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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 anaphylatic shock in an emergency situation.
Most children can inject themselves, however in the event that they become weak or unfit to administrate the Epipen 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 your at home you never know who will hear your call for help.
Your 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 helps 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 adrenalin, 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 its the first time and I have no Epipen?
- What happens if pen is out of date or fluids not clear?
- What happens if the child/infant becomes unconscious?
- What happens if the Child/Infant stop Breathing?
These are all important questions that need to be answered.
Q1 . What happens if the auto inject does not work?
There are a number of reason 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 its the first time and I have no auto injector?
Firstly its important to establish the cause of swelling I.e bee sting.
1. The child is showing signs of Anaphlatic Shock
- A. Call 999/112 and inform them of the Anaphlactic shock.
- A. Stay calm keep the child/Infant calm. Sit them up to help in 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 a 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 Anaphlactic Shock.
- DO NOT USE
The adrenaline will have changed its chemical balance, by injecting into a child/Infant you will more likely to create further complications.
Q4. What happens if the child/infant becomes unconscious?
A. The first 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 the Anaphylaxis.
What happens if the child/infant stops breathing?
A. CPR management must be implemented once 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 compression's (1 Hand)
- Give 2 breaths
- Give 30 compression's
The above process amounts to 1 minutes of CPR if your on you own you must make the emergency call on 999/112 yourself.
Baby nose does not get pinched you must perform Mouth to Mouth and Nose breaths. Compression's 2 fingers for baby.
The Auto Injector will have no effect once the child has stopped breathing therefore CPR management becomes you 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 baby 5 rescue breaths
Your Mouth to babies 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 Compression's
This is 1 minute of CPR
Go Phone 999/112