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Pane Anaphylaxis Kula, Loaʻa i ka Epinephrine, a me nā Papahana 504 pilikia

He ʻokoʻa nā helu ulia pōpilikia ma ka ʻāina. Hoʻohana kēia ʻaoʻao i ka 911, ka helu no ʻAmelika a me Kanada. Nui nā ʻāina ʻē aʻe i hoʻohana i ka 112, 999, a i ʻole ka helu ʻē aʻe. E huli i ka helu no kou ʻāina.

Ma kahi kokoke i 1 i loko o 13 mau keiki o ke kula (ma kahi o ʻelua mau haumāna i loko o kēlā me kēia lumi papa) e noho ana me kahi maʻi maʻi ʻai, a hiki i ka 25 pākēneka o nā lawelawe epinephrine mua ma ke kula i loaʻa i nā keiki nona ka maʻi maʻi ** i ʻike ʻole ʻia ma mua o ka ʻaina awakea a i ʻole ka papa ʻaina lumi papa. ʻAʻole like me ka maʻi ʻino ma ka ʻāina, ʻo anaphylaxis kahi maʻi maʻi weliweli a me nā ʻōnaehana lehulehu i hoʻoulu ʻia e nā protein meaʻai (peanuts, nati lāʻau, waiu, hua manu, palaoa, soy, iʻa, shellfish, a i ʻole sesame), insect venom (bee a wasp stings), latex a i ʻole nā ​​lāʻau lapaʻau. I loko o nā keiki a me nā ʻōpio, pili nui ka anaphylaxis kula make a kokoke i ka make i ʻelua hewa hiki ke pale ʻia: ** ka hoʻopaneʻe ʻana i ka epinephrine intramuscular** oiai e kali ana e ʻike inā hana nā antihistamine o ka waha, a ** hoʻokuʻu i kahi keiki me ka haʻalulu anaphylactic a hele i ke alaloa i ke keʻena kahu kula** (no ka mea e hoʻoulu ai i ka maʻi maʻi maʻi o ka maʻi maʻi maʻi maʻi maʻi **).

ʻO ka pale ʻana i kahi haumāna i ka wā o ka pilikia maʻi maʻi kula e pono ai ke hoʻokō koke ʻia ma ka lumi papa a i ʻole ka papaʻaina cafeteria i hui pū ʻia me nā palekana kīwila federal i hoʻokō ʻia ma lalo o Pauku 504 o ka Rehabilitation Act a me ka Americans with Disabilities Act (ADA). Ma ka ʻike ʻana i nā hōʻailona anaphylaxis pediatric ("My tongue feels spicy or itchy"), e hoʻokomo i ka epinephrine i loko o ka ʻūhā waena (vastus lateralis) ma ka hōʻailona mua loa o ke komo ʻana o ka ʻōnaehana a ʻelua paha, mālama i ke keiki paʻa ma ke kua (supine) me nā wāwae i hoʻokiʻekiʻe ʻia, e lawelawe i ka ** lua epinephrine dose i 5 mau minuke ** inā mau nā hōʻailona, a me ka hoʻokō ʻana i ke kānāwai ** Student Epinephrine Self-Carry and School Stock Undesignated Epinephrine laws.

E hana i kēia i kēia manawa

  1. E hoʻokomo i ka Epinephrine i loko o ka ʻūhā waena o waho inā manaʻo ʻia he anaphylaxis, a laila e kelepona iā 911 / 112 / 999. Inā hōʻike ke keiki ** i kekahi ** ʻeha ʻeha a i ʻole ka maʻi cardiovascular (pōkole o ka hanu, ʻuwī, ʻuhu hou, stridor, hāʻule a ʻeleʻele a i ʻole nā ʻeha o ke kino, a i ʻole ka ʻāʻī o ke kino a i ʻole ka ʻāʻī o ke kino a i ʻole ka ʻāʻī o ke kino ʻōnaehana** (e like me nā hives a me ka luaʻi ʻana/ka ʻōpū o ka ʻōpū) ma hope o ka ʻike ʻia ʻana o ka maʻi allergen, e hoʻokomo i kahi Epinephrine Auto-Injector (0.3 mg no ka mea >=25 to 30 kg / 55 to 66 lbs, 0.15 mg no ka mea 15 to 25 kg / 33 to 55 lbs, a i ʻole 0.1 mg no ka mea 7.5 to 15 kg / 16.5 to 33 lbs) aiʻole i ʻae ʻia Intranasal Epinephrine (neffy) koke, a e kelepona i ka lua o ka makua i kāu helu pilikia kūloko (911 ma ʻAmelika Hui Pū ʻIa a me Kanada, 112 ma waena o ʻEulopa, 999 ma United Kingdom, a i ʻole e ʻike i nā mea āpau. helu pilikia) e noi ana i kahi kaʻa kaʻa kaʻa Advanced Life Support (ALS).
  2. ** MAI hookiekie i ke keiki ma'i a hele i ke keena kahu kula.** E lawe mai i ka Epinephrine Auto-Injector a me ke kahu kula i ke keiki. E hoʻomoe i ka haumāna paʻa ma ke kua (hoʻomoe) me nā wāwae i hoʻokiʻekiʻe ʻia 30 kenimika (12 ʻīniha) (a i ʻole e hoʻopaʻa ʻia ma ko lākou ʻaoʻao ma ke kūlana hoʻihoʻi inā luaʻi, a i ʻole e noho me nā wāwae i waho inā pilikia ka hanu e hiki ʻole ai ke moe palahalaha); ʻO ke kū pololei ʻana o ke keiki i ka wā anaphylactic vasodilation e hoʻokomo i ke koko ma nā ʻaoʻao haʻahaʻa a hiki ke hoʻopaʻa koke ʻia ka naʻau.
  3. ** Mai hāʻawi i nā lāʻau antihistamine waha (Benadryl / Cetirizine) a i ʻole he mea hānō ma kahi o ka Epinephrine.* Hoʻohana nā antihistamines i 30 a 60 mau minuke e hana a ** hoʻomaha wale i ka ʻili a me nā hives **; hana lākou i ka zero no ka hoʻohuli ʻana i ka pehu ʻana o ke ala ea a i ʻole ka hāʻule ʻana o ke koko anaphylactic. Pēlā nō, ʻaʻole hiki i ka albuterol asthma inhaler ke hoʻōki i ka edema laryngeal o luna; e hoʻokahe mau i ka Epinephrine FIRST (ʻoi loa i nā haumāna me ka hānō a me nā maʻi maʻi ʻai, ka poʻe e lawe ana i ka pilikia kiʻekiʻe loa o ka anaphylaxis make).
  4. E hoʻomākaukau i ka lua o ka Epinephrine Auto-Injector a hoʻopaʻa iā ia ma hope o 5 mau minuke inā ʻaʻole maikaʻi nā hōʻailona. E lawe mau i ** ʻelua ** mau ʻāpana Epinephrine (2-Pack). Inā hoʻomau a ʻoi aʻe ka ʻinoʻino ʻana o ka ʻūhū, ʻāʻī ʻāʻī, lethargy, a i ʻole ka luaʻi ʻana 5 a 15 mau minuke ma hope o ka hoʻokomo mua ʻana, e hoʻohana i ka lua Epinephrine Auto-Injector ma ka ʻūhā waena waena.
  5. E hoʻouna i ke keiki i ke Keʻena ʻOihana Hoʻomaʻamaʻa ma o ke kaʻa kaʻa inā ʻike lākou he 100% ka ola hou ʻana. Ua pau ka epinephrine i loko o 15 a 30 mau minuke, a hiki i ka 15 pakeneka a hiki i ka 20 pakeneka o ka poʻe maʻi e loaʻa i ka ** Biphasic Anaphylaxis**, kahi hawewe lua weliweli o ka hoʻopaʻa ʻana o ke ea a me ka haʻalulu e hoʻihoʻi mai 1 a 12+ mau hola ma hope me ka loaʻa ʻole o ka meaʻai hou. E hāʻawi i ka (mau) auto-injector i hoʻohana ʻia me ka manawa kikoʻī i kākau ʻia ma ka lipine i nā mea lapaʻau.
  6. Inā paʻa ke kula i kāu keiki EpiPen, hoʻokaʻawale iā ia mai kahi huakaʻi kula, a hōʻole paha i ka noho ʻana i ka maʻi maʻi, e kāhea koke i ka Pauku 504. Ma lalo o ke ADA Amendments Act of 2008 a me ka US Department of Justice / Office for Civil Rights (OCR) precedent, he meaʻai weliweli i ke ola a i ʻole ka maʻi ʻawaʻawa he pale kānāwai; Pono nā kula e hāʻawi i kahi Section 504 Plan (a i ʻole UK Statutory Individual Healthcare Plan / Canadian Sabrina Law Plan) e hōʻoiaʻiʻo ana i ka loaʻa ʻana o ka epinephrine i wehe ʻia a hoʻokomo piha ʻia.

No ke aha e make ai ke kū ʻana a i ʻole ka hele ʻana i ke keʻena kahu hānai i ka wā anaphylaxis

I ka wā o ka anaphylaxis koʻikoʻi, kahe ka nui o ka wai mai ke kahawai i loko o nā ʻiʻo a puni i ka wā e hoʻomāhuahua koke ana nā kīʻaha koko, e hoʻemi ana i ka 35 pākēneka o ka nui o ke koko e holo pono ana i loko o 10 mau minuke. Ma nā noiʻi forensic forensic e pili ana i ka anaphylaxis fatal (Pumphrey, Journal of Allergy and Clinical Immunology), nā poʻe maʻi i koi ʻia e noho pololei, kū i luna, a hele paha i 20 mika wale nō (65 kapuaʻi) i ke keʻena kahu kula a i ʻole ke kaʻa kaʻa kaʻa i loaʻa i ka make koke i loko o kekona mai "Empty Ventricle Syndrome, hoʻihoʻi i ke koko mai ka puʻuwai," nā keʻena piha loa. Rule #1 o ka pane anaphylaxis o ke kula: E hoʻokuʻu i ka haumāna ma ke keʻena lumi papa a i ʻole ka noho hale ʻaina kahi i hoʻomaka ai nā hōʻailona, e waiho palahalaha ma ka papahele me ka hāpai ʻana o nā wāwae, a e holo i ka EpiPen I ka haumāna.

ʻO ka hoʻāʻo anaphylaxis kula a me ka lāʻau hoʻoholo hoʻoholo hoʻokō Pauku 504

flowchart TD
    Start["Hōʻike ʻia ka Haumāna i ka meaʻai / ʻaʻai allergen OR Hōʻike i nā hōʻailona maʻi maʻi ma ke kula"] --> AssessSymptoms{"E loiloi koke i nā hōʻailona (ʻAʻole e hoʻoneʻe i ke keiki i ke keʻena kahu hānai):<br/>Loaʻa i ka haumāna kekahi hōʻailona koʻikoʻi (Lung/Puʻuwai/Puʻu)<br/>A i ʻole Nā hōʻailona maʻalahi ma 2+ Pūnaehana Kino (e laʻa, Hives + Vomiting)?"}

    AssessSymptoms -->|"ʻAe: Manaʻo ʻia ka Anaphylaxis"| GiveEpi["1. E HOʻOKE KOE I KA EPINEPHRINE ma ka ʻūhā waena (ma o nā ʻaʻahu) <br/> (a i ʻole e hoʻohana i ka Epinephrine Undesignated School Stock inā ʻaʻohe RX o ke keiki ma ka faila)<br/>2. E hoomoe i ka Haumāna FLAT ma hope me nā wāwae i hoʻokiʻekiʻe ʻia (Ke kūlana hoʻihoʻi inā luaʻi)<br/>3. Kāhea iā 911 / 112 / 999 (Noi ALS Ambulance me Epinephrine)<br/>4. Hoʻomaka 5-Minute Timer & Hoʻomaopopo i nā Mākua"]

    GiveEpi --> FiveMinCheck{"Ma 5 Minute: Ke hoʻomau ʻia nei nā hōʻailona o ka hanu, ka ʻāʻī, a i ʻole ka haʻalulu?"}
    FiveMinCheck -->|"ʻAe"| SecondDose["INJECT SECOND EPINEPHRINE AUTO-INJECTOR ma ke kū'ē i ka ʻūhā waho<br/>E hoʻokomo i ka mea hoʻohāhā Albuterol hou ma hope wale nō o ka Epinephrine inā hāwī<br/>E hoʻomaka i ka CPR inā lilo ka haumāna i pane ʻole a pau ka hanu maʻamau."]
    FiveMinCheck -->|"ʻAʻole (E hoʻomaikaʻi ana nā hōʻailona)"| HospitalTransfer["E hoʻomoe i ka haumāna ma luna o ka Stretcher i ka wā o ka hoʻololi ʻana o EMS i ER<br/>Mandatory 4+ Hour Hour Emergency Observation for Biphasic Reaction"]
    SecondDose --> HospitalTransfer

    AssessSymptoms -->|"ʻAʻole: Hoʻokahi Hōʻailona Māmā wale nō (e laʻa."| HighRiskCheck{"Ua ʻike paha ka haumāna i ka maʻi allergy/asthma koʻikoʻi A me ka ʻai ʻana?"}
    HighRiskCheck -->|"ʻAe (Ua ʻike ʻia ka mea make allergen)"| GiveEpi
    HighRiskCheck -->|"ʻAʻole"| ObserveClosely["Noho ka Haumāna me nā mākua i aʻo ʻia a me ka EpiPen ma ka lima<br/>E hāʻawi i ka antihistamine waha WALE inā i kuhikuhi ʻia ma ka Plan FARE no ka ʻōnaehana māmā hoʻokahi<br/>E nānā mau no 60 mau minuke; inā ʻike ʻia ka ʻōnaehana 2 -> INJECT EPINEPHRINE"]

Māhele 1: Pehea e wehewehe ai nā keiki i ka anaphylaxis a me ka 2-System Clinical Diagnostic Rule

ʻAʻole hiki i nā keiki liʻiliʻi ke ʻōlelo, *"Ua loaʻa iaʻu ka edema laryngeal a me ka systemic hypotension." * Akā, ʻo ke keiki 6 makahiki ma ka papaʻaina cafeteria e huki i ko lākou kola, e ʻoni i ko lākou mau pepeiao, e kuha i ka meaʻai ma ko lākou ʻāwī, a i ʻole e hoʻohana i nā huaʻōlelo hoʻomohala e pono e aʻo ʻia kēlā me kēia kumu, ka mea nānā hale ʻai, a me ke kaʻa kaʻa e ʻike koke.

Pehea ka wehewehe ʻana o nā keiki liʻiliʻi i ka anaphylaxis mua

  • "He wela ko'u alelo, wela, a he mea la'a paha." (When eating non-spicy food)
  • "Ma'i ko'u waha a me he lauoho a he rana paha ma ko'u pu'u."
  • "Ua nui a kaumaha paha ko'u alelo i ko'u waha."
  • "Ke u'i nei kekahi mea i ko'u pu'u a eha paha ke ale."
  • " ʻO koʻu mau pepeiao a i ʻole koʻu mau poho lima, ʻaʻohe maoli."
  • "Pihoihoi au, hiamoe, a i ʻole e hiki mai ana kekahi mea weliweli." (Sense of impending doom cause by sudden blood pressure drop)

Nā pae hoʻohālikelike: I ka manawa e hoʻokomo koke ai i ka Epinephrine (NiaID / FARE / WAO Guidelines)

Ma lalo o ka Food Allergy Research & Education (FARE) Emergency Care Plan a me National Institute of Allergy and Infectious Diseases (NIAID) maʻi maʻi, ** hoʻokomo koke i ka Epinephrine** inā loaʻa ʻo ** EITHER Trigger A OR Trigger B** i loko o nā minuke a ʻelua mau hola o ka ʻike ʻia a i ʻole ka manaʻo ʻia he allergen:

Hoʻomaka ʻo diagnostic ʻIke ʻia nā hōʻailona ma ka Haumāna ʻO ka hana lapaʻau koke
Hoʻomaka A: Kekahi hōʻailona koʻikoʻi hoʻokahi i loko o nā akemāmā, naʻau, a i ʻole ka puʻu/waha. - Lāmā: Pōkole o ka hanu, ʻūhū, ** ʻū maloʻo hou ** (ke kuhi pinepine ʻia he hōʻeha hānō), paʻa ka umauma.
- Puʻuwai / Vascular: Haʻihaʻi, ʻili ʻulaʻula/hinahina, maule, nāwaliwali/ʻulaʻula puʻupuʻu, dizziness, floppiness hikiwawe i loko o kahi keiki ʻōpio.
- Puʻu / Waha: ʻOʻiʻo a haʻahaʻa paha ma ka ʻāʻī, pilikia ke ale ʻana, stridor (leo hoʻoulu ʻana kiʻekiʻe), pehu nui o ke alelo a i ʻole nā ​​lehelehe.		 1. E hookomo koke i ka EPINEPHRINE.
2. E moe palahalaha (hoʻokiʻekiʻe ʻia nā wāwae).
3. Kāhea iā 911 / 112 / 999.
**Hoʻomaka B: ʻO kēlā me kēia hui ʻana o nā hōʻailona haʻahaʻa a haʻahaʻa ma waena o ʻelua ʻōnaehana kino a ʻoi aʻe ** No ka laʻana, ʻo Skin + Gut e hana pū ana:
- Ka ʻili: ʻAha, ʻulaʻula nui/ʻulaʻula, ʻili lima/pepeiao, pehu maʻemaʻe o ka maka.
- Gut (GI): Ka luaʻi ʻana, ka ʻōpū nui o ka ʻōpū, ka maʻi maʻi hikiwawe.
- Nā ihu/Nā: Ka ihu puʻupuʻu puʻupuʻu, ʻāhuehue, ʻulaʻula nā maka wai.		 1. E hookomo koke i ka EPINEPHRINE.
(Hoʻolaha: ʻOiai inā ʻaʻohe pilikia o ke keiki i ka hanu ʻana, loaʻa iā Hives + Vomiting like ʻelua ʻōnaehana kino = Anaphylaxis = Inject Epinephrine i kēia manawa).
**Trigger C: Moʻolelo Iʻike ʻia no ka Anaphylaxis Koʻikoʻi + Hoʻopaʻa ʻia i ka ʻai ʻana i ka Allergen ** He nui nā mea maʻi maʻi e nānā i ka pahu ma ka haumāna FARE Action Plan e ʻōlelo ana: "Inā ʻai maoli ke keiki i [Peanut/Tree Nut/Dairy], hoʻokomo koke i ka Epinephrine ma mua o ka hoʻomaka ʻana o nā hōʻailona." E hahai i ke kauoha a ke kauka ma ka FARE Plan a hoʻokomo koke.

ʻAʻohe hōʻaiʻē lāʻau i ka hāʻawi ʻana i ka Epinephrine i kahi pilikia maʻi i manaʻo ʻia

Ke kānalua nei nā kumu a me nā mākua i ka hoʻohana ʻana i ka EpiPen no ka mea hopohopo lākou: "Pehea inā he hōʻeha weliweli a i ʻole ka hopena mālie, e hōʻeha anei ka Epinephrine i ke keiki?" I loko o kahi keiki olakino a ʻōpio paha, ʻo ka nui o ka epinephrine i loko o ke kaumaha ke kumu o ka haʻalulu manawa, ka puʻuwai wikiwiki (e like me ka holo ʻana i ka sprint), a me ka ʻili haʻihaʻi no 20 mau minuke, akā ʻo ka ** ʻauʻa a hoʻopaneʻe paha i ka epinephrine i 15 mau minuke i ka wā anaphylaxis maoli hiki ke hopena i ka hōʻeha lolo a i ʻole ka make*.

Māhele 2: Hoʻoponopono i kēlā me kēia ʻanuʻu no nā mea hana Epinephrine kula 4 āpau

Loaʻa i nā keʻena olakino kula hou a me nā ʻeke ʻeke haumāna ʻehā ʻano nui o nā mea epinephrine a FDA/EMA/Health Canada. E mālama i nā mea hana epinephrine a pau ma ka lumi wela ma waena o 20 a me 25 degere Celsius (68 a me 77 degere Fahrenheit), mai hoʻokuʻu a waiho ʻole paha i loko o ke kaʻa wela a i ʻole kaʻa, a e nānā i ka puka aniani i kēlā me kēia mahina e hōʻoia i ka mālamalama a me ka waihoʻoluʻu o ka wai. No ka mea ʻokoʻa ka hana ʻana o kēlā me kēia mea hana i ka wā pilikia, e nānā i ka mīkini pololei ma lalo nei:

Hoʻohālikelike o nā Epinephrine Auto-Injectors a me Nasal Spray (EpiPen, Auvi-Q, Generic, neffy)

Ka inoa o ka hāmeʻa a me nā pae hoʻohana ʻAno hoʻoponopono ʻAiʻAi ʻAi ʻAi Paʻa i ka manawa ma ka ʻūhā a me ka palekana ma hope o ka hoʻopaʻa ʻana
1. EpiPen / EpiPen Jr (a me Mylan/Teva Generics)
- ** Melemele (0.3 mg)**: >= 30 kg (66 lbs)
- Omaomao (0.15 mg): 15 to 30 kg (33 to 66 lbs)		 1. E hoʻoheheʻe i ka pāpale o ka pahu lawe melemele/'ōmaʻomaʻo a hoʻoneʻe i ka injector auto-i waho.
2. E paʻa i ka pahu ma ka lima me ka ʻālani e kuhikuhi ana i lalo ("Puliuli i ka lani, ʻAlani i ka ʻūhā," ʻaʻole e kau i ka manamana lima ma kēlā me kēia kihi).
3. Huki i ka Hoʻokuʻu palekana BLUE pololei i luna.
4. E koli a pahu i ka ** ʻĀlani ʻAlani** i loko o waena waena o ka ʻūhā waho (vastus lateralis) ma kahi kihi 90-degere (ma o nā jeans/ʻaʻahu maikaʻi, e pale ana i nā humuhumu/ʻeke) a hiki i ka ** kaomi **.		 Paʻa paʻa i ka ʻūhā waho no 3 kekona piha (1-1000, 2-1000, 3-1000).
(Hoʻonui ʻakomi ʻia ka uhi nila ʻalani e uhi i ka nila ke wehe ʻia).
2. Auvi-Q / Allerject (Mea ʻAi ʻAi ʻAi Leo)
- 0.3 mg: >= 30 kg (66 lbs)
- 0.15 mg: 15 to 30 kg (33 to 66 lbs)
- 0.1 mg: 7.5 to 15 kg (16.5 to 33 lbs)		 1. Huki iā Auvi-Q mai loko mai o kāna ** pahu ʻāpana ʻāpana ʻē aʻe** (e hoʻāla ʻia kēia ** ʻōlelo aʻoaʻo leo ** e kamaʻilio iā ʻoe ma kēlā me kēia pae).
2. Huki pono i ka Kāi palekana RED i lalo a hemo.
3. E kau i ka ** kumu BLACK** ma ka waena o ka uha waho ma kahi kihi 90-degere, a laila e kaomi ikaika a lohe 'oe i ka ** kaomi a me ka hīnaʻi**.		 Paʻa paʻa ma kahi no 2 kekona piha (2-second countdown beep).
Hoʻihoʻi hou ʻo Needle i loko o ke kumu ʻeleʻele ma hope o 2 kekona no laila ʻaʻole ʻoe e ʻike i kahi nila i ʻike ʻia.
3. Adrenaclick / Impax / Lineage Generic Epinephrine
*		 1. Wehe i ka mea hana mai ka pahu lawe pale.
2. Huki i ka Pūpoko #1 (Gray) mai kekahi ʻaoʻao, a laila huki iā Cap #2 (Red/Gray) mai kekahi ʻaoʻao.
3. E kau i ka ** RED tip** ma ka ʻūhā waena o waho a kaomi ikaika i lalo a komo ka nila i loko o ka ʻiʻo (ʻaʻole pono ke kowali).		 E hoʻopaʻa paʻa i ka ʻūhā waho no 10 kekona piha, a laila wehe pono (e waiho ʻia ka nila e ʻike ʻia; e hoʻihoʻi i loko o ka paipu).
4. neffy (Epinephrine Nasal Spray, Needle-Free)
- 2 mg: >= 30 kg (66 lbs)
- 1 mg: 15 to <30 kg (33 to <66 lbs) (makahiki 4+)		 1. E wehe i ka pūʻolo pohū a wehe i ka mea hoʻoheheʻe ihu.
2. Mai hoʻomāhuahua a hoʻāʻo paha i ka pulupulu i ka lewa (loaʻa i hoʻokahi kumu hoʻokahi).
3. E hoʻokomo pololei i ka nozzle i loko o KEKAHI puka ihu a pā kou manamana lima i ka lalo o ka ihu keiki.
4. E kaomi pa'a i ka plunger a hiki i luna e pulu.		 Inā ʻaʻole maikaʻi a ʻoi aʻe paha nā hōʻailona ma hope o 5 mau minuke, e hāʻawi i kahi ** lua hou neffy mea i loko o ka puka ihu SAME**.

Meka no ka hoʻopaʻa ʻana i kahi keiki e hakakā nei: I ka wā e hoʻokomo ʻia ai ka ʻūhā i loko o ka ʻūhā i ke keiki ʻōpio makaʻu, e ʻapo mālie ke kanaka makua lua i ka ʻōpū o ke keiki a hoʻopaʻa paʻa i ke kuli/wāwae lalo i ka papahele i ʻole e hū ke keiki i kona wāwae i ka wā o ka pukaaniani hoʻoheheʻe 2-a-3-kekona (hiki ke hemo i ka ʻūhā mua a i ʻole ka ʻūhā).

Māhele 3: Nā Kānāwai Epinephrine Haumāna a me ka waihona kula ("ʻAʻole i koho ʻia") Epinephrine

I ka wā ma mua, pono ke kula kahiko "Zero-Tolerance Drug Policies" i kēlā me kēia lāʻau lapaʻau, me nā EpiPens hoʻopakele ola a me nā mea hānō, e laka ʻia i loko o kahi keʻena o ke keʻena kahu kula. I ka wā i hele ai ke kahu kula i ka ʻaina awakea, uhi i kekahi hale ʻē aʻe, a i ʻole haʻalele i ka hola 15:00 ma mua o ka hoʻomaʻamaʻa haʻuki ma hope o ke kula, make nā keiki ma waho o nā puka hale lapaʻau paʻa.

1. ʻO kāu keiki ke kuleana kūʻokoʻa no ka lawe ʻana iā ia iho (nā 50 ʻAmelika Hui Pū ʻIa, Kanada, UK)

  • Nā Kānāwai Universal Self-Carry & Administration Self-Administration: ʻO 50 United States (me Washington, D.C.), nā panalāʻau Kanada (ma lalo o Sabrina's Law ma Ontario a me nā kuhikuhi panalāʻau like), a ua kau ʻo United Kingdom i nā kānāwai e hōʻoiaʻiʻo ana i kēlā me kēia haumāna me ke kauka hōʻoia ʻia i ka pilikia o ka anaphylaxis a me ka Injeadmine-autoʻona ponoʻī i ke kānāwai. hānō hoʻopakele inhaler) ma ko lākou kino** i nā manawa a pau i loko o nā lumi papa, hale ʻaina, papa haʻuki, nā kaʻa kaʻa kula, a me nā huakaʻi kula.
  • ** Ka mea e koi ai ke kula (a ʻaʻole hiki ke koi)**:
  • Pono paha ke kula: (1) palapala ʻae i kākau ʻia e ke kauka keiki e hōʻoia ana ua aʻo ʻia ka haumāna i ke ʻano o ka hoʻohana ʻana i ka hāmeʻa, a (2) i kahi palapala ʻae makua i pūlima ʻia (a me ka backup auto-injector i mālama ʻia ma ke keʻena olakino).
  • ʻAʻole hiki i ke kula ** ke koi aku i kahi haumāna kula waena a kula kiʻekiʻe paha (a i ʻole he haumāna kula haʻahaʻa makua i ʻae ʻia e ko lākou allergist) e waiho i kā lākou EpiPen i paʻa i loko o ke keʻena, ʻaʻole hiki i ke kumu ke hopu i ke kāʻei pūhaka kauka haumāna (SPIbelt) a i ʻole ʻeke allergy i ka wā o ka hoʻokolohua a i ʻole ka papa haʻuki.

2. Kula "Stock / Undesignated" Epinephrine Laws (Federal School Access to Emergency Epinephrine Act)

He aha ka hopena inā ʻai kahi keiki papa 1 i ** ʻaʻole i loaʻa i ka maʻi maʻi ʻai** i ka cashew a i ʻole ʻia e ka ʻaʻahu melemele ma ke kahua pāʻani a hele i ka haʻalulu anaphylactic me ka ʻole o ka EpiPen pilikino ma ka faila? - Ma lalo o ka School Access to Emergency Epinephrine Act (a me nā kānāwai mokuʻāina ma nā mokuʻāina he 50 a pau, Section 238A of the UK Human Medicines Amendment Regulations 2017, and Canadian provincial statutes), ua ʻae ʻia nā kula (a ma nā mokuʻāina he nui ** kauoha ) e hoʻopaʻa i ** Undesignated / "Spare Auto-Injectors Protocol" - Hāʻawi kēia mau kānāwai i ** ka palekana kīwila maikaʻi no Samaria i kekahi kahu kula, kumu, kumu aʻo, a i ʻole kekahi limahana e lawelawe ana i kahi lāʻau Epinephrine Auto-Injector me ka hilinaʻi maikaʻi i kekahi haumāna a i ʻole malihini kipa i manaʻo ʻia e loaʻa ana i ka anaphylaxis.

Māhele 4: Ke kūkulu ʻana i kahi hoʻolālā Ironclad Section 504 no nā meaʻai koʻikoʻi a i ʻole nā ​​​​allergies Venom

He nui nā kula e hāʻawi i nā mākua o nā keiki maʻi i kahi palapala lapaʻau 1 ʻaoʻao i kapa ʻia ʻo Individualized Healthcare Plan (IHP) a i ʻole Emergency Action Plan (EAP) i kākau wale ʻia e ke kahu kula, me ka haʻi ʻana aku i ka makua: *"Loaʻa i kāu keiki nā A pololei ma kā lākou kāleka hōʻike, no laila ʻaʻole lākou i kūpono i ka Plan Section 504 ma ke kānāwai."

E hōʻole koke i kēlā hōʻole ma ke kākau ʻana. ʻOiai ʻo ka IHP/EAP he pepa aʻo koʻikoʻi koʻikoʻi, ʻo ka IHP wale nō ka palapala kahu hānai kūloko me ka ʻaʻohe niho hoʻokō pono kīwila federal. A Pauku 504 (ma lalo o Section 504 o ke Kanawai Hoʻoponopono o 1973, 29 U.S.C. 794, a me Title II / III o ka Americans with Disabilities Act) he aelike pono kīwila federala i hoʻokō ʻia e ke Keʻena Hoʻonaʻauao o ʻAmelika Keʻena no nā Pono Kivila.

No ke aha e hiki ai i kāu keiki ke hoʻolālā i ka Māhele 504 inā ʻo ko lākou Allergy "Ke kala ʻia" i ka wā e pale ai i ka meaʻai

Ma lalo o ke ** ADA Amendments Act of 2008 (ADAAA, 42 U.S.C. 12102(4)(D)): 1. ** Rula "Episodic Conditions": ʻO kahi pōʻino i episodic a i ʻole i ke kala ʻia (e like me ka maʻi ʻai koʻikoʻi, asthma, epilepsy, a i ʻole ka maʻi diabetes) ma ke kānāwai he kīnā ma lalo o ka Paukū 504 a me ka ADA inā e ** kaohi nui ʻana i kahi hana ola nui (e like me ka hanu ʻana, ka ʻai ʻana, a i ʻole ka ʻōnaehana hoʻoikaika kino) ** 2. ** Rula "ʻAʻole Nā Hana Hoʻohaʻahaʻa": Pono nā kula e loiloi inā ua kaupalena ka maʻi maʻi i ka hanu/ʻai ʻana ** me ka noʻonoʻo ʻole i nā hopena maikaʻi o nā hana hoʻohaʻahaʻa (e like me ka pale ʻana i ka allergen a i ʻole ka lawe ʻana i kahi EpiPen). 3. ** ʻAʻole pili nā māka**: ʻAʻole ** kau palena ʻia ka ʻae ʻia ʻana o ka pauku 504 i nā kino kīnā a i ʻole nā ​​māka haʻahaʻa; ʻO kahi haumāna me ka pīnī weliweli, ka waiu, a i ʻole ka maʻi maʻi piʻi ʻana he kuleana kūʻokoʻa ko ke aupuni pekelala i kahi papahana ʻo Pauku 504.

Pono e hoʻokomo i loko o kāu keiki Food Allergy Section 504 Plan

  • 1. Unlocked Epinephrine Access & Proximity Rule: Pono e mālama ʻia nā Epinephrine Auto-Injectors (2-pack) ma kahi keʻena pilikia wehe ʻia ma ke keʻena olakino A e lawe ʻia e ka haumāna (a i ʻole e ke kumu lumi papa i loko o ka ʻeke hip no Pre-K a i ka Papa 3) i hiki i ka Epinephrine ke komo i ka haumāna i loko o 60 a 90 kekona, ma nā wahi āpau o ka pā kula.
  • 2. ʻAʻole Walk Emergency Protocol: Manaʻo maopopo inā hōʻike ka haumāna i nā hōʻailona maʻi a i ʻole hōʻike i ka manaʻo e ʻai ʻia, ʻaʻole e hoʻouna ʻia ka haumāna ** e hele wāwae i ke keʻena kahu hānai**; Pono nā limahana e kāhea i "Code Medical" e lawe pololei i ke kahu a me ka Epinephrine i ka haumāna.
  • 3. ʻAi ʻAi ʻAi ʻAʻole-Paʻa i ka hale ʻaina a me ka lumi papa:
  • Ka hoʻolako ʻana i kahi Pakaukau Palekana-Allergen (hoʻomaʻemaʻe ʻia ma mua o ka ʻaina awakea me kahi lole hou i hoʻolaʻa ʻia a me ka mea holoi holoi a ʻae ʻia e EPA; e hoʻomanaʻo ʻaʻole ʻo ** ʻaʻole hoʻomaʻemaʻe lima lima ʻaʻole e wehe i nā protein allergen meaʻai **, a ʻo ** kopa a me ka wai kahe ** a i ʻole nā ​​holoi pāʻoihana e wehe i nā protein mai nā lima a me nā papa ʻaina), me ka ʻike pono ʻaʻole e hoʻopaʻa ʻia ka haumāna ma kahi kihi o ka ʻaina awakea. e noho pu me lakou.
  • Koʻikoʻi ** ʻAʻohe Meaʻai Kumu Kumu Rula**: Ka pāpā ʻana i ka hoʻohana ʻana i nā mea ʻaleʻale keiki i loko o nā helu helu makemakika lumi papa, nā hoʻokolohua ʻepekema, nā pahu hoʻomaʻamaʻa (e like me ka hua manu i loko o ka pīkī, ka pāpaʻi maloʻo/palaoa pāʻani palaoa, a i ʻole nā ​​pahu huamoa), a i ʻole nā ​​​​mea kūʻai bake ʻaʻole i ʻae ʻia.
  • Kaʻina holoi lima: Holoi lima nā haumāna a pau i loko o ka lumi papa haʻahaʻa me ka kopa a me ka wai (a i ʻole ka holoi ʻana i ka wai, ʻaʻole ka waiʻona gel) i ke komo ʻana i ka lumi papa ma hope o ka ʻaina awakea/papaʻaina.
  • 4. Hoʻolaha i ke kumu pani a me ke kaʻa kaʻa: ʻO ka pepa makaʻala ʻulaʻula "Sub Folder" i hāʻawi ʻia i kēlā me kēia kumu pani i ke komo ʻana i ke kakahiaka, a hoʻomaʻamaʻa ʻia i nā protocol kamaʻilio pilikia ma ke kaʻa kula. ulia kaʻa kaʻa kula, pilikia huakaʻi kula, a hui hou ʻia nā mākua-keiki).
  • 5. Hoʻokomo ʻia ka huakaʻi kula holoʻokoʻa (Zero Mandatory Parent Chaperone Conditioning):
  • ** Rula Federal Koʻikoʻi**: Ma lalo o nā ʻōlelo hoʻoholo o ke Keʻena ʻOihana Hoʻonaʻauao o ʻAmelika Hui Pū ʻIa, ʻaʻole hiki i kahi kula aupuni ** ke haʻi i kahi makua: "Hiki i kāu keiki maʻi a i ʻole ka maʻi diabetes ke hele i ka huakaʻi papa inā hoʻomaha ʻoe i kahi lā e hele mai e alakaʻi iā lākou iho."
  • ʻOiai e hoʻokipa mau ʻia nā mākua e hāʻawi manawaleʻa ma ke ʻano he chaperones, ua koi ʻia ka apana kula ma lalo o ka Pauku 504 e hāʻawi i kahi ** limahana i aʻo ʻia a kahu hānai paha ** e lawe a lawelawe i ka haumāna Epinephrine ma kēlā me kēia huakaʻi kula i kākoʻo ʻia e ke kula, me ka nānā ʻole inā hele ka makua.
  • 6. Palekana Anti-Bullying: Kūkākūkā ʻokoʻa e mālama ana i ka hoʻoluliluli ʻana o kahi mea allergen i ka maka o ka haumāna, e hoʻoweliweli ana e hamo i ka pata pīnī ma luna o ko lākou pākaukau, a i ʻole e hoʻomāʻewaʻewa ana i ko lākou maʻi maʻi ma ke ʻano he hewa nui ** Disability Harassment / Title II / Section 504 violation** (e nānā hoʻoweliweli haumāna, hazing, a cyberbullying).

Māhele 5: Hale ʻaina a me nā pono allergy dormitory (DOJ Lesley University Precedent)

ʻAʻole pau nā kuleana allergy meaʻai ma ka puka kula kiʻekiʻe. Ke komo ka haumāna me ka maʻi ʻai nui a i ʻole maʻi celiac i ke kulanui a i ʻole ke kulanui e koi ana i nā keiki hou e noho i loko o nā hale moe a kūʻai i kahi hoʻolālā pāʻina $3,000-per-semester:

  • Ke Keʻena ʻOihana Hoʻokolokolo o ʻAmelika Hui Pū ʻIa Lesley University Landmark Settlement: Ua hoʻokumu ʻia ka US Department of Justice Civil Rights Division ma lalo o ka Americans with Disabilities Act (ADA) ʻo ia ka pale ʻana i nā maʻi ʻaʻai koʻikoʻi a me ka maʻi celiac i ke kino kīnā ma ke kula kiʻekiʻe.
  • Inā koi ke kulanui i ka uku hoʻolālā ʻai pono, pono ke kulanui e: (A) hāʻawi i nā meaʻai palekana, cross-contact-controlled allergen-free meaʻai (e like me ka hale hoʻolaʻa ʻole allergen-free, nā meaʻai kīhini i kauoha mua ʻia, a me ka lepili ʻana o nā mea hoʻohui), (B) hāʻawi i ka haumāna i kahi lumi moe pilikino/suite i lako me kahi lumi kuke palekana / pahu hau hoʻokuʻu ʻia/waiver mai ka papaʻai ʻai pā kula ponoʻī**.
  • Pono e hoʻolaha ʻia nā Kākoʻo Noho Kūleʻa (RA) a me nā mākaʻi Campus ma o ka Campus Disability Services Office kahi i mālama ʻia ai ka Epinephrine i loko o ka lumi hoʻomaha haumāna.

Ma muli o ka hiki ʻana o nā maʻi maʻi koʻikoʻi i ka hoʻopaʻa ʻana i ka hanu i loko o nā minuke, koi ikaika mākou i nā mākua a pau, nā kumu, nā kumu aʻoaʻo, a me nā kahu hānai e hoʻopiha i kahi papa hoʻomaʻamaʻa lima lima, CPR, a me Anaphylaxis / Epinephrine Auto-Injector ma o ke Keʻa ʻulaʻula, St John Ambulance, a i ʻole kahi mea lawelawe kūloko i hōʻoia ʻia.

Nīnau pinepine

My child school says they will give my child liquid Benadryl first if they accidentally eat a peanut at lunch, and then "watch them for 20 minutes" before using the EpiPen. Is that safe?

No, that "wait-and-see with Benadryl" approach is dangerous and directly contradicts current clinical guidelines from the American Academy of Pediatrics (AAP), NIAID, and Food Allergy Research & Education (FARE). Oral antihistamines like diphenhydramine (Benadryl) or cetirizine (Zyrtec) take 30 to 60 minutes to reach peak effect and ONLY treat mild skin hives and itching; they cannot stop fatal airway swelling or anaphylactic blood pressure collapse. Worse, waiting 20 minutes to see if Benadryl works masks early skin symptoms while life-threatening internal respiratory or cardiovascular shock progresses silently. Epinephrine is the ONLY first-line medication for anaphylaxis and must be injected immediately.

Does hand sanitizer (like Purell) remove peanut butter, milk, or egg allergens from a child hands or a classroom desk?

No. Clinical studies published in the Journal of Allergy and Clinical Immunology prove that alcohol-based hand sanitizer gels disinfect bacteria and viruses, but do NOT break down or remove food allergen proteins, as they simply smear intact peanut or dairy protein around on the skin. To actually remove food proteins from hands after eating, students must wash their hands with **soap and running water** (or use a commercial wet wipe with physical friction). Classroom and cafeteria tables must be cleaned with soap/detergent and water or commercial cleaner using a clean disposable towel to prevent cross-contact.

The school principal told me that my 3rd-grader with a severe tree nut allergy cannot go on the class zoo field trip unless I take off work and go with them to hold the EpiPen. Is that legal?

No. Under Section 504 of the Rehabilitation Act and the Americans with Disabilities Act (ADA), public schools (and private schools receiving federal funds or covered by ADA Title III) are strictly prohibited from conditioning a disabled student participation in a school field trip on their parent serving as an unpaid medical chaperone. While a parent may *choose* to attend voluntarily, the school is legally required to send a school nurse or a trained, delegated staff member who carries the child Epinephrine Auto-Injector and is trained to administer it throughout the trip.

If we use an EpiPen on a student at school and their breathing and hives completely clear up within 5 minutes, do we still have to call 911 and send them to the hospital in an ambulance?

Yes, 100 percent of the time. Calling 911 and transporting the student to the Emergency Department by ambulance is mandatory after every school epinephrine administration for two reasons: First, the first dose of epinephrine may not be enough, and paramedics carry advanced airway equipment, oxygen, IV fluids, and additional epinephrine. Second, epinephrine metabolizes out of the body in 15 to 30 minutes, and up to 20 percent of patients suffer a "Biphasic Reaction," a sudden, severe return of anaphylaxis 1 to 12 hours later without any new exposure to the allergen. Hospital observation (typically 4+ hours) is required to make sure the reaction does not rebound.

Nā alakaʻi pili

Nānā ʻia nā kumu

  • Nā Center for the Disease Control and Prevention (CDC) a me ke Keʻena Hoʻonaʻauao o ʻAmelika Hui Pū ʻIa (ʻAmelika Hui Pū ʻIa): *Nā Kūlana Kūʻokoʻa no ka Hoʻoponopono ʻana i nā Allergies Meaʻai ma nā Kula a me nā Papahana Hoʻonaʻauao Hoʻonaʻauao.
  • National Institute of Allergy and Infectious Diseases (NIAID) / World Allergy Organization (WAO) / American Academy of Pediatrics (AAP): Nā Papa kuhikuhi no ka ʻike ʻana a me ka mālama ʻana i nā hoʻolālā hana hoʻopilikia ʻana i ka maʻi ʻai a me ka Anaphylaxis (Intramuscular Epinephrine First-Line Dosing, Supine Positioning, a me Biphasic Monitoring).
  • ʻImi a me ka hoʻonaʻauao ʻana i nā meaʻai allergy (FARE) (ʻAmelika Hui Pū ʻIa): *Hoʻolālā Hoʻolālā Hoʻomaʻamaʻa ʻAi ʻAi & Anaphylaxis a me ke komo ʻana i ke kula i nā Kūlana Kūlana Epinephrine.
  • Keʻena ʻOihana Hoʻonaʻauao no nā Kuleana Kivila (OCR) a me ke Keʻena ʻOihana Pono Civil Rights Division (United States): Pauku 504 o ke Kanawai Hoʻoponopono (34 CFR Part 104), ADA Hoʻololi i ke kānāwai o 2008 (Episodic Conditions Coverage), Field Trip Inclusion Rulings, a me United States v. Lesley University Settlement Agreement.
  • Keʻena no ka Hoʻonaʻauao (DfE) a me nā lāʻau lapaʻau a me nā huahana mālama ola Regulatory Agency (MHRA) (United Kingdom): Kōkoʻo ʻana i nā haumāna ma ke kula me nā Kūlana Lapaʻau Ke alakaʻi a me ke alakaʻi ʻana i ka hoʻohana ʻana i nā Adrenaline Auto-Injectors (AAIs) i nā kula.
  • Food Allergy Canada and Provincial Ministries of Education (Kanada): Sabrina's Law (Anaphylactic Pupils Protection Act, Ontario) and Anaphylaxis in Schools & Other Settings Consensus Guidelines.