As an integral part of our training for camp staff, we discuss the use and ‘must-know’ facts about children who suffer from severe allergies.The Quebec Govenment has initiated a certification to be offered to all relevant caregivers in order to avoid the preventable situation of Anaphylactic shock and the fallout that follows.The good news is that the Ministry of Health and Social services has developed a course to address this problem.The 90 minutes “Administration of Epinephrine for severe anaphylactic type allergic reaction” addresses the need. The auto epinephrine injector is for use only on previously diagnosed with severe allergic reactions.The training first gives the learner a comprehensive education about Anaphylaxis as well as how to use an auto-injector and lots of simulations to practice. The Training also satisfies the law (section 39.8 of the professional code) so that all camp staff can use an Epi-pen or Twin-ject if the need were to arise.Be sure to have relevant staff certified in the safe delivery of emergency epinephrine.Did you know…The appropriate dosage delivered only last for 15 minutes (have a back-up dose)If expiration date has been reached or passed it is still ok to use the injector. However, it will provide less than the usual 15 minutes of lifesaving benefits. (have a back-up dose)Never use someone else’s injector (have a back-up dose)Always have it close by or in a fanny pack at camp, and excursionsOnce grey safety cap is removed and injected in muscular area of the thigh, hold injector in place for 10 seconds. Rub area to disperse medicine, and ice area. Dispose of released needle (and break) immediately.Hold pen in fist, never with thumb over the endPractice with a trainer only!!!
My sincerest sympathies go out to the parents. If only something positive can come from such a devastating incident. Babies and children are vulnerable in the water. Most are not aware of how fast and quietly drowning actually happens. We imagine being able to breath hold for much longer than it takes to drown. The drowning response however is a stress reaction, where the heart beats fast and requires more oxygen to sustain itself.
The drowning response and progression is as follows…
The drowning response cannot be heard, and a child can drown in 15-60 seconds. Any chance the child can call for help is replaced by a breath in. Once breathing stops, the heart stops within a minute or so. This is clinical death, where the heart and breathing have stopped. This is the state where CPR and AED use is possible and can prevent and prolong the onset of biological death (brain death). Without CPR, Clinical death will progress into biological death in 4-6 minutes. The average response time for the abulance to arrive is 7-8 minutes once the call is made! The Automatic External Defibrillator (AED) is useful only within the first 8 minutes, in order to restart the heart. Waiting is not an option.
CPR can be considered a manual life support system, stopping it or delaying the onset is the same as pulling the plug on life support. Please spread this information and the essential need for pre-ambulance care.
Mitch Katz-Zeitlin, Aquatics Professional and the Owner of Urgences Reanimation and PLPS pools.
With the recent deaths of children in schools due to severe allergic (Anaphylactic) reactions I have been pondering how we as first-aid instructors teach Anaphylaxis.
First of all regulations here in Quebec get in the way. In schools, even if the child is known to be allergic, by-laws do not allow a teacher or other school worker to administer Epinephrine (Epi-Pen /Twin-ject) when required.
This of course places doubt and fear in the mind of the rescuer. The result is the child does not receive the lifesaving injection.
I have always been amazed at how much time it takes to teach this topic as it generates so many questions.
The good news is that the Ministry of Health and Social services has developed a course for school workers to address this problem.
The 90 minutes “Administration of Epinephrine for severe anaphylactic type allergic reaction” addresses the need.
The training first gives the learner a comprehensive education about Anaphylaxis as well as how to use an auto-injector and lots of simulations to practice. The Training also satisfies the law (section 39.8 of the professional code) so that all adults that work in schools can use an Epi-pen or Twin-ject if the need were to arise.
Keep in mind that this to help youngsters already diagnosed with Anaphylaxis. That is to say they are known to be allergic. One should not attempt to diagnose someone not known to be allergic.
This is a great step in the right direction. I am guessing I will be teaching this a lot in the New Year.
Norman Goldberg at URGENCES REANIMATION
Master Instructor FMCQ