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THREATENING
Developed by: Becky Neff, RN & Becky Adams, RN using OSPI's Guidelines for Care of Students with Anaphylaxis (2009)


Food allergy overview Emergency Medication What is your role? Signs and symptoms  Increasing numbers of children (6-8%) are diagnosed with life-threatening food allergies that may potentially life- A reaction can occur within minutes to hours after ingestion. Symptoms can be mild to life- An allergic reaction begins after ingesting a threatening. food causing the body to produce an antibody If the reaction becomes severe it that attaches to the is then known as anaphylaxis, a surfaces of cells. A reaction may not occur with 1st time exposure but the next time the There is no cure for life- food is ingested, the threatening food allergies. proteins in the food The only way to prevent life- antibodies and cause the cells to release histamine threatening food allergies from which leads to the allergic reaction.
occurring is strict avoidance of the identified food allergen.  TREE NUTS (Walnuts, cashews, pecans…) Most stings are caused by yellow jackets, wasps, and hornets.
Some precautions school should follow include:•Insect nests should be removed on or near school property.
•Garbage should be stored in well-covered containers.
•Eating areas should be restricted to inside school buildings for students and staff at risk.
Students/staff at risk should:•Wear proper shoes that cover the feet. Sandals and flip-flops increase risk.
•Long pants and sleeves rather than shorts•Avoid playing in areas where insects are seen and report to staff.
•Latex products are a common source of allergic type reactions.
•Two common types of reactions include: Contact dermatitis (skin rash) usually after 12-36 hours.
 Immediate allergic reactions. Rarely, does exposure lead to anaphylaxis but depends on the amount of latex allergen they are exposed to and their degree of sensitivity.
•Our district makes an effort to purchase non-latex products in the health room such as, gloves, band aids,  Itching (any part of  Throat tightness or  Swelling (any part  Red, watery eyes  Difficulty breathing  Sense of doom  Vomiting/Diarrhea  Stomach cramps  Fainting or loss of  Change of voice  Change of skin color  Symptoms usually appear within minutes or can occur several hours later.
 Symptoms can have a ‘biphasic reaction' meaning they respond initially to treatment but experience a resurgence of symptoms hours late.
 Studies have shown students with peanut and nut allergies who also have asthma may experience a more severe reaction.
Anaphylaxis includes the most dangerous
symptoms including but not limited to breathing difficulties, a drop in blood pressure or shock, all of which are potentially fatal.
 Anaphylaxis is a potentially life-threatening condition, requiring immediate medical attention.
 Emergency medications should be given immediately upon concern of exposure to the allergen and/or any symptoms.
MOST FATALITIES OCCUR DUE TO DELAY IN
THE DELIVERY OF THE EMERGENCY
 When in doubt it is better to give epinephrine and  Anyone given epinephrine should be transported to a hospital even if symptoms appear to have  Epinephrine, also known as adrenaline, is a natural occurring hormone in the body.
 Epinephrine-Brand names include, but are not limited to EpiPen, EpiPen Jr., and Twinjet auto- Parents supply the injectors.
School nurses (RN'S) can train unlicensed school personnel to administer epinephrine to a student with an order from a physician.
 Antihistamines such as, Benadryl and Zyrtec may be prescribed but ALWAYS GIVE THE EPIPEN  Epinephrine is the life-saving medication
that must be given immediately to avoid
 Antihistamines should not be the only medication given in anaphylaxis since epinephrine is the drug Notify the office for assistance and request they bring the Epipen if student/teacher/staff does not have one. Do not move the student especially if they have any Keep the student calm.
Have someone CALL 911, parents and school nurse.
Administer the Epipen and note the time given.
If a student is exhibiting signs of a life-threatening
allergic reaction, epinephrine must be given
immediately and 911 called. There should be no
delay in the administration of epinephrine.
Work with school nurse and parent to create a safe environment for the student.
Participate in training. Review the Emergency Care Plan (ECP).
Never send a student with a reaction to the health room alone Alert substitute teachers to their ECP.
Keep the classroom as allergen-safe as possible.
If the student's parent requests, a letter can be sent home alerting all parents to the fact there is a student with significant allergies in the class. The student's name should not be shared in the letter unless their parent provides permission.
Remember to inform volunteers of any life-threatening  Work with the school nurse and administration to determine if food allergens are on the menu.
 Develop protocols for cleaning and sanitation which avoid cross-contamination.
 Order non-latex gloves.
 Set up tables in cafeteria that are ‘allergen-free' if  Decisions should be made on a district level as to whether a not to serve foods with allergens and what steps can be taken to reduce the chance of a student experiencing accidental exposure.
 Keep a copy of the ECP.
 All school sponsored after-school activities should be consistent with school policies and procedures regarding life-threatening allergies.
 Participate in training.
 Ensure that emergency communication equipment is always available.
 Clearly identify who is trained and responsible for administering the Epipen.
 Bus drivers should have the ECP of each student they transport.
 Student may require designated seating.
 Transportation supervisor will have list of students with life-threatening allergies.
 Attend training as provided by the district and become familiar with the district's protocols and procedures.
 Take as much responsibility as possible, based on developmental level, for avoiding allergens.
 Learn to recognize symptoms of an allergic reaction and alert an adult immediately.
 Avoid allergen exposure as much as possible.
 Report any teasing or harassment to a school  WA state law allows students to carry and self- administer Epipen if parent/physician and school nurse feel they are responsible.
Obtain a detailed health history.
Obtain medication orders signed by the physician and Write an Emergency Care Plan (ECP) for use by school Train staff as needed on the ECP and Epipen.
Work with staff to modify the student's environment to ensure the student's safety in all areas of the school Develop an Individualized Health Plan (IHP) when Provide educational overview for the entire school Continued collaboration with parent/guardian, teachers, and health care providers to address continuing student needs.
 Avoidance of exposure to allergens is the key to preventing a reaction.
 The risk of adverse events related to allergens for a student is reduced when school personnel, medical provider and parent/guardian work together to develop a plan for the student.
 Allergy information for a student should be noted by school and health staff on appropriate records while respecting the student's right to  Before leaving collaborate with the school nurse.
 Ensure the epinephrine and Emergency Care Plan are taken on the trip.
 Only trained staff can administer the epinephrine and should be responsible for the student unless their parent attends.
 A cell phone should be available.
 Invite parent/guardians to accompany their child but make sure they have the students EpiPen.
 Notify kitchen staff well in advance especially if they are responsible for providing a meal so that appropriate food substitutes can be made if necessary in the event a parent does not provide

Source: http://www.swsd.k12.wa.us/cms/lib/WA01000765/Centricity/Domain/22/2015-16/Allergies.pdf

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Fitting Surge Functions to Data FITTING SURGE FUNCTIONS Sheldon P. Gordon ADDRESS: Department of Mathematics, Farmingdale State University of New York, Farmingdale NY 11735 USA. gordonsp@farmingdale.edu ABSTRACT: The problem of fitting a surge function to a set of data such as that for a drug response curve is considered. A variety of differenttechniques are applied, including using some fundamental ideas fromcalculus, the use of a CAS package, and the use of Excel's regressionfeatures for fitting a multivariate linear function to a set of trans-formed data. The results of the different approaches are contrastedand discussed.

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