How NYC School Nurses Treat Anaphylaxis

Spring is finally here!  It is a time where we come out of hibernation, and the world starts to wake up.  Flowers are blooming, the sky is blue, and everyone wants to be outside.  With the blossoms and flowers also come bees, pollen and allergies. For children to adults, we are all aware of allergy season.  Itchy watery eyes, runny noses, and coughing are a price that some of us pay for the beautiful weather.  Sometimes though, allergies can be a bit more. For school nurses the increased presence of children with allergies is enormous.  Children can go into anaphylaxis which is acute and potentially life threatening.

What exactly is anaphylaxis? It is a multi system response which manifests itself throughout the body, resulting from a rapid release of inflammatory mediators. Symptoms include difficulty swallowing, difficulty breathing,rapid swelling of tongue, lips, and possible throat closing. It also includes possible wheezing and/ or cough, Itching and/or hives. In some cases the patient can go into a full cardiovascular collapse.  The fastest treatment for anaphylaxis is to administer an EpiPen.  There are two kinds of EpiPens, the EpiPen Jr. for patients under 55 lbs or the regular EpiPen for patients 55 lbs and over. The EpiPen is an intramuscular injection that provides a single dose of epinephrine to the patient.  This injection is administered in the outer thigh.  The EpiPen injection can be administered through clothes (even jeans).  Once you give the injection, you must hold it for 10 seconds to make sure all the medication is given.  After you give the injection, call 911.  School nurses in every New York City school are covered by a non-patient specific standing MD order for Epi-Pen administration.  This means that a school nurse already has a doctor’s order to give a stock EPiPen to anyone in the school, from the principal to the students.

When nurses see anaphylaxis, no two cases present alike.  Onset can be rapid, or symptoms can slowly increase.  The faster the epinephrine is administered, the easier everyone can breathe again (pun intended).

* Disclaimer – The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.