Do you have an epi-pen at school?

Posted on: Tue, 03/25/2003 - 6:04am
Anonymous's picture
Anonymous (not verified)

My situation is a little (ok a lot) different than most parents here. My son has an allergy to insect bites/stings. I carry an epi-pen for him mostly because places we go where he is likely to get bit/stung are far from hospitals. His first reaction was to a bite to his ankle and he swelled to the hip. The next was a sting behind his ear and the back of his head and side of neck (outside)swelled. Both times we did go to the hospital, and waited for the benedryl to fully kick in. Since bite/sting allergies are often fatal I now carry a jr. epi.

Here's my problem, I am more worried about him unnecessarily getting epinephrine than I am about anaphylaxis. I know that goes against what a lot of others here feel, but I've had that stuff, so I'm not totally unaware of what we're talking about. I'm just worried about school. He has never had a reaction in the city we live in. It's always been in another province - on a farm actually - and even the doctor agrees that the insects he's allergic to are probably not around here.

If I send an epi-pen to school can I trust them to follow my instructions? Benedryl first and call me. IF he has breathing difficulty or swelling in mouth give epi and call ambulance.

I know that this goes against what many of you believe for YOUR child. I'm NOT suggesting YOU follow my instructions. I don't know your child or his/her situation, but I do know mine. So I hope we can agree to disagree on that point, and I would still like opinions of whether or not to trust the school.

BTW, it seems his school does not have it's own guidelines. They use the school districts guidelines (which I am going to try to type out for Cindy and friends) but it's very broad since it deals with kindergarten to grade 12.

Posted on: Tue, 03/25/2003 - 6:56am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

What does your physician think? If you could get a physician to say what you did (Benadryl first, etc) then the school might feel more compelled to listen...
It does seem that any person who has ever had anaphylaxis from any cause is a bit more susceptible to it in general- if it were me I would work on getting them to follow my Emergency Action Plan rather than not providing epinephrine at all. How rapid was your child's anaphylaxis? (Might make a difference.)

Posted on: Tue, 03/25/2003 - 10:03am
Dawn's picture
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Joined: 02/22/1999 - 09:00

AnnaMarie, I am in a similar situation, my ds is allergic to both pnt and bees. Well, maybe fire ants, too. I will be watching this thread closely because I have been wondering the same thing, thinking he may get the epi and an ambulance ride unnecessarily.
I plan to ask his allergist when we go in April, but for now, we are going with the plan that he will recieve the epi if he shows 2 or more symptoms, the same plan for his pa.

Posted on: Wed, 03/26/2003 - 1:06am
Anonymous's picture
Anonymous (not verified)

First, my son has not had any breathing difficulty from insect bite/sting. Only swelling outside. That, of course, doesn't mean he won't have anaphylaxis next time--or the time after. WE all know, reactions that WERE just inconvenient or uncomfortable CAN become fatal.
The doctor at first felt that an epi-pen was only necessary when we went on vacation. That's where my son has had his reactions, and we stay about 1 1/2 - 2 hours from the nearest hospital. There is no phone, other than our own cell-phone and it is not reliable there. The plan is -- we give him antihistamine and get in the car headed to the hospital. If any breathing difficulties start I give him jr. epi and we pull over at one of the two places we know we get cell service (yes, we know exactly where on the road to pull over). We call 9-1-1 and find out where the ambulance will be coming from, and drive towards it, to meet at an agreed upon location. The first time we drove to the hospital and saw a really good doctor. He had us wait at the hospital for about an hour after all swelling went down, then advised us to stay in the city for several hours. He also suggested I take him to his doctor to get epi-pen. The second time, we sat in ER, told them what was wrong, but didn't want to see a doctor unless things went bad -- then we didn't want to wait, but get in immediate. The nurse complained to the doctor about my request, but he told her I was doing "exactly the right thing". He came over took a quick look at my son, agreed only the outside of his neck was swollen (no difficulty breathing) and told me to HOLLER if anything else started swelling. "We'll deal with the paper-work later."
My doctor was only agreeable to giving me a prescription for the jr. epi because he knows I won't *over-react* and give it if it is not needed. (Not to say others would be over-reacting - just referring specifically to my son.)
I never concerned about school because he was two when this started. However, the school he is in does not have garbage cans at the doors or in the playground. There is a HUGE park all around it though. Lots of plants and greenery, so, that has raised my concern.

Posted on: Wed, 03/26/2003 - 6:04am
California Mom's picture
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Joined: 07/14/2000 - 09:00

I've discussed this concern with my dd's allergist - that of the school administering the epi-pen when its not really needed. Our doctor felt that this was not something that we needed to be concerned about. She felt strongly that nobody wants to use the epi-pen, and that teachers would be most likely to hesitate, and be sure it was really needed before they used it. Of course, this was just one doctor's opinion, but it reassured me greatly. Good luck, Miriam

Posted on: Wed, 03/26/2003 - 6:48am
Anonymous's picture
Anonymous (not verified)

Anna Marie, do you have any type of medical plan or form filled out for your son at school indicating that he is anaphylactic to bee stings? I know that Jesse's school just learned that they had a child in their midst that was anaphylactic to bee stings and they were horrified that they didn't learn about it at the beginning of the school year. The superintendent just said "well, at least it's not that season yet".
Now, as I posted elsewhere, I have seen the emergency medical plan for the other PA child in Jesse's school. It is very different than mine. Very different. The different that makes me look like Psycho Mom from He**.
But, if you get the emergency medical form from the school (it should be a really standard piece of paper - it is used for any type of medical condition whereby the school is given the *right* to give your child medication - i.e., I eventually have to get one filled out for Ember for her migraines allowing the school to administer Tylenol), you are allowed to put YOUR instructions of what YOU want done on it.
So, yes, you can very well say if your child is stung, administer Benadryl. Then, if the other symptoms you mention happen, Epi and dial 911. The form does have to be signed by a doctor. I have always just filled out the form myself, with MY instructions to the school (even if they weren't followed this year when Jesse had his anaphylactic reaction) and the doctor has read them, understood where I was coming from, and simply signed off on them.
I think your plan makes sense. From what YOU have experienced with YOUR child, why would you want to have an Epi-pen administered if it didn't have to be? Even when Jesse had his anaphylactic reaction in December month whereby the school *should* have administered the Epi-pen (per my instructions in his emergency medical plan), I chose, as his Mother, NOT to administer the Epi-pen.
I did post a question after that reaction about whether Epi-pens cause *wear and tear* on the body and they don't. However, I would still prefer that my child NOT have to have one. Now, my instructions to the school are different than what I follow at home, but, to me, that's none of their business. I can trust my *gut* at home. I can't trust the teachers and other people at the school to trust their *gut* re someone else's child when Jesse is at school.
I think your instructions are clear. I don't see any problem with them. In fact, I have seen PA parents with basically the same instructions.
Yes, a lot of us do have different ways of dealing with this (for example, my instructions to the school are very different than say another PA parents), but I do believe again this enters the comfort zone thing and although we can certainly discuss things whereby someone may take a look at their situation again (as I did with "may contains" in Jesse's written school plan), it is never our place, IMHO, to question what YOU feel is right for YOUR son.
I think your instructions are clear, not confusing to the school, and I also think a doctor would sign off on them no problem.
Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
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Posted on: Wed, 03/26/2003 - 6:51am
Laureen's picture
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Joined: 01/26/2003 - 09:00

DD carries an epi-pen in a pouch around her waist and there is another one for her in the office in case she needs another shot before the ambulance arrives.

Posted on: Wed, 03/26/2003 - 9:48am
becca's picture
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Joined: 05/22/2001 - 09:00

I think the key thing to communicate is that the epinephrine is used to treat anaphylaxis, *not* the bee sting. So, it requires observing his *reaction*, not simply administering the epipen upon acquiring the knowledge that he was stung.
I do see your concern there. I have had two converstions in the past two weeks where someone brought up insect stings and being concerned about anaphylaxis. Both cases involved first time stings to children and the adult in charge feeling very fearful of potential anaphylaxis. One was a 20 minute hike into the woods. What that says to me is a perception by the general population that it is fairly common to have such a reaction to bee stings. If they had epipens, would they overreact and give it uneccesarily? Who knows? But I see the conceren since I just had these conversations.
I personally think it better to have the lifesaving drug available just in case, but I do not know the true likelihood of a reaction converting to more serious ones based on histiry of reactions. If it is known to be unpredictable, like PA, I would have it at the school. It is not too likely he would be stung there, but it could happen. I would just be clear about not giving the drug for the sting, but for anaphylaxis, and teaching the signs of anaphylaxis. Becca

Posted on: Thu, 03/27/2003 - 12:21am
Anonymous's picture
Anonymous (not verified)

Thank you everyone for your opinions and ideas. Also, for your understanding.
I think the reason I'm worried is I used to work in the lunchroom of an elementary school. There was a child in my room with an anaphylactic food allergy and his mom and I talked to make sure I understood her instructions. HER instructions were antihistamine and call her - an adult stays with him to watch for further reactions - epi-given only if throat/mouth/breathing affected. One day the little boys teacher came to talk to me (months later) to make sure I knew this little boy had an epi-pen. She told me if he gets "one hive - one itch anywhere" you get his epi-pen and give it to him. That night i called his mom to let her know and again she was back at the school to re-explain everything. This was the second year the boy was in that teachers class.
Funny thing is, the boy (grade 3 at the time) came up to me later and said "she really doesn't get it does she - one little hive might just be a mosquito bite, not a hive" he laughed and asked me to help wrestle it (the epi-pen) away from her if he got bit.
That happened at a school that really didn't "get it" with a teacher who was terrified of her anaphylactic student. It just scared me enough that I have to decide where the bigger risk is.
BTW, I did fill out the forms about his allergy, I just didn't include info about an epi-pen because i wasn't leaving it with them.
Like you Cindy, I trust my own "gut" more than theirs. Since your son has had ana. reactions you feel for him it is better to use epi sooner. Since mine hasn't I feel for him it is better to wait.
Again, thank you all for your help. I think i will go in and actually talk to the principal - maybe if i like her responses I will feel leaving the epi-pen there will be the right choice.

Posted on: Thu, 03/27/2003 - 2:01am
Anonymous's picture
Anonymous (not verified)

Anna Marie, are you close to the school? How reachable are you should the school call you in an emergency?
I can sense that you're hesitant to leave an Epi-pen at the school and I also completely understand why. You don't want it used if it doesn't have to be. Your last post about the teacher that didn't "get it" pretty well sums things up.
However, with your son, the symptoms that require Benadryl are SO clear. I would say, if my son has these symptoms, please administer Benadryl. Should other symptoms occur (such as.....) then administer the Epi-pen, but only if other symptoms appear. You can be very clear in your wording on the medical form (not that clarity helped Jesse in December month at his school [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img] ).
These again, are basically what the other PA parent has instructed Jesse's school. If this happens, administer Benadryl. But, if this happens, administer Epi-pen.
Please let us know how your talk with the principal goes. When I first met the principal at this school, she was new this year, and I really got the sense that she was reluctant with me and felt I was telling her how to run her school (although I don't come across as demanding at all except I have a written school plan in my hand). We had the newspaper article done and I chose to have it written that the meeting went well and kinda put a spin on what had actually happened in the hopes that I could get the principal to turn around and work with me on this. It worked.
Please let us know how it goes.
Now, *should* be posted in your other thread, but wow, what a lot of typing. It took me enough time to Control C it, I haven't even had the opportunity to read it yet. Thank-you SO much. I am sure this will be helpful to many members and remember, you won't hear from everyone that you help and everyone that uses the plan. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
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Posted on: Fri, 03/28/2003 - 11:32pm
Anonymous's picture
Anonymous (not verified)

I'm about a 5 minute walk from the school, at my regular fast pace. Quicker if I want to be... I'm almost always home, and have call waiting (for teenagers and emergencies). I really am *easy* to get hold of. Oh ya, and internet is on cable, so that doesn't interfere with my phone either lol.

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