First Aid Management: Asthma & Anaphylaxis

First Aid 1: Management and Prevention of High Acuity Presentations

• Course: SGSCC JNCOS Course
• Topic: Asthma and Anaphylaxis management and prevention.

Learning Objectives

• Understand the management and prevention of Asthma
• Understand the management and prevention of Anaphylaxis

Asthma

• How asthma affects the lungs:
  • Asthma causes the smooth muscles in the airways to tighten, inflame, swell and produce extra mucus.
  • This makes breathing difficult.
  • Diagrams of the airways and lungs show the affected areas.

Asthma Presentations: Signs and Symptoms

• General: Difficulty breathing, difficulty speaking, coughing, wheezing, chest tightness, anxiety.
  • Patients may know they are having an attack.
• Severe: Confusion, drowsiness, cyanosis, difficulty speaking in single words.

Asthma Prevention

• Common Triggers: Exercise, respiratory infection, air particles (pollen, smoke, dust), sudden weather changes, anxiety/emotional stress.
• Triggers Unknown: If triggers are unknown, inform PLT staff.
• Medication: Cadets may need to regularly take "preventer" medication.

Asthma Preventer Medication

• Responsibility: SGS staff are responsible for cadets taking their prescription medication.
• Not JNCO's responsibility: JNCOs should not take responsibility for medication -This information is for reference only.
• Purpose: Used to prevent asthma attacks, not to treat ongoing attacks.
• Variety: Many types, colors, and designs of preventer medications are available.

Asthma Treatment

• Reliever Medication (bronchodilator): Used to quickly relax airway muscles.
• Spacer: If available, always use a spacer with reliever medication to improve effectiveness.
• Procedure (4 x 4 x 4): Give 4 puffs, wait 4 minutes, give 4 more puffs, and wait 4 more minutes. This procedure should be repeated as needed.
• Call for Help: Call 000 for medical assistance if symptoms worsen or do not improve.

Anaphylaxis

• Definition: A life-threatening systemic response to an allergen involving multiple body systems. -This is not a simple skin reaction. A severe systemic hypersensitivity reaction.

Anaphylaxis Signs and Symptoms

• Symptoms: Respiratory distress (coughing, wheezing, stridor, difficulty breathing), abdominal symptoms (nausea, vomiting), skin/mucosal symptoms (hives, welts, itching, facial swelling), hypotension/shock.

Anaphylaxis Prevention

• Triggers: Identify and limit exposure to common triggers like food (peanuts, tree nuts, eggs, dairy, fish, shellfish, soy, sesame seeds), insect stings, latex, and medications (new ones are a good example).

Anaphylaxis Prevention (Cadet-Specific)

• Inform Staff: PLT CDT Staff to be informed if cadet has anaphylaxis.
• Dietary Restrictions: Anaphylactic cadets have Special Dietary Requirements (SDR). Their rations are managed by the Food Management Officer (FMO).
• Risk from Fellow Cadets: Food brought by fellow cadets poses the biggest risk.

Anaphylaxis Treatment

• Call for Help: Call CASEVAC (000) for immediate help.
• Lying Flat: Lie the person flat; do not allow them to stand or walk.
• Adrenaline Auto-injector (EpiPen): Administer adrenaline auto-injector (EpiPen) intramuscularly to the outer mid-thigh.
• Follow-up: If no response after 5 minutes, repeat adrenaline injection.

Adrenaline and its Effects

• Purpose: Reverses allergic reaction effects.
• Effects: Increases blood pressure, tightens blood vessels, reduces fluid leakage, improves breathing, and opens airways.

Adrenaline Auto-Injector specifics

• Different brands are available, containing 500mcg (Anapen), 300mcg (EpiPen), or 150mcg (EpiPen Junior) of adrenaline.
• Specific instructions are available on how to use each type of auto injector (Anapen and EpiPen).

Summary of Adrenaline Auto-Injector

• Anapen: White end on leg, press thumb on red button.
• EpiPen: Blue end to the sky, orange end to the thigh.

Anaphylaxis Key Points

• Cause: Life-threatening systemic hypersensitivity reaction.
• Presentation: R.A.S.H. Symptoms
• Prevention: Identifying possible triggers and avoiding them.
• Treatment: Use adrenaline auto-injector.