Considering out-of-area school - safe travel-time from hospital?

Posted on: Wed, 09/24/2003 - 2:38am
randgmom's picture
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Joined: 07/21/2002 - 09:00

Hi everyone. Am currently negotatiating with my children's school. I have two 4-yr-olds, both PA. School had been peanut-free on a class by class basis -- no peanut products in PA class but okay in other rooms -- but principal says she's just sent out the letter drafted for PA classmates to the entire school. We still need to clarify the school's policy, particularly when it comes to common areas, and how the policy will be enforced, and feel we need to be prepared to pull our kids out if the answers aren't satisfactory.

There are two schools a little out of town that have definite, specific, enforced peanut-free policies. They are both about 15 minutes from the hospital, and the only way I would send my kids there is if the principals agreed to drive either child directly to hospital, rather than depending on ambulance response time. I've called the ambulance service and bottom line is that the best we could hope for with ambulance is 30 minutes from time of 911 call to arrival at hospital. That's with ideal traffic conditions, good weather, etc.

If kids are driven directly to hospital by school staff, the time is reduced to 15 minutes. How do you feel about this time-frame? Would my kids be safe that far away from a hospital? What is a safe travel time away from a hospital? What is the farthest one should be from a hospital in terms of driving time? Any ideas? Stats? Other resources/guidelines anyone can pass on?

With thanks,

Joanne

Posted on: Wed, 09/24/2003 - 5:05am
ACBaay's picture
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Joined: 03/19/2002 - 09:00

Hi Joanne,
I don't think that having somebody drive your child to the hospital would be a good idea. If your child is having a reaction, that driver would not be able to concentrate on either your child or driving safely. They may become flustered. Also, once the ambulance personnel arrive, they can begin treating your child. If epi-pen has already been given, they can give another, when needed, or even begin rescue treatments, if needed. They also have lights and sirens and can get through traffic and traffic lights (the principal might get stuck in traffic, have to stop at traffic lights, get lost, or at the worst, get into an accident. One more thing, the ambulance people can get your child right into emergency room treatment. If you bring somebody to emergency, your child may have to wait even longer to be seen.
Anyway, I don't think that 15 min is that far away. It would be great if it were closer, but if it is a safer situation, you just have to consider risk vs. benefit. I would, though, make sure that there are multiple epi-pens and that Paramedics, who either carry or can administer epi would be responding.
Take care,
Andrea
[This message has been edited by ACBaay (edited September 24, 2003).]

Posted on: Thu, 09/25/2003 - 11:10am
ssmd's picture
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Joined: 08/07/2003 - 09:00

I totally agree with your answer to this question. I would most always feel safer having the ambulance come than someone driving my DS. They have so many more advantages to help him than someone else and time is of so much less consern when he is with peramedics than the principal, they are much more capable of treating him even if it did take longer to get to the hospital.
Good luck!

Posted on: Thu, 09/25/2003 - 12:01pm
randgmom's picture
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Joined: 07/21/2002 - 09:00

Thank you, both, for your thoughts. I'm sure you are right. It's good to get other ideas when you are exploring your options and trying to balance pros and cons.
Hopefully, I won't have to consider the issue of ambulance vs staff transport to hospital for the out-of-town schools further since, as of this afternoon, the school where my children are currently enrolled has extended their Reduce the Risk policy to the entire school. What a relief. I will just have to monitor the situation and see that they support their new policy.
Thanks again for your feedback and encouragement.

Posted on: Thu, 09/25/2003 - 11:35pm
Tamie's picture
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Joined: 09/23/2002 - 09:00

Hi,
We live quite far from the hospital, about 30 minutes, and our ambulance is all volunteer so it even takes longer for them to respond. I posted on here last year something about the ambulance and someone else responded that I should make sure our ambulance is equipped with the meds to deal with a food allergy, (I guess some arent.) I spoke with the volunteers and they do have the proper equipment.
Tamie

Posted on: Fri, 09/26/2003 - 12:25am
Peg541's picture
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Joined: 12/29/2002 - 09:00

Hi, I used to teach CPR for the Red Cross and one thing we always taught was to never put a person with a suspected heart attack in your car. Imagine you having to do CPR if something should happen on the way to the hospital.
It is the same for anyone experiencing a severe allergic reaction.
If your ambulance is too slow in coming you should make a visit to their headquarters and introduce yourself and your child. Let them know you exist and MIGHT need them some day. This cannot hasten their travel time but it will certainly put a face on the call.
Bring them some cookies too. It helps. My son is 18 and away at college for the first time. We have already visited the paramedics in the college town AND brought them cookies.
Your school and home should also have a bigger supply of epi pens. One or two are not enough.
In 7th grade my son was on a school trip, on top of a mountain in Santa Barbara. A helicopter flight away from help and 120 miles away from home.
Months in advance I called the paramedic station at the bottom of the mountain just to let them know DS would be at that camp and the dates.
It turns out one of their guys is allergic to peanuts. He made a trip up the mountain to introduce himself to my son and compare stories. This was the first time my son ever met anyone else who had PA and it helped immensely.
I would also remind everyone that calling 911 or whatever way you get into your emergency system is much much safer than transporting your child in your car to the hospital.
Of course you are going to use your own judgement and not take what I said as gospel. This is my experience and what works for us.
Good luck
Peggy

Posted on: Fri, 09/26/2003 - 1:33am
randgmom's picture
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Joined: 07/21/2002 - 09:00

Peg541, you said one or two epipens are not enough for home and school. How many would you recommend?
I have two at school for DD and two at school for DS, plus two for each of them at home.
I've spoken to a supervisor at the ambulance service on the phone and emailed follow-up questions to him, but a visit probably wouldn't hurt.
Thanks.

Posted on: Fri, 09/26/2003 - 3:32am
Peg541's picture
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Joined: 12/29/2002 - 09:00

You said your ambulance arrival time would be 30 minutes so you need enough epi pens to last that amount of time. If one wears off you need another but for sure don't take this as advice.
Ask your allergist how long to expect the effects of an epi pen to last once administered. I hear all sorts of numbers from 10 to 30 minutes.
Peg

Posted on: Fri, 09/26/2003 - 12:07pm
darthcleo's picture
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Joined: 11/08/2000 - 09:00

Also consider that there is a risk of malfunction with each Epipen. I heard 10%, and even 20% but I have no hard numbers for you, just rumours.
Add to that the fact that sometimes an Epipen is not enough.
A doctor (of all people!) died around here this summer from a bee sting. He had one Epi with him on the golf course, and it wasn't enough. No talk about 20 minutes here, simply that the reaction was stronger than what a single Epipen could handle.
I have 5 Epis around the house, I usually take two out with us, but if we go in a moderate-risk area (we avoid all high rish) I take 3 or 4.
In my own book, two is definitely not enough.

Posted on: Sat, 09/27/2003 - 12:50am
randgmom's picture
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Joined: 07/21/2002 - 09:00

During my conversations with the ambulance supervisor, he said that if 2 epipens had already been administered and, during their transport of the patient, a third became necessary, they have to call the base hospital and get the okay from a doctor. I understood this to be because of concerns about overdosing, which can lead to heart problems.
I asked my allergist if I should ever have more than two available in case of malfunction and he assured me that was extremely rare. Not, of course, that it couldn't happen, but he didn't think it was necessary to carry more than two, and that an ambulance was sure to arrive by the time a second became necessary anyway.
I suspect the answers we'll get from our doctors and allergists and even ambulance staff will vary, so we're probably back to doing what feels right to us.
But I do think it's a good idea to check about the safety of actually administering more than two epipens during a reaction, or if/when that would be okay.

Posted on: Sat, 09/27/2003 - 1:17am
Peg541's picture
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Joined: 12/29/2002 - 09:00

I think that doctor died because his epi pen malfunctioned. Or maybe that is another case but it was a doctor on a golf course and a bee. Too scary.
If I think about epi pens malfunctioning I'm going to DS College, bring him home and lock him in the house. That is too surreal to imagine.
DS carries two and has three extras in his room at school. I have about 4 or 5 at home all in various stages of near expiration.
I tried to get DS to carry a third in his back pack but he refused. He's felt the immediate relief an epi pen gives him and feels confident he can call 911 in time. His school is minutes away from two major medical centers. I have to let him have his confidence since he's gonna do what he's gonna do anyway right?
But a 30 minute away paramedic is another story. Ask the allergist and use your judgement like you said, that sounds smart.
An epi pen is a machine and machines break down.
Peggy

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