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Dear all.
This is a question relevant to nurse immunisers
We are now in the middle of our employee ‘flu vaccination campaign and the question has arisen about administering adrenaline.
If an employee has a reaction following administration of the vaccine and the health service has a 24 hour anaesthetic service and a code blue team, should the nurse immuniser wait to administer adrenaline until the team arrives?Thanks in anticipation
MareeMaree Sommerville
Infection Control Coordinator
Mercy Hospital for Women[cid:image001.jpg@01CF7A4D.FAAAC600]
163 Studley Road
Heidelberg 3084DISCLAIMER This email and any files transmitted with it
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Hi Maree,
I wouldnt wait if it was clearly a reaction requiring adrenaline quickly. That said I am ALS/PALS trained and work in ED/ICU so may be more comfortable than another who has only done BLS and the immunisation training. It would also very much depend on local policy/procedure and how the immunisation program is set up. I think, and this may vary in jurisdictions, the nurse would also have to be able to prescribe adrenaline as per some hospital policy in order to cover the nurse should something go wrong as I dont think just being a nurse immuniser would cover them in that setting. Could be wrong though.
Cheers MattMatt Mason
Lecturer
School of Nursing & Midwifery
Faculty of Science, Health, Education and Engineering
University of the Sunshine Coast
Ph: +61 7 5456 5191 | Fax: +61 7 5456 5940 | Email: mmason1@usc.edu.au | Web:www.usc.edu.auFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Maree Sommerville
Sent: Friday, 1 May 2015 11:40 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Administering adrenaline for anaphylaxis following ‘flu vaccinationDear all.
This is a question relevant to nurse immunisers
We are now in the middle of our employee flu vaccination campaign and the question has arisen about administering adrenaline.
If an employee has a reaction following administration of the vaccine and the health service has a 24 hour anaesthetic service and a code blue team, should the nurse immuniser wait to administer adrenaline until the team arrives?Thanks in anticipation
MareeMaree Sommerville
Infection Control Coordinator
Mercy Hospital for Women[cid:image001.jpg@01CF7A4D.FAAAC600]
163 Studley Road
Heidelberg 3084
Phone: 8458 4759
Mob: 0408 789 798
Fax: 8458 4751DISCLAIMER This email and any files transmitted with it
may be confidential and intended solely for the use of the
individual or entity to whom they are addressed. If you have
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should use their own systems to detect computer viruses or other
materials that may corrupt files or systems. Find out more about
Mercy Health at http://www.mercyhealth.com.au
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, Queensland, 4558 Australia.
CRICOS Provider No: 01595D
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Hi Maree,
I think that you should not hesitate to give the adrenaline if the employee is having an anaphylactic reaction. The code blue team will arrive by then and if the person needs another dose then they can give it. I found this in The Australian Immunisation Handbook:
Management of anaphylaxis
Rapid IM administration of adrenaline is the cornerstone of treatment of anaphylaxis. Adrenaline is life saving and must be used promptly.8
If in doubt, IM adrenaline should be given. No serious or permanent harm is likely to occur from mistakenly administering adrenaline to an individual who is not experiencing anaphylaxis.11The next line says to call for assistance, so I would give the adrenaline and then call a code blue.
Regards,
Elizabeth Orr
Infection Control Consultant
Victorian Hand Hygiene Coordinator
VICNISS , Doherty Institute
792 Elizabeth St, Melbourne, Victoria, 3000
T: (03) 9342 9356
F: (03) 9342 9355
E: Elizabeth.Orr@mh.org.auFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Maree Sommerville
Sent: Friday, 1 May 2015 11:40 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Administering adrenaline for anaphylaxis following ‘flu vaccinationDear all.
This is a question relevant to nurse immunisers
We are now in the middle of our employee flu vaccination campaign and the question has arisen about administering adrenaline.
If an employee has a reaction following administration of the vaccine and the health service has a 24 hour anaesthetic service and a code blue team, should the nurse immuniser wait to administer adrenaline until the team arrives?Thanks in anticipation
MareeMaree Sommerville
Infection Control Coordinator
Mercy Hospital for Women[cid:image001.jpg@01D08403.940EA360]
163 Studley Road
Heidelberg 3084
Phone: 8458 4759
Mob: 0408 789 798
Fax: 8458 4751DISCLAIMER This email and any files transmitted with it
may be confidential and intended solely for the use of the
individual or entity to whom they are addressed. If you have
received this email in error please notify the sender immediately
by return email and delete or destroy this message and its
attachments. While this email and any attachments have
been cleared by Mercy Health’s virus protection systems, recipients
should use their own systems to detect computer viruses or other
materials that may corrupt files or systems. Find out more about
Mercy Health at http://www.mercyhealth.com.au
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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Hi Maree
I think this question needs to be considered around your state legislation / guidance for nurse immunisers and staff vaccination programs, and also your local facility/ health department policies.
I would personally not hesitate to give adrenaline in the light of an obvious anaphylactic reaction to vaccination, but this is covered in my facility standing order for our staff vaccination program. Whilst adrenaline is unlikely to be the cause of an adverse event in this situation, I would hate to be working outside my scope of practice and legislation with this.
Cheers
MichaelMichael Wishart
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0]
P Please consider the environment before printing this emailFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Maree Sommerville
Sent: Friday, 1 May 2015 11:40 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Administering adrenaline for anaphylaxis following ‘flu vaccinationDear all.
This is a question relevant to nurse immunisers
We are now in the middle of our employee flu vaccination campaign and the question has arisen about administering adrenaline.
If an employee has a reaction following administration of the vaccine and the health service has a 24 hour anaesthetic service and a code blue team, should the nurse immuniser wait to administer adrenaline until the team arrives?Thanks in anticipation
MareeMaree Sommerville
Infection Control Coordinator
Mercy Hospital for Women[cid:image001.jpg@01CF7A4D.FAAAC600]
163 Studley Road
Heidelberg 3084
Phone: 8458 4759
Mob: 0408 789 798
Fax: 8458 4751______________________________________________________________________
For the purposes of protecting the integrity and security of the SVHA network and the information held on it, all emails to and from any email address on the svha.org.au domain (or any other domain of St Vincents Health Australia Limited or any of its related bodies corporate) (an SVHA Email Address) will pass through and be scanned by the Symantec.cloud anti virus and anti spam filter service. These services may be provided by Symantec from locations outside of Australia and, if so, this will involve any email you send to or receive from an SVHA Email Address being sent to and scanned in those locations.DISCLAIMER This email and any files transmitted with it
may be confidential and intended solely for the use of the
individual or entity to whom they are addressed. If you have
received this email in error please notify the sender immediately
by return email and delete or destroy this message and its
attachments. While this email and any attachments have
been cleared by Mercy Health’s virus protection systems, recipients
should use their own systems to detect computer viruses or other
materials that may corrupt files or systems. Find out more about
Mercy Health at http://www.mercyhealth.com.au
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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______________________________________________________________________
For the purposes of protecting the integrity and security of the SVHA network and the information held on it, all emails to and from any email address on the svha.org.au domain (or any other domain of St Vincents Health Australia Limited or any of its related bodies corporate) (an SVHA Email Address) will pass through and be scanned by the Symantec.cloud anti virus and anti spam filter service. These services may be provided by Symantec from locations outside of Australia and, if so, this will involve any email you send to or receive from an SVHA Email Address being sent to and scanned in those locations.MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Hi All
The National Immunisation Handbook 10th Edition states adrenaline MUSTbe given pages 89-91.:
Management of anaphylaxisRapid IM administration of adrenaline is the cornerstone of treatment of anaphylaxis. Adrenaline is life saving and must be used promptly.8
Anaphylaxis occurs without warning usually within 15 minutes of giving a vaccine. A protocol for the management of anaphylaxis adrenaline and 1 mL syringes must always be immediately at hand whenever vaccines are given.
If the patient is unconscious lie him/her on the left side and position to keep the airway clear. If the patient is conscious lie him/her supine in head-down and feet-up position (unless this results in breathing difficulties).If there are any respiratory and/or cardiovascular symptoms or signs of anaphylaxis give adrenaline by IM injection into the anterolateral thigh (see Use of adrenaline below for dosage). Adrenaline is not required for generalised non-anaphylactic reactions (such as skin rash or angioedema). If in doubt IM adrenaline should be given. No serious or permanent harm is likely to occur from mistakenly administering adrenaline to an individual who is not experiencing anaphylaxis.11Call for assistance. Never leave the patient alone.If oxygen is available administer by facemask at a high flow rate.If there is no improvement in the patients condition within 5 minutes repeat doses of adrenaline every 5 minutes until improvement occurs.Check breathing if absent commence basic life support or appropriate cardiopulmonary resuscitation (CPR) as per the Australian Resuscitation Council guideline12 (available at http://www.resus.org.au/policy/guidelines). In all cases transfer the person to hospital for further observation and treatment.Complete full documentation of the event including the time and dose(s) of adrenaline given.Also needs to be 1:1000
Jodie Burr
Infection Prevention and Control-Clinical Practice Consultant
Disability and Domiciliary Care Services
Department for Communities and Social Inclusion
103 Fisher Street Fullarton 5063
Mobile:0401 120 597
Jodie.Burr@dcsi.sa.gov.auDear all.
This is a question relevant to nurse immunisers
We are now in the middle of our employee flu vaccination campaign and the question has arisen about administering adrenaline.
If an employee has a reaction following administration of the vaccine and the health service has a 24 hour anaesthetic service and a code blue team
should the nurse immuniser wait to administer adrenaline until the team arrives?Thanks in anticipation
MareeMaree Sommerville
Infection Control Coordinator
Mercy Hospital for Women163 Studley Road
Heidelberg 3084DISCLAIMER This email and any files transmitted with it
may be confidential and intended solely for the use of the
individual or entity to whom they are addressed. If you have
received this email in error please notify the sender immediately
by return email and delete or destroy this message and its
attachments. While this email and any attachments have
been cleared by Mercy Health’s virus protection systems recipients
should use their own systems to detect computer viruses or other
materials that may corrupt files or systems. Find out more about
Mercy Health at http://www.mercyhealth.com.au
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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