatic Shock Occurs
Step 1
Shout for help. Always shout for help, even if you're at home; you never know who will hear your call for help.
You're on your own, GO! get the Auto Injector.
Step 2
Ensure you have both injectors; the child should be on the floor. Carry out your checks of the injector.
If help is available, they should be calling
999/112
Step 3
Give the child the auto injector according to the type and time.
Step 4
Side Effects
The child must remain on the floor
IMPORTANT!
Evidence shows that adrenalin may cause heart failure after the administration of adrenaline. Keep the child still and remain on the floor until the arrival of emergency services.
Step 5
Side Effects
Side Effects
Monitor the child, a secondary wave can attack up to 72 hrs after the first and has been known to start very shortly after the first attack.
Side Effects
Side Effects
Side Effects
IMPORTANT!
When you have injected a child, tell the doctor or nurse if they experience any of the following side effects:
- Nausea or vomiting
- Difficulty breathing
- Pounding, fast, or irregular heartbeat
- Pale skin
- Headache
- Sweating
- Dizziness
- Nervousness, anxiety, or restlessness
- Weakness
- Uncontrollable shaking
Dealing With The Outcomes
Important Questions
There are a number of questions we need to ask when dealing with certain outcomes of Anaphylaxis.
For example.
- What happens if pens don't work?
- What happens if it's the first time and I have no EpiPen?
- What happens if the pen is out of date or the fluids are not clear?
- What happens if the child/infant becomes unconscious?
- What happens if the Child/Infant stops Breathing?
These are all important questions that need to be answered.
Q1 . What happens if the auto-injector does not work?
There are a number of reasons why the auto injector does not work:
1. The injector is damaged or malfunctions.
- A. Use the 2nd injector and ensure emergency services have been contacted
2. The Adrenaline has leaked out.
- A. Check the viewing window
Q2. What happens if it's the first time and I have no auto injector?
Firstly, it's important to establish the cause of swelling, I.e bee sting.
1. The child is showing signs of anaphylaxis Shock
- A. Call 999/112 and inform them of the anaphylaxis.
- A. Stay calm, keep the child/Infant calm. Sit them up to help with breathing.
- A. Place ice packs or cold towels around the child's face and neck. Reduce the swelling and buy some time.
Recent publications from the Department of Education " In the event an Auto Injector belonging to someone else is made available, this can be used only after calling 999 and speaking to the Emergency services."
This information is linked below. It will help to define training and policy.
Q 3. What happens if the Auto Injector is out of date or the fluid is not clear?
- A. Call 999/112 and inform them of the anaphylaxis.
- DO NOT USE
The adrenaline will have changed its chemical balance. By injecting into a child/Infant, you are more likely to create further complications.
Q4. What happens if the child/infant becomes unconscious?
A. The priority is airway management and maintaining an open and clear airway. The auto injector can still be given in the normal manner. However, the child should be placed into the recovery position, especially if you are on your own and need to call emergency services. Infants/Babies must not be left alone and should go with you.
You should also consider giving the second injector; remember this child is unconscious because of the Anaphylaxis.
What happens if the child/infant stops breathing?
A. CPR management must be implemented once an established child/infant has stopped breathing. Emergency services should be contacted immediately. Should you be on your own, the following should occur.
- Open Airway, Pinch Nose,
- Start CPR
- Give 5 breaths
- Give 30 compressions (1 Hand)
- Give 2 breaths
- Give 30 compressions
The above process amounts to 1 minute of CPR. If you're on your own, you must make the emergency call on 999/112 yourself.
Baby's nose does not get pinched, you must perform mouth-to-mouth and Nose breaths. Compress 2 fingers for the baby.
The Auto Injector will have no effect once the child has stopped breathing; therefore, CPR management becomes your priority.
Not Breathing Start CPR
Child Step 1
Check Breathing 10 Seconds
Not Breathing
No Help
Your on
Your Own
Child Step 2
Give Child 5 rescue breaths
Pinch the nose
Release between each breath
Followed by
30 Compression's
One
Hand
Child Step 3
Child Step 3
Continue with 2 breaths followed by a further 30 Compression's
This is 1 minute of CPR
Go Phone 999/112
Baby Step 1
Baby Step 3
Child Step 3
Check Breathing 10 Seconds
Not Breathing
No Help
Your on
Your Own
Baby Step 2
Baby Step 3
Baby Step 3
Give the baby 5 rescue breaths
Your Mouth to the baby's mouth and nose
Lift your head between each breath
Followed by
30 Compression's
Two
Fingers
Baby Step 3
Baby Step 3
Baby Step 3
Continue with 2 breaths followed by a further 30 compressions's
This is 1 minute of CPR
Go Phone 999/112