https://www.proanaphylaxis.com/training/video/course-summary-USA https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4377.mp4 Course Summary Completing Your ProTrainings Course: Next Steps This guide outlines the final steps you need to take to successfully complete your ProTrainings course and prepare for the test. Reviewing Course Materials Maximize your chances of success by revisiting any course materials as needed. Accessing Video Content Again Remember, you have the option to review any of the videos before taking the test, ensuring a thorough understanding of the content. Preparing for the Test Approach your test with confidence by thoroughly preparing using the resources provided. Utilizing ProTrainings Resources Make the most of the ProTrainings materials to ensure you're fully prepared for the assessment. Final Words of Encouragement We thank you for choosing ProTrainings and wish you the best of luck with your test. Good Luck! With the right preparation and review, you're set to succeed in your ProTrainings course test. https://d3imrogdy81qei.cloudfront.net/video_images/7849/Course_Summary-01.jpg Yes 84 https://www.proanaphylaxis.com/training/video/minor-allergic-reactions https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4746.mp4 Minor allergic reactions We have spoken about full, allergic, anaphylactic reactions, but now we are going to take a step back and briefly talk about minor allergic reactions. These are allergic reactions that do not affect the respiratory system. One of the more common minor allergic reactions presents itself in the form of a rash, or even simply a bit of redness on the skin. Cases like these are not necessarily treated in the same way as anaphylactic reactions. It may be that creams can be applied to the affected area, or it can be treated using certain tablets. An example could be antihistamine tablets, such as Benadryl, Allegra, or Claritin, that a patient takes when they come into contact with an allergen. Even something like hay fever is still an allergic reaction, but it’s not having the same, full blown effect that an anaphylactic reaction has. It's quite important to recognise the difference between the major anaphylactic reactions and other, more minor reactions. You can get advice on both major and minor reactions from your doctor, pharmacist, or online. Just be sure that if you use the internet that the source is a recognised and trusted one. Something like hay fever, for example, there are websites and non-profits or charities around that can offer support. If someone has any type of minor reaction you must still be vigilant. Just because it’s a minor reaction at the moment doesn’t mean that it won’t develop into something worse in the future. If the condition of the patient starts to become at all worrying, you must activate the emergency services immediately. https://d3imrogdy81qei.cloudfront.net/video_images/8457/minor-allergic-reactions.jpg Yes 107 https://www.proanaphylaxis.com/training/video/about-anaphylaxis-reactions https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4743.mp4 About Anaphylaxis Contrary to popular belief, anaphylaxis has actually been around for a very long time, but in recent years it has become much more of a problem. Anaphylaxis is a serious type of allergic reaction, which can occur through a whole variety of ways. These include by eating or drinking, for example peanuts or milk, inhaling, for example dust, injecting, such as the result of a bee sting, or even by simply touching or coming into close contact with something. The substance which causes the allergic reaction is called the allergen. For example, if someone ate something with eggs in, and that caused an allergic reaction, then the egg would be the allergen. Allergens are unique to each person, meaning not everyone who experiences reactions is allergic to the same allergens. Consequently, of course, not everyone is allergic to something, meaning not everyone will be at risk of anaphylaxis. So for the majority of people, if they are stung by a bee, all that will happen is the local pain and discomfort of the sting. However, for those that are allergic to bee stings, the problem can become much more serious, the signs and symptoms can be much more complicated and can even be fatal if not treated correctly and urgently. This is going to be very stressful for the individual and they are probably going to have a lot of trouble breathing. I am sure that everyone watching this video will be familiar with food labels such as “This product may contain nuts” or “possible allergens within food”. Looking back not so long ago, allergens did not need to be highlighted on food packaging, but FDA regulations passed in 2004 under the Food Allergen Labelling and Consumer Protection Act meant that this needed to be present on food products labelled on or after January 1, 2006. This is because allergic reactions and anaphylaxis are becoming more and more prevalent in today’s society. There's lots of thought into why this has become an increasing problem more than it was maybe 25 years ago. Now, due to these FDA regulations, you can look at the packaging of food and better identify the risk of allergens. You might hear announcements on airplanes where a passenger has a severe peanut allergy and therefore the consumption of nuts on the plane is being forbidden. So you can see that allergies and anaphylaxis are prevalent in many different areas, and as the years pass will only continue to increase in their prevalence. The houses we live in are also playing a part in this change. Houses are a lot more controlled now in terms of temperature and humidity, whereas older houses would have had open cracks in the windows and have been generally less clean. Central heating can cause problems as we now live in much more of a controlled environment. This means that at a younger age, our bodies are exposed to fewer harmful substances, meaning we don’t build up the antibodies to resist certain things and anaphylaxis has links with asthma, which is also an increasing problem. In this course we're going to be talking about the different treatment methods that are available, but in all cases where you suspect anaphylaxis you should call the EMS. Anaphylaxis is something that comes on very quickly and even if you can give the auto-injector and the person can appear to feel better very, very quickly, advanced medical help should still be sought. Results from a 2015-2016 survey of more than 38,000 children indicate that nearly 8 percent have food allergies, and the CDC reports that between the two periods of 1997-1999 and 2009- 2011, food allergy prevalence among children increased by 50 percent. https://d3imrogdy81qei.cloudfront.net/video_images/8451/about-anaphylaxis-.jpg Yes 233 https://www.proanaphylaxis.com/training/video/course-overview-anaphylaxis https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4742.mp4 Course overview Before we start this course, we will first look at what will be covered during the training. The course is divided into categories, and in each category there are a number of videos. You can pause, or watch again any video on the course and as we regularly update our courses you will be able to see any new videos as they are released. This may be an online course, but if you have any questions during the course you can contact us by phone, email, or via the online chat facility. You work through the categories and videos on this course in the following order: Firstly, what anaphylaxis is, living with anaphylaxis, allergic reactions and activating the Emergency Medical Services. Autoinjector types, storage and disposal is also another category of this course. This includes who can prescribe auto-injectors and the safe storage and disposal of them. Signs, Symptoms and treatment of Anaphylaxis is the third category of the course. This will inform you of basic first aid advice, schools and teachers and anaphylaxis, giving a second dose of medications and biphasic anaphylactic response. Then we look at Immunotherapy drugs and Idiopathic Anaphylaxis. And finally, the last category will give you the basic knowledge and skills that you need when using an auto-injector. https://d3imrogdy81qei.cloudfront.net/video_images/8449/course-overview-anaphylaxis.jpg Yes 83 https://www.proanaphylaxis.com/training/video/life-with-anaphylaxis https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4745.mp4 Living with Anaphylaxis For patients living with an allergy that may cause them to go into anaphylactic shock, there are many things to consider. First of all, make sure you know what triggers the allergy, and do your best to avoid these things at all times. Unfortunately this may mean that patients will not be able to do everything or perhaps eat what they want, but it is essential that you minimise the risk of reaction as much as possible. On top of this, they must know how to recognise the signs and symptoms of anaphylaxis, and make sure their close friends and family are also aware. Having as much awareness as possible can help not only save this patient’s life, but also others who have allergies. The medication used to treat someone in anaphylactic shock will be covered in more depth later on in the course. This fast-acting medication is stored in and administered using what is called an auto-injector. This does as the name suggests, and automatically injects the drug into the patient. When living with the risk of anaphylaxis, the patient must ensure that not only is the auto-injector not expired and properly maintained, but it must also always be kept close by the owner. There is no point having it stored safely at home if they are having an anaphylactic reaction in the middle of a field, miles away, and need their medicine. Not only this, but make sure that you understand how and when to correctly take the medication, otherwise it is useless. Practicing with an auto-injector trainer is often really helpful to the patient, as they can repeat the training if they don’t feel confident. https://d3imrogdy81qei.cloudfront.net/video_images/8455/living-with-anaphylaxis-.jpg Yes 107 https://www.proanaphylaxis.com/training/video/anaphylaxis-activating-ems https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4748.mp4 Activating the EMS For anybody experiencing an anaphylactic reaction, you must activate the emergency medical services on the nation-wide number, 911. This works no matter what state you are in and will connect you to the nearest dispatcher. It’s a toll-free number and most mobile phones will allow you to call 911 even if the phone is locked and you don’t have the unlock code. When you call the emergency services, it is important to give them some basic information. You must make sure that they know early on that this is an anaphylactic reaction. This means that they will send someone out to you very quickly, but they will need further information from you. They will need to know who the person is, and they may ask you about their age or gender, and of course where exactly you are. Now sometimes knowing where you are is not always that easy. It may be you have travelled somewhere and are not sure of the exact address. If you are dialling from a landline phone, the emergency services can usually track you very, very easily. Have a look at the phone. It may well be that something close by has the address on. Maybe a panel if you are calling from a payphone, where there'll be a little card that actually says your location. If you are dialling on a mobile but you’re unsure exactly, then tell them where you think you are. They will be able to triangulate your signal, so maybe they just need to know what else around you can see. Emergency medical services will give you lots of information during the call, and will also instruct you on what you should be doing. You will be able to ask them questions. Tell them if the anaphylactic drug been delivered. If you are worried, they can stay on the phone right up until the paramedics arrive, and when they do, you need to tell them exactly what has happened and what medical treatment has been given. If the person has had one or even two auto-injector doses, they will need to know that so they know what drugs that they can then give, without the danger of overdosing. Any treatment you have given, hand to the paramedics when they arrive, they will be able to see the exact type and make of the drug, and exactly the dose that's been given. If you are at work, it's a good idea to make sure you know who has been trained in CPR and first aid. In a workplace, you may have a special emergency plan, so people should know if a certain person is susceptible to anaphylaxis. You would dial the emergency services first, but you must also then activate the in-house first aider. If you have got any doubts about what to do in the workplace, please ask your manager. If you are working in a child setting, perhaps in a school, there will also be policies and procedures in place as to where the drugs are kept, so in the case of an emergency you can access them quickly. The most important thing, if someone is having an allergic reaction, is that you must dial the emergency medical services immediately and tell them you have an anaphylactic emergency. While you are waiting for the emergency medical services to arrive, you should monitor for other issues, such as loss of consciousness, an increase in breathing difficulties, respiratory arrest, and cardiac arrest. If the person stops breathing but still has a pulse, perform rescue breathing. If the victim stops breathing and loses his or her pulse, begin full CPR. If the victim begins showing signs of shock – cool, pale, sweaty skin and a rapid pulse – cover him or her with a sheet, coat, or blanket and keep them as warm and comfortable as possible while waiting for EMS to arrive. https://d3imrogdy81qei.cloudfront.net/video_images/8461/activating-the-ems-.jpg Yes 212 https://www.proanaphylaxis.com/training/video/anaphylaxis-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4762.mp4 Practice and keeping up to date Now we are going to look at training and practice. The training element that you are undertaking within this course gives you the basic knowledge and skills you need, however training is all about practicing regularly. People who are diagnosed with anaphylaxis may be given a training unit to practice on. The advantage of these is that you can practice again and again on a regular basis. You can just make sure that you're happy with how to use the unit, how to deliver the drug, and that you keep your skills fresh. But also, if you've got friends or family, get them to practice as well. They can try using it on themselves or try using it on you. They are completely safe, with no drug in them and are very, very easy to use. https://d3imrogdy81qei.cloudfront.net/video_images/8487/practice-and-keeping-up-to-date-.jpg Yes 53 https://www.proanaphylaxis.com/training/video/immunotherapy-drugs https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4765.mp4 Immunotherapy drugs Peanut allergies are becoming more and more common in children, and this usually continues into adulthood. In severe cases, a peanut allergy can be life threatening, and at this moment in time there is no approved treatment for it. A current study is investigating a new drug and its effectiveness to reduce the symptoms seen in people with severe peanut allergies. The new drug being tested is called AR101 and it’s based on peanut protein, with the idea being that the dose is gradually increased to build up tolerance. This treatment is not a cure to peanut allergies, rather its aim is to make people with severe allergies less likely to experience a serious reaction if they are exposed to peanuts. This drug is not available in all countries but it has been licensed in the USA by the Food and Drug Administration or FDA, as an approved drug in the reduction of allergic reaction incidence and severity in patients aged 4-17 years old with a peanut allergy. The trial involved a total of 555 participants, 499 children and 56 adults, and was carried out in 10 countries in North America and Europe. The study compared the drug AR101 with a dummy powder, a placebo. Some participants received the real drug, which was gradually increased over a 12 month period. The other participants received the placebo, which was also gradually increased over 12 months. It is important to note that all tolerance tests were conducted in a research facility under medical supervision. This meant that participants could receive immediate medical attention if they experienced a severe allergic reaction. So, what were the results? Well, the research showed that young people with peanut allergies could experience a reduction in the severity of their symptoms, and a greater ability to tolerate small amounts of peanut protein following treatment with AR101 compared with the placebo. The study also showed that although this treatment appeared to work in children and adolescents, it had no significant effect in adults. The reason behind this has not yet been made clear. There are continuous ongoing studies for peanut allergies in the attempt to offer some hope for parents and children with serious peanut allergies. We must point out that tolerance testing should never be attempted at home. Allergic reactions can be life threatening if not treated immediately. https://d3imrogdy81qei.cloudfront.net/video_images/8491/immunotherapy-drugs.jpg Yes 152 https://www.proanaphylaxis.com/training/video/idiopathic-anaphylaxis-diagnosis https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4766.mp4 Idiopathic Anaphylaxis Sometimes, people are diagnosed as having what the doctor may call idiopathic anaphylaxis. This special type of anaphylaxis means that the cause for the anaphylactic reaction is unknown. During idiopathic anaphylaxis, the reaction is normally exactly the same and the signs and symptoms are typical. If the doctor diagnoses this, they will advise you to stay away from all of the most common allergens like shellfish, peanuts and eggs. This is because it could be that there may be more than one thing you are allergic to. Sometimes, the doctor will diagnose the condition as idiopathic, but then later on you may realise that you only get anaphylactic reactions after eating certain foods or after being stung by something. The doctor may also ask you to undertake allergy testing and physical examinations. In cases of idiopathic anaphylaxis, it is essential that you always carry around your prescribed auto-injector, as you cannot always stay away from allergens. Many people with idiopathic anaphylaxis see a decrease in reactions as their life goes on, again however, it is unclear why this is. https://d3imrogdy81qei.cloudfront.net/video_images/8489/idiopathic-anaphylaxis-.jpg Yes 77 https://www.proanaphylaxis.com/training/video/reporting-requirements https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4758.mp4 Reporting Requirements An anaphylactic emergency that has happened in the workplace would be recorded in the accident book, and you do need to make sure that the correct accident records are kept. This would be the standard accident book in your workplace. You would document who has had the problem and you would also write down in the book what treatment they've had and who put the information in there. You'd also need to follow general policies within your company. If you're unsure about this, talk to your manager. There may be a separate medications record of who has them and what exactly they have. Also, if you deliver any medications, you may need to record this separately. If your organization is an “authorized entity” that is permitted to have undesignated auto-injectors on-site, you may also be subject to additional reporting requirements by your state if an auto-injector has been administered. Please refer to your local state laws for details on how to file a report. https://d3imrogdy81qei.cloudfront.net/video_images/8481/reporting-requirements.jpg Yes 70 https://www.proanaphylaxis.com/training/video/course-intro-anaphylaxis https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4767.mp4 Course Introduction Welcome to this ProTrainings Epinephrine Auto-Injector and Anaphylaxis course. Throughout this course, you will watch a series of videos, answer some knowledge review questions and then finally take a short completion test. You can start and stop the course as often as you wish and return to it exactly where you left off. You can also watch any of the videos again, at any time, during and after the course. The course can be viewed on any device, so if you wish you can start watching it on your computer and finish it on your smart, phone or tablet. On each page of the course, there is text available to read about the subject covered, to further support the video and there is also additional help available if you initially answer any of the questions incorrectly. The course includes subtitles which you can view by clicking the CC icon if you wish. You can change the size and colour of the subtitles from the bottom right of the player. If you want you can select from the options on the bottom right of our player to show an additional smaller video player that stays on the screen as you read the text, allowing you to read and watch the video at the same time. Once you have passed the test your completion certificate and other downloads will all be available for you to print off. There are many resources and links to support your training and these can also be accessed from the course home page. We are constantly updating our courses, so check back regularly to view any new material. We give you access to the course for 8 months from when you started it, even after you've passed your test. We offer free company dashboards, so if you're responsible for staff training in your workplace and you'd like more information on our company solutions, please contact us by email, phone or by using our online chat facility. This may be a course that's delivered online but we offer you complete support throughout your training. Finally, with all our online courses you will receive an email every Monday morning, to keep your skills fresh and to see any new videos that we add to the course. These emails also include news from our blog and you can choose to receive them, or stop them, at any time. We hope you enjoy your course and thank you for choosing ProTrainings. Good luck! https://d3imrogdy81qei.cloudfront.net/video_images/8493/course-introduction-anaphylaxis-usa-.jpg Yes 125 https://www.proanaphylaxis.com/training/video/common-causes-of-allergic-reactions https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4747.mp4 Common causes of allergic reactions As we have already discussed, people may be allergic to a number of different substances, referred to as allergens. People who are allergic to one substance are often allergic to others. Some of the most common allergens include:- Venom from insect bites and stings, especially those of bees, wasps, hornets, and yellow jackets- Foods, including nuts, shellfish, crustaceans, peanuts, milk, eggs and chocolate- Plants, including contact with poison ivy, poison oak, and pollen from ragweed and grasses- Medications, including penicillin and other antibiotics, aspirin, seizure medications, muscle relaxants and over-the-counter remedies- And finally, other things such as dust, latex, glue, soaps and make-up https://d3imrogdy81qei.cloudfront.net/video_images/8459/common-causes-of-allergic-reactions.jpg Yes 60 https://www.proanaphylaxis.com/training/video/anaphylaxis-for-teachers https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4755.mp4 Schools and teachers When you're dealing with an anaphylactic emergency in either a child or an adult, the actual treatment is the same. However, when you're dealing with a child there are certain other things you need to think about. One of these is that the fact that the child is going to be very scared, maybe they've had an anaphylactic reaction before, and now they're really worried because they know what it's like. So, you have to guide them through using their auto-injector as quickly as possible. The quicker the drug is injected into the child, the quicker the problem will go away. The child will know this and you need to encourage them to inject themselves without delay, to therefore make themselves feel better. The child may be scared about putting the needle into themselves but again, just try and tell them that the drug will help them and it will make them feel better very quickly. There are other things that need to be taken into account when working with children. These may be written policies from an employer, duty of care, and you may need to have a signature from the parent who could possibly allow you to administer the drug to the child should there be an emergency. There will also be other records that you need to keep, such as: - What are the names of the children in school or a play centre that have anaphylaxis, what drug do they use, where are the drugs kept, what does the prescription say, how is it delivered, do they need one or two auto-injectors? - Do the children carry it with them to class or is it stored in a special location? - All these types of record-keeping will be planned out by your employer, so it's important to find out exactly what their policies are in relation to the storage of anaphylactic medication, and also what their treatment policies are. The first aid procedures will be the same. Activate the emergency services, give the patient their drug, but also consider other policies that may differ from one workplace to another. If you're working with children on a day-to-day basis, the most important thing you can do is talk to their parents or guardians. They should be able to give you all the information you need to best care for their child. So when you're talking to the parents, make sure you understand whether or not they've had an anaphylactic problem in the past. If so, how did they handle it? It may be that the parent says that the child is very adult about it and they just get their auto-injector out and deliver the drug without fuss. Others may say that the child gets very upset and scared. The more information you have the better. As somebody looking after children it may well be that you have quite a few in your care, so make sure that you keep their records up to date. Also, talk to the children themselves, they will be able to help you. Make sure you know and understand any developments with their treatment. Just keep reminding them where their drugs and treatments are, so you're communicating with the child and they know how important it is. https://d3imrogdy81qei.cloudfront.net/video_images/8479/schools-and-teachers-.jpg Yes 176 https://www.proanaphylaxis.com/training/video/auto-injector-second-dose https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4756.mp4 Giving a second dose Sometimes, one auto-injector is not enough, so doctors may well prescribe a second one. If you or the patient has delivered one auto-injector, and they're feeling worse, or certainly no better at all, then it may be that you need to administer a second dose between five and 15 minutes after the first. Remember, these are single dose syringes, so you can't deliver it twice from the same unit. So use a brand new unit and inject the medicine in the exact same way. Make sure that the paramedics know exactly what's happened, that two auto-injectors have been used instead of just the one. This is very important because the paramedics may well give further drugs, so they need to know what's actually in the patient’s system already. Otherwise there could be a risk of overdosing, or other interactions between various chemicals. Having a second dose is not needed for everybody, so patients must consult their doctor individually. Remember that they won't prescribe something if they don't think that it’s needed. Reasons for a second auto-injector vary from things like body size and age, and also what's happened in the past. It may well be that in previous attacks two drugs have been required, so two are now routinely prescribed. If you're caring for a child then again, get advice from their parents or themselves as to whether they need to have one or two doses. https://d3imrogdy81qei.cloudfront.net/video_images/8475/giving-a-second-dose-.jpg Yes 92 https://www.proanaphylaxis.com/training/video/biphasic-anaphylaxis https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4757.mp4 Biphasic Anaphylactic Response We have looked at a single anaphylactic reaction but now we are looking at a possible Biphasic anaphylactic response. A biphasic response means that there are two separate and distinct reactions that are separated in time. Consequently with anaphylaxis, this would be an immediate reaction to the trigger which is then followed by a recurrence of symptoms after an interval of time. Being exposed again to the allergen is not necessary for a biphasic reaction to occur. This reaction can happen between 2 and 72 hours after the first incident, so perhaps long after discharge from the hospital. This can occur in as many as 20 percent of cases. The biphasic reaction can be less, equally or more severe than the initial reaction, ranging from mild symptoms to a potentially fatal reaction. Biphasic reactions do not always show the same symptoms as the initial reaction. Predicting if a second reaction will occur is not easy but the more severe the reaction or when two auto-injectors are initially needed, the higher the chance of a recurrence. Being aware of a possible biphasic response is important if you are caring for someone, so you can monitor them closely just in case. If you are administering first aid then it may be worth telling them, or their parents or guardians, to watch for additional symptoms after hospital discharge. Knowing this is important, but remember that every patient is sent to the hospital after experiencing anaphylaxis and will be advised on the actual care they think is needed after discharge. Finally, always make sure you have a spare auto-injector once discharged from hospital, just in case, and that you monitor the patient closely for up to 72 hours after the first attack. https://d3imrogdy81qei.cloudfront.net/video_images/8477/biphasic-anaphylactic-response-.jpg Yes 115 https://www.proanaphylaxis.com/training/video/allergy-medical-id-tags https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4805.mp4 Medical ID tags for allergies When you are dealing with a patient, one big problem you have is finding out what existing medical conditions they have, so the use of ID tags can be really really helpful. So these can be built into different sections, we've got an example of some here, but the first ones we've got are general medical tags. So with these, you can write general medical information down and this one here is one where you'd actually write on a card and you insert that card into the strap and then you can just wear that around your wrist. There are others which are a rubber band type and on the inside you can write medical information but on there always use a pen that is permanent. Do not use one that will easily rub off. And there are lots of other general ones you can have which could be metal ones, necklaces or, metal bracelets around the wrist. You can then have ones that are specific to the individual condition they have so, for example, we've got some here which are for anaphylaxis. So these would be in the form of a rubber band and they would be something that an adult or a child could wear and they come in different sizes. So, if you've got a child with a small wrist you can have a smaller one on them and on these they literally state this person has got anaphylaxis so it doesn't actually say on that band what they have got an allergy to but on this one on the inside you can see they've got a little band and you can actually write what the person is allergic to. There are others which are this type which is the clip around the wrist. This one in particular is a child one which clips around their wrist and on the inside you can put the medical data as well on there. Other ways of identifying with anaphylaxis we've got keyrings which will hook on to maybe a case where their auto-injector is and also there are little stickers the child could wear or they could have them on their books or things like that, and at least that tells them what they're allergic to. This particular one says that they're allergic to tree nuts and peanuts. Other ones you can have are unique to individual conditions. So here we've got two which are for people with diabetes and again they can put emergency contact details on the inside and this one here says that the person has epilepsy so, if you're dealing with something you need to look out for all types of ID bracelet whether this type or whether the metal type because you're not necessarily going to know what's wrong with that person. If someone's feeling unwell and maybe they're unable to talk to you then you would know that they have got that relevant condition. An example of this very good one would be somebody who has a seizure, you are not sure whether they are having this seizure for the first time but if they're wearing a medical alert bracelet you would know this person suffers from epilepsy. https://d3imrogdy81qei.cloudfront.net/video_images/8557/medical-id-tags-for-allergies-.jpg Yes 157 https://www.proanaphylaxis.com/training/video/allergies-covid-19 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4761.mp4 Allergies and COVID-19 There are some relations that need to be made between the Coronavirus pandemic and allergies. For example, some medications can affect a person’s immune system, which may make them more liable to the more serious signs and symptoms of COVID-19, should they contract the virus. Most anti-allergy medications do not affect immunity, however this doesn’t mean that this doesn’t happen with some medications. If you are at all worried, you should consult your doctor or allergy team. The Asthma and Allergy Foundation of America have stated “Antihistamines do not suppress the immune system. There is no reason to think they would increase your chances of getting a virus or a bacterial infection.” If you are self-isolating and can’t get the required medications, you must arrange for someone else to buy over the counter drugs for you. You may also be able to arrange for prescriptions by mail from your pharmacy to help you if you know in advance that you need to self-isolate. https://d3imrogdy81qei.cloudfront.net/video_images/8485/allergies-and-covid-19-.jpg Yes 69 https://www.proanaphylaxis.com/training/video/anaphylaxis-first-aid-advice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4754.mp4 Basic First Aid Advice The purpose of first aid is to prevent the patient getting worse and this can be performed with some simple, easy skills. Before entering into a rescue scene, the rescuer should perform an initial assessment to ensure that the scene is safe. Next, personal protective equipment should be worn to protect the rescuer. The ABCD concept is designed to give the rescuer a guide of what to do, in what order, during a first aid emergency when the person is unconscious. First of all, there is "A". This stands for the Airway, which starts at the mouth and nose and ends at the lungs. It is very important that this is not blocked, as it delivers oxygen to the lungs. You can check that it is not blocked by opening the airway. This is done by tilting the head back and lifting the chin. After this, you must check to see if the person is breathing. You need to Look, Listen and Feel for any signs of breathing for 10 seconds. If they are not breathing you must commence CPR and check for Circulation, which is what C stands for. You can do this by checking what is called capillary refill. Gently but firmly push the blood in the thumb towards the body. If the blood returns in 2 seconds then there is adequate circulation. The next thing the patient needs is "D" - Defibrillation, where an electric shock interrupts a cardiac arrest and hopefully allows the heart to start again. If alone, the rescuer may need to put the patient into the recovery position, whilst leaving to contact emergency services, if the patient is breathing. If the patient is not breathing, call the EMS and then perform CPR. The recovery position allows the patient to breathe easily, stay safe, whilst removing the risk of them choking, should they vomit. https://d3imrogdy81qei.cloudfront.net/video_images/8473/basic-first-aid-advice-.jpg Yes 114 https://www.proanaphylaxis.com/training/video/amneal https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4793.mp4 Amneal Epinephrine Auto-injectors As with all auto-injectors, the Amneal Epinephrine Auto-Injector contains a prefilled dose of adrenaline to be used during serious allergic reactions or anaphylaxis. This training unit is black and beige colored, but the actual units you would be using are black and yellow, which makes them easily identifiable in a possible time of panic. When using the Amneal Epinephrine Auto-Injectors, first of all, you have to grab both ends of the unit and then twist and pull to separate the outer shell casing. You need to remove both sides of the casing. Otherwise, you may drop the unit, which could damage the medicine inside or possibly cause it to either leak or malfunction. Once the outer shell casing has been removed, the actual auto-injector is exposed, but be sure to keep the casing nearby, as it is used after the adrenaline has been administered. As with most auto-injector units, instructions on how to use it are printed on the actual unit. Be sure to read these, even if you think you know what you are doing. Remember that sometimes there may have been some changes made that you did not know about. Once you are holding the Amneal Epinephrine Auto-Injector, you must first pull off the smaller cap, which is the back end of the unit. In this training unit, the cap is yellow, but the actual unit would have a blue cap. Next, you should pull off the larger blue cap, which is located in the front end. This exposes the bright red end of the unit, which indicates that is where the needle will come out of. Hold the Amneal Epinephrine Auto-Injector unit as you would with any other auto-injector, remembering to keep your fingers and thumb away from either end, just in case it is the wrong end. Then gently place the red needle end against the outer thigh and push it into the leg. This injects the adrenaline and must be held in place for 10 seconds. After that, you must pull the unit out, away from the leg. This exposes the needle, so be careful not to injure either yourself or others. Then you must carefully put the needle end back into the black half of the outer casing. Next, return the yellow end back in place and finally twist it until you hear a click, sealing the container. When the EMS arrive, make sure to give the auto-injector to them, as medical professionals need to know what medicines have been administered in what dosages. https://d3imrogdy81qei.cloudfront.net/video_images/8537/the-impax.jpg Yes 149 https://www.proanaphylaxis.com/training/video/epipen-usa2 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/5073.mp4 EpiPen® The EpiPen is an auto-injector that administers adrenaline and is carried by people who suffer from anaphylaxis so that it can be used if the person goes into anaphylactic shock.There are two types of EpiPen, the EpiPen and the EpiPen Junior. To avoid accidents and prevent damaging the EpiPen, they should always be kept in their case when not in use.  There are easy to read instructions down the side of each pen and these should be read to make sure you use it correctly.The blue cap shows you the top of the EpiPen, this is the safety cap that makes sure that the needle does not come out when not in use. Once removed, the unit is live. The cap can be replaced without the EpiPen being used; however, you must do so carefully as you could inject yourself accidentally with the adrenaline.When using an EpiPen, you should first remove it from its case. Then lie down with your legs slightly raised to keep blood flowing, or if breathing is difficult then just sit down.Remove the safety cap and gently push the auto-injector into the thigh. This can be done through clothing, but make sure that the needle will not go through any thick seams in the clothes or anything in a pocket.Once the needle has hit, hold it in place for 3 seconds and then remove it. Stay where you are until the emergency services arrive, if you are treating someone and they are unconscious, place them in the recovery position.  When the EpiPen has been used, a needle cover will appear automatically over the needle, to prevent any needle injuries. The used EpiPen should be given to the emergency services after use so that they can see exactly what has been administered to the patient, and they can also dispose of it properly. Should a second dose be required, repeat the process, and make sure that you give both to the emergency services. https://d3imrogdy81qei.cloudfront.net/video_images/9051/epipen-usa2.jpg Yes 112 https://www.proanaphylaxis.com/training/video/auto-injector-storage-disposal https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4751.mp4 Storage and disposal Your auto-injector must be stored correctly, but you must also be aware that different auto-injectors will have different temperature ranges and requirements that they can be kept under. So you need to make sure you know how to correctly store your particular unit, and then actually go on and store it correctly. You can get this information from the manufacturer's website, from your pharmacist or doctor, or on the ProTrainings website. Now generally speaking, all auto-injectors have to remain in set temperature ranges, you can't allow them to freeze or reach too high a temperature. If this happens, the shape of the chemical will change, which can render it useless. Most auto-injectors are quite resistant to temperature changes and will be able to resist small changes, however it is the extremes which you need to guard against. With regards to cold temperatures, for example if you are going to put them into your coat pocket and you are out in a very snowy or frosty day, then you must look at what the minimum temperature of that environment is. Err on the side of caution, do not risk taking your auto-injector into an area which is likely to reach either extremely hot or cold temperatures. If you have an auto-injector left in the car on a hot sunny day, the temperature inside your car can get extremely hot, so you may need to make special arrangements to keep the unit cooler. Perhaps have an insulated storage box within your car, or maybe even just put it in the trunk of the vehicle. So make sure to check exactly with the manufacturers as to what the temperature extremes for your particular unit are. Other requirements may be that the unit must have a UV protecting case. UV light comprises of sunlight between a particular wavelength range, which can make it not only dangerous to humans, but can also affect certain chemicals. For example, the EpiPen unit has a special case that protects it from UV light, since the adrenaline inside the EpiPen can be seriously affected by the sun’s rays. So, keep the unit in whatever storage case it comes in, not only may it offer protection against UV light, but it will also obtect against dust, dirt and other potential hazards. There are different times when you are going to need to dispose of an auto-injector, and you need to take special precautions when doing this. One example would be once you have actually used it, and another would be if it becomes damaged or expired – meaning the medicine is still in the unit. If you have actually used an auto-injector, you should always give that to the paramedic or medical professional on the scene. That way they can tell exactly what has been administered to the patient. In times where both the unit and the medicine needs to be disposed of, you would need to take it back to your pharmacist, doctor or hospital and they can dispose of it correctly. Never just put these straight into the trash, as not only do they contain a needle, but also potentially dangerous medicine if not administered correctly and not expired. https://d3imrogdy81qei.cloudfront.net/video_images/8467/storage-and-disposal-.jpg Yes 186 https://www.proanaphylaxis.com/training/video/auvi-q https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4792.mp4 The Auvi-Q® There are 3 types of AUVI-Q auto-injectors. The first one, which is white and purple, has 0.1 milligrams of epinephrine, and is for infants and toddlers weighing 16.5 to 33lbs. The next step up is for children weighing 33 to 66lbs, contains 0.15milligrams of the drug, and has a light blue casing. Finally, the red cased auto-injector is for anyone weighing 66lbs or more, and contains a much higher 0.3 milligrams of the medicine. If you have the white and purple unit and are injecting an infant or toddler, you should hold the leg firmly in place while administering an injection. All units come equipped with a set of voice instructions, so the unit will literally tell you what you need to do. Should this part of the unit malfunction however, the unit will still work as an auto-injector, meaning you can still use it to inject the drug. To start using the unit, pull off the bottom part of the case, which will activate the instructions. Then it will tell you to pull the red safety guard off of the bottom of the unit, which exposes the site where the needle will come out. After that, put the same end, which is black, against the outer thigh and push in firmly. Once in place, it will countdown for two seconds and should not be moved until you hear it say “injection complete”. After that, you can remove the unit from the leg. When administering AUVI-Q to an infant or toddler, their leg should be held firmly in place. This stops them from flailing their legs about, should they become scared. However if they are having a serious allergic reaction then the medicine must be administered, otherwise the reaction could prove to be fatal. Always follow instructions to make sure that nothing goes wrong. https://d3imrogdy81qei.cloudfront.net/video_images/8539/the-auvi-q.jpg Yes 110 https://www.proanaphylaxis.com/training/video/auto-injector-prescriptions https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4750.mp4 Who prescribes auto injectors? Auto-injectors are a prescription-only medicine, which means that only a doctor can prescribe one once he knows you need it. However, there is an exception to the rule regarding prescriptions in many U.S. states. You should check your state’s website for the exact information. Many have passed epinephrine auto-injector laws in the past few years allowing certain organizations (also commonly known as “authorized entities”) to either directly purchase auto-injectors from the pharmacy without a prescription or to obtain a prescription for an auto-injector on behalf of the entity as the patient rather than an individual. Examples of authorized entities may include schools, recreation camps, day care facilities, youth sports leagues, amusement parks, restaurants, sports arenas, and places of employment. Many of these laws also require regular auto-injector training, such as this course, in order to be permitted to administer an auto-injector to a patient. It is important to recognize that auto-injectors come in different dosages depending upon the size of the person. Generally, children between 33 and 66 pounds should use a smaller dosage than an adult would. For children under 33 pounds, you should not administer the auto-injector and call 911 immediately to determine what to do next. Be sure to always read the label on the auto-injector before use, both too much or too little epinephrine could affect the patient’s recovery. The doctor is involved in actually deciding which drug you'll be given. What he's going to look at is the problem you have, what you are allergic to, any previous problems, the effectiveness of previous drugs, and also your lifestyle. So you are going to need to keep going back to the doctor to make sure that you have the correct treatment for your condition. If you need any advice on this, contact your doctor’s office and speak with either the doctor, or one of the nurses. The pharmacist is the person who will actually hand over the drug to you, but they can also offer further help, should you need it. They can give you advice on the units, they can tell you about storage. They can also dispose of medicines if you have some expired drugs you need to get rid of. So there is lots of help out there for you. Just ask. Talk to your doctors, talk to your pharmacists, and anybody else you think can give you useful advice. https://d3imrogdy81qei.cloudfront.net/video_images/8465/who-prescribes-auto-injectors-.jpg Yes 157 https://www.proanaphylaxis.com/training/video/auto-injector-storage-pharmacist https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4752.mp4 Storage of auto injectors - Pharmacist comments Auto-injectors are a device to administer an injectable preparation into the skin without the skills that a professional such as a doctor or nurse would have. They are designed for yourself and myself, as members of the public, to use. And the auto-injector as a pen has the dosage, a unit dose of medication that is required. The storage requirements are that they remain within the packaging that they come. That they are safety, that they function correctly when you pull them out of there. Do not open them and store them outside of the container that they come in. Do read the instructions carefully as to how they should be stored in the temperatures. In general, they can be carried everywhere, but do not leave them on the windscreen of your car, do not leave them in the refrigerator with your sandwiches. Do make sure that you read that and follow the instructions on there. Always carry them in the original container that they have been supplied in. https://d3imrogdy81qei.cloudfront.net/video_images/8469/storage-of-auto-injectors---pharmacist-comments-.jpg Yes 74 https://www.proanaphylaxis.com/training/video/auto-injector-expire-dates https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4809.mp4 Checking Auto Injector and Expiry Dates It is important to check your auto-injector to ensure that it's in date, undamaged and it has been stored correctly to ensure that it's fit for use when needed. Check the expiry date printed on the auto-injector to make sure that it has not expired or, if it is close to expiring, make sure you've ordered a replacement from your doctor. Most manufacturers of auto-injectors have an expiry notification service where you enter the expiry date of a unit as soon as you receive it and then they send you an email or a text when they are needing to be replaced. Carry out a visual inspection to ensure that nothing is damaged and, depending on the brand, you may also be able to see the solution to ensure that it hasn't changed in appearance. Many brands are stored in UV protection cases to prevent them from damage from the sun. Ensure you store your auto-injector within the temperature ranges of the brand. This means not storing it where it can get very hot, like in a car in summer, or very cold where it could freeze in winter. Always keep your auto-injector in the case it comes with to protect it from damage. If you have a second auto-injector or units kept at different locations, make sure you always check these at the same time. If you detect any problems with your auto-injector ask your doctor or pharmacist for advice. It's very important to always make sure that they are ready for use to make sure that they're effective in treating an anaphylactic reaction. https://d3imrogdy81qei.cloudfront.net/video_images/8569/checking-auto-injector-and-expiry-dates-.jpg Yes 92 https://www.proanaphylaxis.com/training/video/what-is-auto-injector https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4749.mp4 What is an Auto-Injector? More than 50 million Americans experience some type of allergy each year, so it is relatively likely that you will come into contact with someone who may be at risk of a severe allergic reaction and then going on to experience anaphylaxis. The main drug used to treat anaphylaxis is called either epinephrine or adrenaline. Our bodies are constantly making small amounts of adrenaline, and it is also known as the “fight or flight” chemical. You may have heard of having a pit in your stomach when you are nervous or scared, and this is actually due to excess adrenaline being made to be ready to either “fight”, continue with what you are doing, or “flight”, run away and don’t do it. Auto-injectors contain a pre-measured dose of adrenaline, which is much more than the usual body produces. When injected into the body, the adrenaline is quickly fired into the bloodstream and helps to open back up the airway of the patient, allowing them to breathe again. This is why someone with serious allergies should always carry an auto-injector with them, on their person. Using conventional syringes takes way too much time, and if you yourself are having an anaphylactic attack, there is no way you will cope with drawing a drug out of a bottle in the same way a trained doctor would do. Also, the fact that auto-injectors contain a pre-measured dose of adrenaline means there is no chance of either not injecting enough in, or going to the other extreme and overdosing. This is why auto-injectors are so useful. There are many types of auto-injectors, and the most common ones are very easy to handle and use. They are available to anyone who could be susceptible to anaphylaxis. Even though there are many types of auto injector, they should all be administered into the top quarter of the thigh. The main auto injectors being used are the EpiPen®, the AUVI-Q®, the Adrenaclick®, and a number of generics. We will look into each of them in more detail, as well as cover the differences between them in separate videos. https://d3imrogdy81qei.cloudfront.net/video_images/8463/what-is-an-auto-injector-.jpg Yes 137 https://www.proanaphylaxis.com/training/video/anaphylaxis-definition https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4744.mp4 What is Anaphylaxis The CDC defines anaphylaxis as “a sudden and severe allergic reaction that may cause death.” Not everyone has allergies, and not everyone who has allergies will be susceptible to going into anaphylactic shock. Also, just because someone has an allergic reaction does not mean that they will then go on to experience anaphylaxis.  The reaction may start suddenly within seconds, or take minutes or even hours to develop following contact with the allergen. Common food triggers include peanuts and tree nuts, fish and shellfish, citrus fruit, eggs, and dairy products such as milk and cheese. Other allergens include venom from stinging or biting insects, medicines – most commonly antibiotics, aspirin or ibuprofen, or substances such as latex. Allergic reactions can manifest in many different ways, however anaphylaxis has a few common signs and symptoms, one of the most common being breathing difficulties. This is because all of the small tubes in the lungs which deliver oxygen swell up, and consequently the person cannot get enough oxygen into their body. If this happens, they will be breathing very quickly but each breath will be very shallow. Anaphylaxis can also cause a drop in the person’s blood pressure which may make them faint or even go unconscious. This is also the body’s response to not receiving enough oxygen. This is because fainting normally makes the person fall to the floor, which in turn makes it easier for blood to get back to the head, and also puts a bit less strain on the heart and lungs. Other signs and symptoms of an allergic reaction include a rapid heartbeat, cold clammy skin, confusion or nausea. It is worth mentioning that the more serious the reaction, the more seriously these signs and symptoms will present. https://d3imrogdy81qei.cloudfront.net/video_images/8453/what-is-anaphylaxis-.jpg Yes 123 https://www.proanaphylaxis.com/training/video/anaphylaxis-signs-symptoms https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4753.mp4 Signs and Symptoms of Anaphylaxis Common allergies children suffer from are to food substances such as peanuts, and even a very small trace of nut can cause someone to have an anaphylactic reaction. This will normally come on very quickly, however sometimes it can take a few hours. If you suspect any anaphylactic reaction, you need to activate the EMS immediately. Signs and symptoms of anaphylaxis include:- General symptoms, such as itchy, watery eyes, a headache, or a runny nose.- Skin problems, such as a swelling of the face, lips, tongue, neck, or hands. Or an itching, hives, rashes, or generally red skin. Breathing problems, such as cough, a difficulty swallowing, rapid breathing, difficulty in breathing, noisy breathing, a change in or loss of voice, a high pitched noise during inhalation, wheezing, or a sharp burning sensation in the chest and throat. Serious breathing problems are a sign that this person may be experiencing a severe allergic reaction. Heart or circulation problems, such as increased heart rate, decreased blood pressure, excessive sweating, or cool and clammy skin. Mental status problems, including confusion, agitation, hallucinations, fainting or a loss of consciousness. https://d3imrogdy81qei.cloudfront.net/video_images/8471/signs-and-symptoms-of-anaphylaxis-.jpg Yes 88 https://www.proanaphylaxis.com/training/video/auto-injector-administration https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4759.mp4 When to Administer an Epinephrine Auto-Injector It can be difficult to know whether an allergic reaction has progressed to the point where it is necessary to use an auto-injector to treat the person. If they have a known history of allergies and allergic reactions and have come into contact with an allergen that has been known to cause this type of reaction in the past, this may be an indicator that an auto-injector is needed. If the person is having difficulty breathing and appears to be in severe respiratory distress, along with any other warning signs of an allergic reaction, such as throat closing, swelling of the tongue or lips and loss of consciousness, you should administer the epinephrine auto-injector immediately. https://d3imrogdy81qei.cloudfront.net/video_images/8483/when-to-administer-an-epinephrine-auto-injector-.jpg Yes 48 https://www.proanaphylaxis.com/training/video/anaphylaxis-recovery-position https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/4760.mp4 Anaphylaxis patient position There are different positions to help a patient to recover from an anaphylactic reaction, depending on their condition. When the patient is using their auto-injector they should either lie flat or be sat down. If the symptoms are affecting breathing, the patient may be more comfortable in either the semi-recumbent position, resting on someone else or on pillows. They will find it easier to breathe in this position. If the patient is feeling cold, dizzy, weak or they are clammy or sweaty, they may have low blood pressure, so you should lay them down with their legs raised up on a chair or something similar, which allows blood to return to the head. It is important to not suddenly stand up after using the auto-injector as a sudden change in body position may lower the blood pressure drastically, which could make the condition much worse. If you are caring for someone, when lying them down, it is a good idea to turn their head to one side to prevent them from breathing in vomit, should they suddenly be sick. If the patient looks like they may vomit, turn them on their side in preparation, and if anyone becomes unconscious, you should always place them in the recovery position. However, if they stop breathing, then you should begin CPR. To put the patient into the recovery position, make sure they are on their back and take the hand nearest to you and place it at 90 degrees from the body with the elbow bent. Lean across them and pull their other hand across their body by the thumb and then interlock your fingers and hold their hand against their face on the side nearest to you. With your other hand grip their leg furthest away from you and lift it so that the foot is flat on the floor. Move your hand on the far side of the knee and pull them towards you using the leg as a lever and keeping their head supported with your other hand. Remove your hand from their hand and open their airway by tilting the head back. Their hand will remain by their face to support it. Then tidy up their leg so it is not reducing circulation, which will also support them better. Check they are breathing, that the airway is open, continuing to closely monitor their breathing and vital signs until the EMS arrives. If one is available you can cover them with a blanket to keep them warm. Remember in all cases of anaphylaxis you must call the EMS, even if the patient is feeling better. https://d3imrogdy81qei.cloudfront.net/video_images/8535/anaphylaxis-patient-position-.jpg Yes 147