AN ADULT IS TO STAY WITH STUDENT AT ALL TIMES. ! 911 must be called WHENEVER EpiPen® administered. ! Advise 911 that a student is having a severe allergic reaction and EpiPen® is being administered. ! Note time epinephrine was given. ! For severe reaction, consider positioning student on back with legs raised. ! Treat student even if parents cannot be reached.

Any SEVERE SYMPTOMS after suspected or known ingestion: One or more of the following: LUNG: Short of breath, wheeze, repetitive cough HEART: Pale, blue, faint, weak pulse, dizzy, confused THROAT: Tight, hoarse, trouble breathing/swallowing MOUTH: Obstructive swelling (tongue and/or lips) SKIN: Many hives over body Or combination of symptoms from different body areas: SKIN: Hives, itchy rashes, swelling (e.g., eyes, lips) GUT: Vomiting, diarrhea, crampy 1. INJECT EPINEPHRINE IMMEDIATELY 2. Call 911 3. Begin monitoring (see box below) 4. Give additional medications:* - Antihistamine -Inhaler (bronchodilator) if Asthma *Antihistamines & inhalers/ bronchodilators are not to be depended upon to treat a severe reaction (anaphylaxis). USE EPINEPHRINE. MILD SYMPTOMS ONLY: MOUTH: Itchy mouth SKIN: A few hives around mouth/face, mild itch GUT: Mild nausea/discomfort 1. GIVE ANTIHISTAMINE 2. Stay with student; alert healthcare professionals and parent 3. If symptoms progress (see above), USE EPINEPHRINE 4. Begin monitoring (see box below)