A'oga Anaphylaxis Tali, Epinephrine Avanoa, ma Faalavelave Tutupu Faafuasei 504 Fuafuaga¶
E eseese numera o fa'alavelave fa'afuase'i ile atunu'u. O lenei itulau e fa'aaoga ai le 911, le numera mo le Iunaite Setete ma Kanata. O le tele o isi atunuu e faʻaaoga le 112, 999, poʻo se isi numera. Su'e le numera mo lou atunuu.
Toeitiiti atoa le 1 i le 13 tamaiti a'oga (e tusa ma le to'alua tamaiti a'oga i potua'oga uma) o lo'o nonofo i se fa'ama'i fa'ama'i e maua i mea'ai allergy, ma e o'o atu i le 25 pasene o fa'atonuga uma o le epinephrine mo le taimi muamua i le a'oga e tupu i tamaiti o latou allergy sa le'i iloa muamua a'o le'i faia lena mea'ai a le a'oga po'o se meaai mama i le potuaoga. E le pei o se mageso, o le anaphylaxis o se ma'i saosaoa, e tele faiga e lamatia ai le ola e mafua mai i polotini mea'ai ( pinati, fatu laau, susu, fuamoa, saito, soya, i'a, figota, po o sesame), iniseti oona (pi po'o tui), latex, po'o vaila'au. I tamaiti ma tupulaga talavou, o le anaphylaxis o le a'oga e oti pe latalata i le oti e matua tele lava le feso'ota'i atu i ni mea sese se lua e mafai ona puipuia: faatuai o le epinephrine intramuscular a'o faatali se'i vaai pe aoga antihistamines o le gutu, ma faia se tamaititi e maua i le anaphylactic te'i e tu i luga ma savali i lalo o le alatele i le ofisa tausima'i a'oga (lea e mafua ai le ma'i faafuase'i o le ma'i o le fatu****(e fa'atupu ai le ma'i fa'afuase'i o le ma'i o le fatu**o le ma'i fatu).
O le puipuia o se tamaititi a'oga i le taimi o se fa'alavelave fa'aleaga a'oga e mana'omia ai le fa'atinoina vave o le falema'i i le potu a'oga po'o le laulau fale'aiga tu'ufa'atasia fa'atasi ai ma puipuiga malu a le feterale i lalo o le Vaega 504 o le Tulafono Toe Fa'aleleia ma le Americans with Disabilities Act (ADA). E ala i le iloaina o fa'ailoga fa'apitoa mo tamaiti anaphylaxis ("My tongue feels spicy or itchy"), tui ** epinephrine i totonu o le ogavae pito i fafo (vastus lateralis) i le fa'ailoga muamua lava o le a'afia o le tino po'o le lua o totoga**, fa'anofo pea le tamaititi i luga o latou tua (fa'apa'o) ma si'i vae**, tu'uina le fa'a'ai lona lua o le epinephrine i le 5 minute pe a fai e tumau pea fa'ailoga, ma fa'amalosia le tulafono Student Epinephrine Self-Carry and School Stock Undesignated Epinephrine laws i so'o se a'oga ma tulafono a'oa'oga a'oga.
Fai nei loa¶
- Tu'i le Epinephrine i le ogatotonu o le ogavae i fafo i le VAVAVE pe afai e masalomia le anaphylaxis, ona valaau lea i le 911 / 112 / 999. Afai ua iloa e se tamaititi so'o se fa'ailoga ogaoga o le manava po'o le fatu (pu'u le mānava, uigi, tale faifaipea, ta'a'i, pa'u'ese/fa'a'ese'e o le tino, po'o fa'ailoiloga o le laulaufaiva po'o le tele o le gutu o le tino. faiga** (pei o suluga'i fa'atasi ai ma pua'i/mana'o) pe a mae'a se fa'ama'i, tui se Epinephrine Auto-Injector (
0.3 mgmo>=25 to 30 kg / 55 to 66 lbs,0.15 mgmo15 to 25 kg / 33 to 55 lbs, pe0.1 mgmo7.5 to 15 kg / 16.5 to 33 lbs) pe faamaonia Intranasal Epinephrine (neffy) i le taimi lava lena, ma fai atu i se tagata matua lona lua e vili lau numera o faalavelave faafuasei (911 i le Iunaite Setete ma Kanata, 112 i le isi itu o le Iuni a Europa, 999 i Peretania, pe vaai uma numera fa'afuase'i) e talosagaina se ta'avale a le Advanced Life Support (ALS). - Aua ne'i faia se tamaititi e ma'i i luga pe savali i le ofisa tausima'i a'oga. Aumai le Epinephrine Auto-Injector ma le tausima'i aoga i le tamaititi. Fa'ata'oto le tamaititi aoga fa'apa'o i luga o latou tua (fa'apa'o) ma fa'ae'e vae 30 senitimita (12 inisi) (pe fa'apipi'i i luga o latou itu i le tulaga toe fa'aleleia pe a pua'i, pe nofo ma fa'apa'o vae pe a tigaina le manava e le mafai ona taoto); O le tu i luga o se tamaititi i le taimi o le vasodilation anaphylactic e tafe ai le toto i pito pito i lalo ma e mafai ona mafua ai le pu'eina vave ma le le mafai ona toe fa'afo'isia le fatu.
- Aua ne'i avatu ni vaila'au fa'ama'i (antihistamines) (
Benadryl / Cetirizine) po'o se fa'ama'i foma'i nai lo o le Epinephrine. O vaila'au fa'ama'i e alu i le 30 i le 60 minute e galue ai ma klzzh:0057; latou faia le zero** e toe fa'a'i ai le fula o le ala ea po'o le pa'u o le toto anaphylactic. E faapena foi, e le mafai e le albuterol asthma inhaler ona taofia le edema laryngeal pito i luga; tui i taimi uma Epinephrine FIRST (aemaise lava i tamaiti a'oga e maua uma i le sela ma mea'ai allergies, o lo'o maualuga le lamatiaga o le anaphylaxis e oti ai). - Sauni se Epinephrine Auto-Injector lona lua ma tui pe a uma le 5 minute pe a le lelei auga. Ia ave faatasi lua tui epinephrine i taimi uma (
2-Pack). Afai e fa'aauau pea pe fa'atupula'ia le uigi, ma'i le fa'a'i, vaivai, po'o le pua'i 5 i le 15 minute pe a uma le tui muamua, fa'aaoga le Epinephrine Auto-Injector lona lua i le faafeagai o le ogatotonu o le ogavae. - Auina atu le tamaititi i le Falema'i Faalavelave Tutupu Faafuasei i le taavale a le falemai tusa lava pe ua foliga mai ua 100% ua toe malosi. E te'a le epinephrine i le 15 i le 30 minute, ma e oo atu i le 15 pasene i le 20 pasene o gasegase e aafia Biphasic Anaphylaxis, ose galu matautia lona lua o le feto'ai o le ea ma te'i e toe foi mai le 1 i le 12+ itula mulimuli ane e aunoa ma se mea'ai fou. Tu'u atu le auto-injector (s) fa'aaoga ma le taimi tonu o tui o lo'o tusia i luga o le lipine i foma'i.
- Afai na loka e le a'oga lau tama EpiPen, fa'ate'aina i latou mai se malaga i fafo, po'o le teena fo'i o mea e nonofo ai allergy, fa'afeso'ota'i loa le Vaega 504. I lalo o le ADA Amendments Act of 2008 ma le US Department of Justice / Office for Civil Rights (OCR) precedent, o se mea'ai e lamatia ai le ola po'o se fa'ama'i oona e puipuia faaletulafono; e tatau i a'oga ona tu'uina atu le Vaega 504 Fuafuaga (po'o le UK Statutory Individual Healthcare Plan / Canadian Sabrina Law Plan) e fa'amaonia ai le avanoa i le epinephrine ma le fa'aofiina atoa.
Aisea e mafai ai ona oti le tu pe savali i le ofisa tausi ma'i ile taimi ole anaphylaxis
I le taimi o anaphylaxis ogaoga, e tele le tele o le vai e tafe mai le toto i totonu o aano o loʻo siomia ai aʻo faʻalauteleina aʻa toto, ma mafua ai ona oʻo atu i le 35 pasene o le tafe toto lelei e paʻu i totonu ole 10 minute. I suʻesuʻega faʻapitoa mo suʻesuʻega faʻapitoa o anaphylaxis faʻamaʻi (Pumphrey, Journal of Allergy and Clinical Immunology), o tagata mamaʻi na faʻamalosia e nonofo saʻo i luga, tutu i luga, pe savali i le na o le 20 mita (65 futu) i le falemaʻi tausimaʻi aʻoga poʻo le taʻavale a le falemaʻi na maliu faʻafuaseʻi i totonu o sekone mai le "Empty Ventricle Syndrome, toe foʻi mai le fatu mai le fatu," potu e matua gaogao lava. Tulafono #1 o le tali atu i anaphylaxis ile aoga: Fa'aisa le tamaititi ile kesi sa'o ile potuaoga po'o le nofoa faleaiga lea na amata mai ai fa'ailoga, fa'ata'atia i luga ole fola ma fa'ae'e vae, ma ta'e le EpiPen I LE tamaititi aoga.
Su'ega anaphylaxis a le a'oga ma le vaega 504 la'au fa'ai'uga fa'amalosia¶
flowchart TD
Start["Tamaiti A'oga Ua A'afia i Mea'ai/Ale Allergen PO'O Fa'aalia Fa'ailoga Fa'afuase'i Fa'aleaga ile A'oga"] --> AssessSymptoms{"Iloilo Fa'ailoga Fa'anatinati (Aua le Si'i le Tamaititi i le Ofisa o Tausima'i):<br/>E i ai i le tamaititi SISI Fa'ailoga Tuga (Mama/Fa'a'i/Fa'a'i)<br/>PO'O Fa'ailoga La'au ile 2+ Tino Fa'atonu (eg, Hives + Vomiting)?"}
AssessSymptoms -->|"IOE: Ua masalomia le Anaphylaxis"| GiveEpi["1. INJECT EPINEPHRINE VA'AVAVAE ile ogatotonu ole ogavae (e ala i Laei)<br/>(Pe fa'aaoga le School Stock Undesignated Epinephrine pe afai e leai se RX ile faila ole tamaititi)<br/>2. Fa'ata'oto le Tamaiti a'oga FLAT i Tua ma Si'i Vaevae (Tulaga toe fa'aleleia pe a pua'i)<br/>3. Valaau 911 / 112 / 999 (Talosaga ALS Ta'avale ma Epinephrine)<br/>4. Amata 5-Minute Taimi & Fa'ailoa Matua"]
GiveEpi --> FiveMinCheck{"I le 5 Minute: O fa'aauau pea/fa'ate'ia auga o le manava, fa'a'i, po'o le te'i?"}
FiveMinCheck -->|"Ioe"| SecondDose["TUSI LE SECOND EPINEPHRINE AUTO-INJECTOR i le faafeagai o le ogavae i fafo<br/>Tuu le fa'aopoopo Albuterol inhaler NA''O LE Epinephrine pe a uii<br/>Amata le CPR pe a le tali mai le tamaititi ma taofi le manava masani."]
FiveMinCheck -->|"Leai (Fa'alelei auga)"| HospitalTransfer["Taofi le tamaititi aoga i luga o le fata i le taimi o le EMS Faʻafeiloaʻi ile ER<br/>Mandatory 4+ Hour Emergency Department Mataʻituina mo le Biphasic Reaction"]
SecondDose --> HospitalTransfer
AssessSymptoms -->|"LEAI: Na'o le Fa'a'ailoga Mama e Tasi (fa'ata'ita'iga, 2 pupuni laiti po'o laugutu mageso vaivai)"| HighRiskCheck{"Pe na iloa e le tamaititi le tu'ina o le allergy/sthma MA fa'amaonia le taumafaina?"}
HighRiskCheck -->|"Ioe (Ua iloa lethal allergen ingestion)"| GiveEpi
HighRiskCheck -->|"Leai"| ObserveClosely["Taofi Tamaiti A'oga ma Tagata Matutua ua A'oa'oina & EpiPen i Lima<br/>Tuu atu le antihistamine tu'ugutu NA'O pe'a fa'atonuina ile Fuafuaga FARE mo le faiga e tasi fa'alelei<br/>Mata'i fa'aauau mo le 60 minute; pe a aliali mai le 2nd system -> INJECT EPINEPHRINE"]
Vaega 1: Fa'afefea ona fa'amatala e tamaiti anaphylaxis & le 2-System Clinical Diagnostic Rule¶
E seāseā fai mai tamaiti laiti, “Ua ou maua i le laryngeal edema ma systemic hypotension.” Nai lo o lea, o le a toso e se tamaitiiti e 6-tausaga le matua i le laulau o le faleaiga, o le a toso lona kola, valu o latou taliga, feanu meaʻai i luga o latou solo, po o le faaaogaina o fuaitau tuputupu aʻe e tatau ona aʻoaʻoina uma faiaoga, faleaiga, ma ave pasi ina ia iloa vave.
Le fa'afefea ona fa'amatala e tamaiti laiti le anaphylaxis vave¶
- “E vevela loʻu laulaufaiva, mu, pe lagona le vevela.” (Pe a ʻai i meaʻai e lē oona)
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- “E maʻi loʻu gutu pe pei ua iai se lauulu po o se rane i loʻu faai.”*
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- “E lagona e loʻu laulaufaiva le telē tele pe mamafa foʻi mo loʻu gutu.”*
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- “E iai se mea o loo tuʻia loʻu faai pe tigā foʻi pe a folo.”*
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- “E matuā mageso lava oʻu taliga po o alofilima o oʻu lima.”*
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- “Ou te lagona le niniva, moe, po o le pei o se mea mataʻutia o le a tupu.”* (Sense of faʻamataʻu mala e mafua mai i le paʻu faʻafuaseʻi o le toto)
Tulaga fa'apitoa: O afea e tui vave ai le Epinephrine (NIAID / FARE / WAO Guidelines)¶
I lalo o le Food Allergy Research & Education (FARE) Emergency Care Plan ma National Institute of Allergy and Infectious Diseases (NIAID) taʻiala, ** tui vave le Epinephrine** pe afai ** EITHER Trigger A PO Trigger B** e tupu i totonu o minute i le lua itula talu ona iloa pe masalomia se allergen:
| Fa'ailoga Fa'ama'i | Fa'ailoga Mata'utia i le Tagata A'oga | Gaioiga Fa'afoma'i Vave |
|---|---|---|
| Fa'aoso A: SO'O se Fa'ailoga Tuga Tasi Tasi i Mama, fatu, po'o le Fa'ai/Gutu | - Mama: Pupu le mānava, fa'atete, ** tale mago faifai pea** (e masani ona fa'aseseina o se ma'i foma'i), fufusi fatafata. - Foto / Vascular: Pa'u, lanu moana/efoefu le pa'u, matapogia, fa'avaivai vaivai/fa'ala'au fatu, niniva, fa'afuase'i le fue o se tamaititi. - Fa'a'i/Gutu: Ma'i po'o lego i le fa'a'i, fa'alavelave e foloina, fa'agasolo (leo fa'aoso maualuga), fula tele o le laulaufaiva po'o laugutu. |
1. TUSI LOA EPINEPHRINE. 2. Ta'oto mafolafola (si'i vae). 3. Valaau 911 / 112 / 999. |
| ** Fa'aoso B: SO'O se Tu'ufa'atasiga o Fa'a'ailoga Mämä-I-Metetele i Faiga Fa'aletino e Lua pe sili atu** | Mo se faʻataʻitaʻiga, Paʻu + Gut o loʻo tupu faʻatasi: - Pa'u: Fa'agogo, mūmū lautele/fufulu, magese alofilima/taliga, fula ma'imata. - Gut (GI): Su'i, tiga tele le manava, manava fa'afuase'i. - Isu/Mata: Fa'afuase'i le tafe o le isu, mafatua mafatua, mata magese mumu. |
1. TUSI LOA EPINEPHRINE. (Fa'aaliga: Tusa lava pe leai se faaletonu o le manava o le tamaititi, ae o le ** Hives + Vomiting* e tutusa ma le LUA faiga tino = Anaphylaxis = Inject Epinephrine i le taimi nei).* |
| Fa'aoso C: Tala'aga Ta'uta'ua o Tuga Anaphylaxis + Fa'amaonia Allergen Ingestion | E to'atele foma'i fa'ama'i e siaki le atigipusa i le Fuafuaga Fa'atino a le tamaititi a'oga FARE o lo'o ta'u mai ai: "Afai e mautinoa na 'ai e le tamaititi [Peanut/Tree Nut/Dairy], tu'i loa le Epinephrine a'o le'i amata fa'ailoga." | Mulimuli i le faatonuga a le foma'i ile Fuafuaga FARE ma tui vave. |
E leai se fa'alavelave fa'afoma'i i le tu'uina atu o le Epinephrine i se fa'alavelave fa'afuase'i masalomia
O nisi taimi e fa'atuai ai faiaoga ma matua e fa'aoga se EpiPen ona o lo latou popole: * "Ae fa'apefea pe a na'o se osofa'iga fa'afefe po'o se tali malie, pe o le Epinephrine e afaina ai le tamaititi?"* O vaila'au fa'afuase'i mo tamaiti ma sosaiete allergy e fa'amamafa i le lautele: pe a masalosalo, avatu le Epinephrine. Ise tamaititi soifua maloloina po'o se talavou, o le fua o le epinephrine e fa'atatau i le mamafa o le epinephrine e mafua ai le tetete mo sina taimi, o le tata vave o le fatu (pei o le tamo'e o le taufetuli), ma le pa'u sesega mo le 20 minute, ae o le ** taofi pe tuai le epinephrine i le 15 minute a'o le anaphylaxis moni e mafai ona i'u ai i manu'a hypoxic fai'ai po'o le oti**.
Vaega 2: Fa'atonu la'asaga ta'itasi mo masini Epinephrine a'oga uma e 4¶
O ofisa fa'alesoifua maloloina a'oga fa'aonaponei ma ato fa'afafa a tamaiti a'oga o lo'o iai ituaiga autu e fa o masini epinephrine e fa'amaonia e le FDA/EMA/Health Canada. Teu uma masini epinephrine i le vevela o le potu e pulea i le va o le 20 ma le 25 tikeri Celsius (68 ma le 77 tikeri Fahrenheit), aua neʻi faʻamaisaina pe tuʻu i totonu o se taavale vevela poʻo se pasi, ma siaki le faʻamalama matamata i masina taʻitasi e faʻamaonia ai o loʻo tumau pea le manino o le vai ma le lanu. Ona o masini ta'itasi e fai sina ese'ese i le taimi o fa'alavelave fa'afuase'i, toe iloilo le faiga tonu o lo'o i lalo:
Fa'atusatusaga o Epinephrine Auto-Injectors ma Nasal Spray (EpiPen, Auvi-Q, Generic, neffy)¶
| Igoa o le Meafaigaluega & Tulaga Tulaga | Sa'o La'asaga ma le La'asaga Fa'atonu Tekinolosi | Taofi Taimi ile Ovae & Saogalemu Pe a uma ona tui |
|---|---|---|
| 1. EpiPen / EpiPen Jr (ma Mylan/Teva Generics) - ** samasama ( 0.3 mg)**: >= 30 kg (66 lbs)- meamata ( 0.15 mg): 15 to 30 kg (33 to 66 lbs) |
1. Su'e le pupuni faagaau lanu samasama/lanumeamata ma fa'ase'e i fafo le tui fa'a-auto. 2. Uu le paelo i le moto ma matau moli e faasino i lalo ("Bila i le lagi, Lanu moli i le ogavae," aua ne'i tuu le limamatua i itu uma e lua). 3. Toso sa'o i luga ** BLUE saogalemu tatala **. 4. Sau ma tulei le ORANGE pito i totonu ogatotonu o le ogavae pito i fafo ( vastus lateralis) i se tulimanu 90-tikeri (e ala i jeans/ofu e lelei, aloese mai su'iga/ taga) se'ia kiliki. |
Uu mau i le ogavae pito i fafo mo 3 sekone atoa (1-1000, 2-1000, 3-1000).(E otometi lava ona alu atu le ufiufi o nila moli e ufiufi ai le nila pe a aveese). |
| 2. Auvi-Q / Allerject (Meafaigaluega Fa'afa'afa'a Ta'ita'i 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. Toso ese le Auvi-Q mai lona fa'atafa'afafafa'i fafo pito (lea e fa'agaoioi ai le otometi ** fa'atonuga leo** e fa'ailoa ai oe i la'asaga uma). 2. Toso sa'o i lalo ma ave'ese le puipui saogalemu mūmū. 3. Tuu le ** BLACK base** i le ogatotonu o le ogavae pito i fafo i se tulimanu 90-tikeri, ona oomi mausali lea seia e faalogoina se kiliki ma siisi. |
Taofi mau i le nofoaga mo 2 sekone atoa (2-second countdown beep).E otometi lava ona toe toso i tua le nila i totonu o le pito uliuli pe a uma le 2 sekone ina ia e le iloa ai se nila fa'aalia. |
| 3. Adrenaclick / Impax / Lineage Generic Epinephrine (Tu'u Va'a Lua) |
1. Aveese le masini mai le atigi pusa puipui. 2. Toso ese Cap #1 (Gray) mai le tasi pito, ona toso ese lea Cap #2 (Red/Gray) mai le isi pito. 3. Tuu le MULAI pito i le ogatotonu o le ogavae pito i fafo ma oomi malosi i lalo seia oo ina ulu le nila i totonu o maso (e le manaʻomia se suigi). |
Uu mau i le ogavae pito i fafo mo 10 sekone atoa, ona aveese lea ma le faaeteete (e tumau pea ona aliali le nila; toe tuu i totonu o le paipa). |
4. neffy (Epinephrine Nasal Spray, E leai se nila)- 2 mg: >= 30 kg (66 lbs)- 1 mg: 15 to <30 kg (33 to <66 lbs) (tausaga 4+) |
1. Ave'ese le pusa ma'i ma aveese le masini fa'asu'i isu. 2. AUA LE fa'aulu pe fa'ata'ita'i le fusu i le ea (e tasi le tui e tasi). 3. Tu'u sa'o le isumu ile tasi isuisu se'ia pa'i ou tamatamailima ile pito i lalo ole isu ole tamaititi. 4. Oomi malosi le plunger i luga i luga e fa'ainu. |
Afai e le fa'alelei pe fa'ateteleina fa'ailoga pe a uma le 5 minute, fa'atonu se fa'ailoga fou lona lua neffy masini i totonu ole SAME puisu. |
Manatua i le uuina o se tamaitiiti o loo tauivi: Pe a tuuina atu se tui o le suilapalapa i totonu o le tino o se tamaititi fefe, fai atu i se tagata matua lona lua e fusi lemu le tino o le tamaitiiti ma taofi mau le tulivae/vae pito i lalo i luga o le fola ina ia aua neʻi sete le tamaitiiti i le faamalama o le tui e 2-i-3-lua (lea e mafai ona motusia ai le vae po o le manava).
Vaega 3: Tamaiti A'oga Epinephrine Tulafono Tau'ave e le Tagata Lava ma le A'oga ("Le'o Fa'ailogaina") Epinephrine¶
I aso ua tuanaʻi, o aʻoga tuai "Zero-Tolerance Drug Policies" na manaʻomia uma vailaʻau, e aofia ai EpiPens faʻasaoina ola ma vailaʻau fomaʻi, e loka i totonu o le kapoti i le ofisa o tausisoifua aoga. Ina ua alu le teine tausima'i a'oga e 'aiga i le aoauli, ufiufi se isi fale, pe alu i le 15:00 a'o le'i faia ta'aloga pe a uma le a'oga, na feoti tamaiti i fafo o faitoto'a o le falema'i loka.
1. Aia Tatau Fa'aletulafono a lau Tama e Avea ai e Ia lava (All 50 U.S. States, Canada, UK)¶
- Tulafono mo le Aveesea e le Tagata Lava Ia ma le Pule o le Tagata Lava Ia: O 50 Amerika uma (faaopoopo i Washington, D.C.), itumalo o Kanata (i lalo o le Sabrina's Law i Ontario ma faatonuga faaitumalo tutusa), ma ua faia e le Malo o Peretania ni tulafono e faamautinoa ai o soo se tamaitiiti aoga e iai se foma'i-faamaonia le lamatiaga o le anaphylaxis ma le Injeadrine o le tagata lava ia e iai le aia tatau faaletulafono e maua ai le Enjeadrine ** fa'aola foma'i) i luga o latou tagata** i taimi uma i potuaoga, fale'aiga, vasega ta'alo, pasi a'oga, ma malaga i fafo.
- O le a le mea e mafai e le a'oga ona mana'omia (ma e le mafai ona mana'omia):
- Atonu e manaʻomia e le aʻoga: (1) se faatagaga tusitusia e sainia e le fomaʻi o tamaiti e faʻamaonia ai le faʻatonuina o le tamaititi aoga i le faʻaogaina o le masini, ma le (2) se pepa faʻatagaga a matua ua sainia (ma le auto-injector e teu i le ofisa o le soifua maloloina).
- E le mafai e le a'oga ona fa'amalosia se tamaititi aoga tulagalua po'o se a'oga maualuga (po'o se tamaititi aoga tulagalua ua fa'amaonia e le foma'i ma'i) e tu'u le latou EpiPen o lo'o loka i le ofisa, e le mafai fo'i e se faia'oga ona faoa se fusi fa'afoma'i tamaiti a'oga (
SPIbelt) po'o se taga allergy i le taimi o le su'ega po'o le vasega ta'aloga.
2. Aoga "Stock / Undesignated" Epinephrine Laws (Federal School Access to Emergency Epinephrine Act)¶
O le a le mea e tupu pe a fai o se tamaititi o le vasega 1 e le'i iloa lava e maua i se mea'ai allergy** e 'ai se kesi pe tuia e se ofu samasama i luga o le malae taalo ma alu atu ai i anaphylactic shock e aunoa ma se EpiPen patino i le faila? - I lalo o le feterale School Access to Emergency Epinephrine Act (ma tulafono a le setete i le toetoe lava o setete uma e 50, Section 238A of the UK Human Medicines Amendment Regulations 2017, and Canadian provincial statutes), e faatagaina aʻoga (ma i le tele o setete mandated) e faʻaputu ** Undesignated / "Spare" Auto-Injectors. - O nei tulafono o lo'o tu'uina atu ai le Samaritan lelei fa'aletulafono fa'ale-malo i so'o se teine tausima'i a'oga, faia'oga, faia'oga, po'o se tagata faigaluega o lo'o fa'afoeina se fa'asoa Epinephrine Auto-Injector i se agaga lelei i so'o se tamaititi a'oga po'o tagata asiasi i le lotoa e talitonu o lo'o maua i le anaphylaxis.
Vaega 4: Fausiaina o se Fuafuaga Fuafuaga 504 Fuafuaga mo Mea'ai Tugā po'o Allergies Venom¶
O le tele o aʻoga e tuʻuina atu i matua o tamaiti faʻamaʻi se pepa faʻafomaʻi e 1-itulau e taʻua o le Individualized Healthcare Plan (IHP) poʻo le Emergency Action Plan (EAP) na tusia naʻo le tausimaʻi aʻoga, aʻo taʻu atu i matua: "E maua e lau tama le A saʻo i lana lipoti, o lea e le agavaa ai mo se Fuafuaga Faʻaletulafono Section 504."
Teena le teena vave i se faiga tusitusia. E ui o le IHP/EAP ose pepa fa'atonuga tau falema'i, o le IHP na'o se pepa tausi soifua i totonu o le fale ma e leai ni nifo e fa'amalosia aiā tatau a le feterale. O le Section 504 Plan (i lalo o le Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794, ma le Title II / III of the Americans with Disabilities Act) ose konekarate feterale e noatia faaletulafono e faamalosia e le US Department of Education **OCR) Civil Rights.
Aisea e agavaa ai lau tama mo se Fuafuaga Vaega 504 e tusa lava pe o lo latou Allergy ua "Faamagalo" Pe a Aloese mai Mea'ai¶
I lalo o le ADA Teuteuga Tulafono o le 2008 (ADAAA, 42 U.S.C. 12102(4)(D)): 1. Tulafono "Tulaga Faʻapitoa": O se faʻaletonu e episodic poʻo le faʻamagaloga (e pei o se maʻi tigaina o meaʻai, sela, epilepsy, poʻo le maʻisuka) ua faʻatulafonoina ose le atoatoa i lalo o le Vaega 504 ma le ADA pe afai o le a *matua faʻatapulaʻaina se gaioiga tele o le olaga (e pei o le manava, 'ai, poʻo le tino o le tino) ** 2. Tulafono "Leai ni Fa'aitiitiga": E tatau i a'oga ona iloilo pe fa'atapula'a e le allergy le mānava/'ai e aunoa ma le mafaufauina o a'afiaga fa'alelei o faiga fa'aitiitiga (e pei o le matua 'alofia o le allergen po'o le aveina o se EpiPen). 3. E le taua ni togi: O le agavaa o le Vaega 504 e *e l faatapulaaina i le le atoatoa o le aoaoina po o togi maualalo; se sa'o-O se tamaititi a'oga o lo'o i ai se pinati e lamatia ai le ola, susu, po'o se allergy lagomeli e iai lona aiā tatau a le feterale i se Fuafuaga aloa'ia o le Vaega 504.
Fa'atonu fale e fa'aaofia i lau tama Food Allergy Section 504 Plan¶
- 1. Tatala Epinephrine Avanoa & Latala Tulafono: Tamaiti Epinephrine Auto-Injectors (2-pak) e tatau ona teuina i totonu o le tatala kapoti faʻafuaseʻi i le ofisa o le soifua maloloina MA ave e le tamaititi aoga (poʻo le faiaoga o le potuaoga i totonu o le suilapalapa mo Pre-K i le Vasega 3) ina ia mafai e Epinephrine ona oʻo atu i le tamaititi aoga i totonu o le 60 i le 90 sekone, i soo se mea i luga o le lotoa (faletaalo).
- 2. No-Walk Emergency Protocol: Fa'atonuga manino e fa'apea afai e fa'aalia e le tamaititi ni fa'a'ailoga fa'ama'i po'o lipoti ua masalomia le 'ai, o le tamaititi aoga e LE'A auina atu e savali i le ofisa tausi ma'i; e tatau i le aufaigaluega ona valaau se "Code Medical" e aumai sa'o le tausima'i ma le Epinephrine i le tamaititi aoga.
- 3. Fale'aiga & Potu A'oga Sone Saogalemu-Saogalemu:
- Tuuina atu o le Allergen-Safe Table (fa'amama a'o le'i 'aiga i le aoauli i se ie fou fa'apitoa ma le EPA fa'amaonia e le vai/solo; ia maitauina e le'i aveesea e le tagata a'oga ni polotini e allergen mea'ai**, ae na'o le fasimoli ma vai tafe po'o solo fa'atau fefa'ataua'iga e aveese ai polotini pinati/susu mai lima ma laulau), fa'amautinoa e le mafai ona fa'asala na'o le tamaititi a'oga i se tulimanu o le vasega" e nonofo faatasi ma i latou.
- Fa'asa'o Tulafono mo le Vasega A'oa'oga e Le'o Mea'ai: Fa'asā le fa'aogaina o mea e a'afia ai tamaiti i su'ega numera o le potuaoga, su'esu'ega fa'asaienisi, talone fa'alogo (pei o fatu manu o lo'o i ai pinati, paluga fa'agogo / paluga saito, po'o pusa fuamoa), po'o mea'ai fa'atauga e le'i fa'atagaina.
- Foma'i Lima: O tamaiti aoga uma i totonu o le potuaoga tulagalua e fufulu lima i le fasimoli ma vai (poo solo solo solo, ae le o le ava malosi) pe a ulufale i le potuaoga pe a uma le aoauli/mea'ai.
- 4. Sui Faiaoga & Aveta'avale Pasi Fa'asilasilaga: Fa'atonu "Sub Folder" Pepa fa'ailoa mumu e tu'u atu i faiaoga sui uma i le taeao e siaki ai, ma a'oa'oina tulafono fa'afeso'ota'i fa'afuase'i i luga o le pasi a'oga (va'ai fa'alavelave pasi a'oga, fa'alavelave fa'afuase'i i malaga, ma le toe fa'atasia o matua ma fanau).
- 5. Fa'aaofia Atoa o Malaga Fa'ato'aga (Se'i Fa'atonu Matua So'ofa'atasi):
- Tulafono Taua a le Feterale: I lalo o le tulafono a le US Department of Education OCR, e lē mafai e se aoga a le malo ona taʻu atu i se matua: "E faatoa mafai lava ona alu lou alo maʻi maʻi i le malaga a le vasega pe afai e te alu i se aso malolo e sau ai oe lava e tausi."
- E ui e talia pea matua e volenitia e avea ma ta'ita'i, e mana'omia faaletulafono le aoga itumalo i lalo o le Vaega 504 e tu'uina atu se tagata faigaluega a'oa'oina po'o se tausima'i na te tauaveina ma fa'atonu le tamaititi Epinephrine i malaga ta'itasi uma e lagolagoina e le a'oga, e tusa lava pe auai le matua.
- 6. Puipuiga e Tete'e i le Fa'atauvalea: Fa'ata'ita'iga manino e togafitia ai so'o se talotalo ma le loto i ai o se allergen i foliga o le tamaititi aoga, fa'amata'u e uu le pata pinati i luga o la latou kesi, po'o le ulagia o latou allergy o se solitulafono matuia Fa'aleaga Mana'oga / Ulutala II / Vaega 504 soliga (va'ai fa'amata'u a tamaiti a'oga, fa'aleaga, ma fa'amata'u i luga ole laiga).
Vaega 5: Fale'ai a le Iunivesite ma le kolisi ma aia tatau mo le allergy (DOJ Lesley University Precedent)¶
E le muta aiā tatau tau mea'ai ile fa'au'uga a le a'oga maualuga. Pe a lesitala se tamaititi e maua i mea'ai ogaoga po'o ma'i selia i se kolisi po'o se iunivesite e mana'omia tamaiti fou e nonofo i fale moe ma fa'atau se $3,000-i-semester fuafuaga o taumafataga a le lotoa.
- O le US Department of Justice Lesley University Landmark Settlement: O le US Department of Justice Civil Rights Division na faavaeina i lalo o le Americans with Disabilities Act (ADA) e faapea o allergies tuga i meaai ma le ma'i celiac e puipuia ai manaoga faapitoa i aoga maualuluga.
- Afai e totogi e le iunivesite se totogi faʻatulafonoina o le fuafuaga o meaʻai, e tatau i le iunivesite ona: (A) saunia meaʻai saogalemu, faʻafesoʻotaʻi-pulea le allergen-free o meaʻai (e pei o se nofoaga tuʻufaʻatasia e leai ni allergen, meaʻai umukuka na muaʻi okaina, ma le faʻailoga manino o meaʻai), (B) tuʻuina atu i le tamaititi se potu moe patino / suite ua faʻapipiʻiina ma se umukuka saogalemu / pusaaisa ** e saunia ai meaʻai saogalemu / pusaaisa ** tuusaunoaga/faate'a mai le fuafuaga fa'atulafonoina o taumafataga a le lotoa.
- E tatau fo'i ona logo Faufautua o Tagata Kolisi (RA) ma Leoleo o le Campus e ala i le Campus Disability Services Office i le mea e teu ai le Epinephrine i totonu o le potu moe a tamaiti aoga.
Talu ai ona o le ogaoga o le ma'i e mafai ona alualu i luma i le manava manava i totonu o minute, matou te matua fautuaina lava matua uma, faiaoga, faiaoga, ma tausitama e fa'amae'a se a'oa'oga Fesoasoani Muamua, CPR, ma Anaphylaxis / Epinephrine Auto-Injector e ala i le Koluse Mumu, St John Ambulance, po'o se tagata e tu'uina atu fa'amaonia.
Fesili e fai soo¶
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.
Taiala fa'atatau¶
- Fa'aa'i ma anaphylaxis fesoasoani muamua
- Ui lagomeli, lagomeli
- Le sa'o a'oga le taofia ma IEP fa'aaliga fa'afofoga
- Faʻalavelave pasi aʻoga, faʻalavelave faʻafuaseʻi malaga i fafo, ma le toe faʻafouina o matua ma tamaiti
- Mana'oga fa'apitoa ma mana'oga fa'afoma'i fuafuaga fa'afuase'i
- Numera o fa'alavelave fa'afuase'i ma fe'au fa'ava-o-malo
Punavai ua siaki¶
- Centres for Disease Control and Prevention (CDC) ma le US Department of Education (United States): Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs.
- National Institute of Allergy and Infectious Diseases (NIAID) / World Allergy Organization (WAO) / American Academy of Pediatrics (AAP): Ta'iala Fa'afoma'i mo le Su'esu'eina ma le Puleaina o Mea'ai Allergy ma Anaphylaxis Fa'alavelave Fa'afuase'i Fuafuaga (Intramuscular Epinephrine First-Line Dosing, Supine Positioning, and Biphasic Monitoring).
- Food Allergy Research & Education (FARE) (United States): Fuafuaga Tausiga mo Faalavelave Tutupu Faafuasei mo Mea'ai Allergy & Anaphylaxis ma Avanoa i le A'oga i Tulaga Tulaga o le Epinephrine Act Standards.
- Matagaluega o Aoga Ofisa mo Aia Tatau a Tagata (OCR) ma le Matagaluega o Faamasinoga Vaega o Aia Tatau a Tagata (Amerika): * Vaega 504 o le Tulafono Toe Faaleleia (34 CFR Vaega 104), Tulafono Toe Teuteu a le ADA o le 2008 (Episodic Conditions Coverage), Field Trip Inclusion Rulings, ma United States v. Lesley University Settlement Agreement*.
- Matagaluega mo A'oga (DfE) ma Vailaau Fa'afoma'i ma Mea Tau Soifua Maloloina Ofisa Fa'atonutonu (MHRA) (United Kingdom): * Lagolagoina Tamaiti A'oga i le A'oga ma Tulaga Fa'afoma'i Ta'iala Fa'aletulafono ma Ta'iala i le Fa'aaogaina o Adrenaline Auto-Injectors (AAIs) i A'oga*.
- Food Allergy Kanata ma Matagaluega o Aoga a le Itumalo (Kanata): Tulafono a Sabrina (Anaphylactic Pupils Protection Act, Ontario) ma Anaphylaxis in Schools & Other Settings Consensus Guidelines.