Can you handle allergic reactions? (Anaphylaxis)

[mrkstvns]

Saw an article about a boy scout who had an anaphylactic reaction while on a backpacking trip in Colorado.  Rescuers carried him over a mile to get to an ambulance.
Story:  https://www.dailycamera.com/2019/07/04/boy-scout-rescued-in-western-boulder-county/ 

Makes me wonder....could I recognize the signs of anaphylaxis if the scout weren't able to tell me what was going on?  Would I know how to properly respond?  Would you?

Info about dealing with anaphylaxis:  https://www.webmd.com/allergies/anaphylaxis#1 

[Treflienne]

FARE's Food Allergy & Anaphylaxis Emergency Care Plan is very helpful in telling the uninformed what to do in case of an allergic reaction.  (How to recognize a reaction and whether to use the epinephrine.)  Worth a read, even if you don't currently have a kid in your troop with known allergies.   Of course it assumes that you have an epinephrine autoinjector at hand and can call an ambulance, and that you only need to deal with the first 20 minutes of the reaction without help. 

https://www.foodallergy.org/life-with-food-allergies/food-allergy-anaphylaxis-emergency-care-plan

https://www.foodallergy.org/media/329

Allergies might be scary for scouters.  Even scarier for the families -- will their kid be unable to advocate for himself?  will the surrounding companions be too hesitant to administer epinephrine promptly (less effective after a delay)? 

Edited July 8, 2019 by Treflienne
typo

[mashmaster]

When I put together our Ship's first aid kit, it includes an epipen.  One of my youth in the program had a bunch of extras and donated it to the kit.  I haven't had to use it but it makes me feel a little better knowing it is there.

[Jameson76]

We had a Scout who had while not an anaphylactic reaction did get some hives while playing a wide game, got into some vines or other underbrush.  We gave him some Benadryl.  One leader wanted to know what happens if they have an allergic reaction to benadryl. 

I told them we would give them more benadryl

[qwazse]

Well, right now, yesterday's yellow jacket sting on my forehead is swelling down my face.

Feels lousy, but I think I correctly determined that it's not anaphylaxis.

Cellulitis,. on the other hand ...

Found out in the process that Daughter's doc suggested that she start carrying an epi-pen, as her response to stings has progressed over the years.

[scoutldr]

My wife retired as a school nurse (RN).  She had a student go into anaphylaxis due to a peanut allergy.  The kid knew he was allergic and he had epi-pens, but the mom just couldn't find the time to bring one to school.  Wife had to use another student's epi pen and was seriously in fear of losing her nursing license, because it was someone else's drug and there was no Dr order in place.  The ER doc told her she had saved his life.  Everyone sorta looked the other way, but if the kid had died, she would not have been able to continue in that job, both emotionally and legally.  

My 36 year old son has recently and suddenly become allergic to shellfish.  He was eating some shrimp when his throat started itching real bad and closing down.  He tested it again a few weeks later by taking a small bite...same reaction.  So, after a lifetime of loving shrimp, he is now unable to eat it.

Carrying an epi-pen in the first aid kit is risky if it is not prescribed and used for the individual prescribed.  It is illegal to give prescription drugs to someone else.  Just be aware of the risk you are taking.

 

[Treflienne]

1 hour ago, scoutldr said:

My wife retired as a school nurse (RN).  She had a student go into anaphylaxis due to a peanut allergy.  The kid knew he was allergic and he had epi-pens, but the mom just couldn't find the time to bring one to school.  Wife had to use another student's epi pen and was seriously in fear of losing her nursing license, because it was someone else's drug and there was no Dr order in place.  The ER doc told her she had saved his life.  Everyone sorta looked the other way, but if the kid had died, she would not have been able to continue in that job, both emotionally and legally.  

My 36 year old son has recently and suddenly become allergic to shellfish.  He was eating some shrimp when his throat started itching real bad and closing down.  He tested it again a few weeks later by taking a small bite...same reaction.  So, after a lifetime of loving shrimp, he is now unable to eat it.

Carrying an epi-pen in the first aid kit is risky if it is not prescribed and used for the individual prescribed.  It is illegal to give prescription drugs to someone else.  Just be aware of the risk you are taking.

There is also the problem of kids at school having an allergic reaction to something they did not know they were allergic to.  In recent years, because of situations such as the one descibed by @scoutldr  in which a kid has an allergic reaction at school but no epipen, effort has been made to allow schools to have "stock epinephrine"  available for use for kids who have an allergic reaction but do not have a prescribed epinephrine auto-injector (epipen or similar).  These sites, https://www.foodallergy.org/education-awareness/advocacy-resources/advocacy-priorities/school-access-to-epinephrine-map  and  https://www.aafa.org/epinephrine-stocking-in-schools/  , have information on  states allowing or requiring schools to have stock epipephrine.  

Unfortunately I do not know what other groups are permitted to carry stock epinephrine -- and this is likely to vary by state.  There is some information here: https://www.foodallergy.org/public-access-to-epinephrine

[Terasec]

On 7/8/2019 at 12:09 PM, Jameson76 said:

We had a Scout who had while not an anaphylactic reaction did get some hives while playing a wide game, got into some vines or other underbrush.  We gave him some Benadryl.  One leader wanted to know what happens if they have an allergic reaction to benadryl. 

I told them we would give them more benadryl

check your laws, in most places its against the law to administer such to others, unless its by a parent or certified to do so.

I only keep such on my personal FAK not in pack accessible FAK,

Benadryl  does not stop reactions only alleviates symptons and could hinder first responders or other medics diagnosis,

 

[Terasec]

On 7/8/2019 at 8:42 PM, scoutldr said:

My wife retired as a school nurse (RN). 

Carrying an epi-pen in the first aid kit is risky if it is not prescribed and used for the individual prescribed.  It is illegal to give prescription drugs to someone else.  Just be aware of the risk you are taking.

 

one could get a prescription for EpiPen to administer to others,

if you tell your dr your a scout leader with regular outings with kids, and inform them of various first aid training you may have had, they can write you a prescription for the EpiPen to administer to others, that would be up to dr's discretion 

I have discussed this issue during various first aid courses, what is always mentioned is do not have your meds available to others, scout trips FAK which is accessible by other leaders and parents should not have such things in them,

want to have meds in your FAK, put it in your personal FAK not in group FAK

 

 

[Eagle1993]

4 minutes ago, Terasec said:

check your laws, in most places its against the law to administer such to others, unless its by a parent or certified to do so.

I only keep such on my personal FAK not in pack accessible FAK,

Benadryl  does not stop reactions only alleviates symptons and could hinder first responders or other medics diagnosis,

 

Health forms should cover this correct?  They state allergies to meds & if you are approved to give over the counter meds.   Most med kits contain Benadryl in wipes or creams.  We have had ER docs in our Troop and we use it all the time if med form doesn’t counterindicate on Benadryl.

It is correct about use of prescription drugs without a prescription is illegal, Epipens fall into a special category.   As far as Epipens, laws vary by state.  California now allows organizations to get prescriptions for Epipens to use them on people without prescriptions.

https://californiahealthline.org/news/new-california-law-allows-organizations-to-buy-epi-pens-for-emergencies-but-will-they/

36 states now have laws to allow usage and stocking at entities.

https://www.ems1.com/anaphylaxis/articles/87691048-25-states-now-allow-public-access-to-epinephrine/

 

[T2Eagle]

7 minutes ago, Eagle1993 said:

Health forms should cover this correct?  They state allergies to meds & if you are approved to give over the counter meds.   Most med kits contain Benadryl in wipes or creams.  We have had ER docs in our Troop and we use it all the time if med form doesn’t counterindicate on Benadryl.

 

BSA Med Form Part B Has a yes/no question authorizing non prescription medications and and any exceptions to that permission.

One more reason why leaders need to be sure they've read and understood the med forms for everyone on a trip.

[Terasec]

11 minutes ago, Eagle1993 said:

Health forms should cover this correct?  They state allergies to meds & if you are approved to give over the counter meds.   Most med kits contain Benadryl in wipes or creams.  We have had ER docs in our Troop and we use it all the time if med form doesn’t counterindicate on Benadryl.

It is correct about use of prescription drugs without a prescription is illegal, Epipens fall into a special category.   As far as Epipens, laws vary by state.  California now allows organizations to get prescriptions for Epipens to use them on people without prescriptions.

https://californiahealthline.org/news/new-california-law-allows-organizations-to-buy-epi-pens-for-emergencies-but-will-they/

36 states now have laws to allow usage and stocking at entities.

https://www.ems1.com/anaphylaxis/articles/87691048-25-states-now-allow-public-access-to-epinephrine/

 

the BSA  medical form I have authorizes camp office to administer the meds its not a blanket authorization for all

have it in front of me as going to camp on sunday

this is a BSA local council med form

" the following medications are available in the camp health office and will be administered at the discretion of the camp medical officer. If approval is ordered by the healthcare provider below"

 

[Eagle1993]

3 minutes ago, Terasec said:

the BSA  medical form I have authorizes camp office to administer the meds its not a blanket authorization for all

have it in front of me as going to camp on sunday

this is a BSA local council med form

" the following medications are available in the camp health office and will be administered at the discretion of the camp medical officer. If approval is ordered by the healthcare provider below"

 

Interesting....

The Second page of Part B of the BSA form states

“Non-prescription medication administration is authorized with these exceptions:_______________________________________________“

This would apply to the Troop leaders and these forms should be filled out in addition to any local form.

https://filestore.scouting.org/filestore/HealthSafety/pdf/680-001_ABC.pdf

 

 

[Terasec]

5 minutes ago, Eagle1993 said:

Interesting....

The Second page of Part B of the BSA form states

“Non-prescription medication administration is authorized with these exceptions:_______________________________________________“

This would apply to the Troop leaders and these forms should be filled out in addition to any local form.

https://filestore.scouting.org/filestore/HealthSafety/pdf/680-001_ABC.pdf

 

 

you skipped the line that says

"Administration of the above medications is approved for youth by: "

OTC medications youth is taking must be listed

its not a blanket authorization to administer any OTC meds at will

[Terasec]

13 minutes ago, Terasec said:

the BSA  medical form I have authorizes camp office to administer the meds its not a blanket authorization for all

have it in front of me as going to camp on sunday

this is a BSA local council med form

" the following medications are available in the camp health office and will be administered at the discretion of the camp medical officer. If approval is ordered by the healthcare provider below"