Epi-pens in restaurants - Peanut Allergy Information

Epi-pens in restaurants

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(I originally posted this under "Manufacturers" - oops, didn't mean to!)

It just struck me the other day that if all restaurants were required to have an Epi-pen and an Epi-pen, Jr. in their first-aid kits, lives could be saved. If someone's "mild" food allergy, for instance, suddenly turned anaphylactic with a bite of shrimp or a Thai salad at a restaurant, and that person wasn't carrying an Epi-pen, valuable minutes could be saved if the restaurant was equipped with an Epi. It seems like I remember reading something about a woman who had a reaction in a restaurant, didn't have an Epi-pen with her, and died waiting for the ambulance to arrive. Does anyone else think this is something worth pursuing? And how would I go about it getting something done - simply write my congressman? Or maybe start by contacting the local restaurant association?

On Oct 9, 2000

I think this is defintitely worth pursuing - teachers and daycare staff are trained to use the Epi in their first-aid courses, so why not waitstaff at restaurants? If you could do some research on this, you could present a good case in favour of it to your congressman (I'm Canadian, so I can't really advise you how to go about contacting one!). For example, there are rarely contraindications for using an Epi - that is, if the allergic reaction turns out to be a minor one, using the Epi won't do any harm. The government needs to be aware of this fact, before they proceed. Do a search on the net using "EpiPen" or "Anaphylaxis" and get some statistics to present your case. Good luck - go for it!! Carolyn

On Oct 10, 2000

Hi. I responded to this post in the other board. Just thought I'd mention it here too.


I absolutely cannot imagine holding restaurants accountable for medication. I mean, who administers it if you are dining by yourself? The busboy? What if the meds expire? What if the eater dies of a heart attack from the epinephrine (I'm sure that must happen sometimes)? I know there are some states (or provinces) that have Good Samaritian Laws, but I'm quite sure where I live, they do not.

Needless to say, teachers should be trained for anaphylactic reactions.

On Oct 10, 2000

You have a great point with the epi-pen at the restaurants. Unfortunatly I bet it would take lots of time to get something like this to pass. My brother are both in the restaurant business, and take this allergy stuff very serious. My one brother is very allergic to shell fish. The other a chef. The chef has seen my son have reactions to nuts so he totally is careful with cooking. If someone comes in with an allergy he takes them back into the kitchen to approve all ingredients in what he is making. I think that if allergic people were even to wear a braclet saying administer epinephrine then the restaurant should not be responsible for trouble that may occur. As far as the Epi-pen being outdated that also should be a problem because it doesn't take long to get a refill and to check dates. I hope that someday this could be possible,but I think people have become to sue crazy in our world. They forget the thanks that people do deserve. Good luck with this topic.

On May 30, 2001

hello, this is a good idea, but the lawsuit side is a reallity abet depressing....but if staff require a first aider etc , why cant epi-pen training be part of that, training that also inculdes symptoms of allergys ?, After all this is just sound common sense , if we can get restaurant staff to have at least someone capable of ringing for help stating allergy etc , that must be some help. now thinking about it l might just nip down with a few leaflets and enquire at my local restaurants. bye williamsmummy

On May 30, 2001

Lovely hypothetical, but if paramedics aren't qualified to administer an epi-pen in some states, restaurant staff CERTAINLY aren't. (On another sad note, at this point, epi-pens are not even a standard part of first aid certification, so if you haven't trained the teachers, I wouldn't assume they know when & how to either.)

On May 30, 2001

Every time I start to think, yeah, they're right, how can we expect restaurant employees to handle the responsibility of an epi-pen, I keep coming back to "airplanes carry them, don't they?". And flight attendants aren't doctors or trained emergency personnel, right? How does that work if someone has a reaction or other medical problem in-flight? Are they just covering themselves by having a well-stocked first-aid kit and then crossing their fingers that there'll be a doctor on board? I'm asking - I really don't know.

At the very least, restaurants could do that if they didn't want to assume the larger liability of actually administering it - just have the epi on hand and then let any medical types who happen to be around - or some other Good Samaritan - take charge in the case of an emergency.

Something to think about anyway...

On May 30, 2001

Be very careful, jh5000. I am afraid you have a false sense of security. NOT all airlines have epi, NOT all ambulances have epi, NOT all schools are epi-literate. YOU need to be responsible for always having your medication on hand. I admire your idealism, but please don't let it jeopardize the safety of you &/or your family.

On May 30, 2001

I appreciate your concern, sillyfeline, but I feel pretty confident that I've taken the steps to protect the safety of my daughter - as I've stated in other threads, I have 10, (yes, 10) epi-pens. Two in my purse at all times, two at home at all times, two in a small carrying case for my husband, two at my daughter's preschool, and two with her babysitter. I haven't taken a flight with her since she was diagnosed, but I can assure you I'd take all ten pens with me (as well as a liquid steroid, benadryl and a nebulizer.) [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Clearly, I absolutely agree that the allergic person or parent of should assume 100% responsibility for carrying their meds. I discussed my reasons for epis in restaurants in greater detail under the "Manufacturers" board when I first brought it up (I accidentally posted it under there first and the bulk of responses unfortunately wound up there.) In no way am I suggesting that restaurants or airlines be primarily responsible - I just saw it as another possible layer of protection at a place where a food-allergic person is at greater risk, something in a first-aid kit that could save the life of someone who maybe forgot their epi or who thought they had a "mild" allergy so didn't carry an epi.

On May 30, 2001

I guess I will be pilloried by some for what I am going to say.

I am a retired restauranteur (and PA/TNA), and I would have fought having to have epipens in our restaurant. I would not have trusted my staff, as good as they were, to administer a shot to me.

We, or our children, are the allergic people here, and we need to take responsibility for ourselves when we go out voluntarily to a place to eat or be entertained. Now, I do feel differently about schools, because we don't have a choice about sending children to them.

But as an allergic person, I decide if I am going out to eat and where I am going to eat. Therefore, I also take the responsibility for providing my own medication and making sure that someone with me can take care of me if I need help. Or else I don't go. I do not go out to many restaurants because I can't trust the food. This is a smart decision. I know that death can be just around the corner. So I take care to have my medication handy at all times.

Most restaurant staff people barely know how to administer the Heimlich maneuver. I don't want them sticking needles into me.

Do you realize that most restaurants do not have a decent first aid kit? Do you realize what their insurance liability would be if they administered medication or handled a medical emergency incorrectly? I do. I paid our insurance bills. I did everything I could to minimize the possibilities of lawsuits.

My philosophy is that I live in a world of peanuts and tree nuts. I have to adapt my life to the world, and not the other way around. I don't expect people to be responsible for my epi nor would I expect them to be responsible for my husband's nitroglycerin or my friend's insulin.

I know many of you will disagree with me, but I think I speak for most restaurant people. I do support more allergy training for restaurant personnel, especially the management. I do support nut free schools.


On May 31, 2001

It would be great to think that epipens would be available everywhere someone went with a pa child that might result in exposure. That would of course mean zoos, rodeos, circuses, football games, baseball games all would have to have them. The would create an incredible market for the epipen and would ultimately affect price due to the laws of supply and demand. Sorry on this one I think everyone needs to see to having their own. Besides can't you just hear the kid at McDonalds..."Do you want fries with that?" (Sorry about the humor it was the very first thing that came to my mind when I read this post) As far as airliner carrying epipen I doubt they do unless the know that they will have a passenger on a particular flight who is severly allergic to certain foods. Epipen are prescription items, and I doubt they could just put one on every flight.

[This message has been edited by MattsDad (edited June 01, 2001).]

On Jun 1, 2001

MattsDad -

Airlines, in fact, have been REQUIRED to have epinephrine on hand, in addition to other medications, including another prescription med, nitroglycerine, since 1986. I found an article dated April, 2001 containing the relevant information below at [url="http://www.therubins.com/geninfo/airdefil.htm"]http://www.therubins.com/geninfo/airdefil.htm[/url] (as well as other sites, too):

"Airlines are taking steps to increase emergency medical care on all their flights. Currently, the FAA requires the following medical equipment to be available on all flights: a first-aid kit with bandages, scissors, smelling salts and an emergency medical kit that includes nitroglycerin pills, EPINEPHRINE, inhalers and other life-saving equipment. The latest addition to these kits, latex gloves, was mandated 13 years ago. The newest addition is the defibrillator to be used in cases of cardiac arrest."

So, there is precedent for allowing non-medical personnel to administer epinephrine in emergency situations - of course, proper training would have to be assumed (all restaurant managers could be trained, since, in theory they would be the more responsible restaurant employees).

When I initially brought this topic up last October (see also the sister thread that I accidently posted under "Manufacturers"), I quickly backed off the idea of MANDATING restaurants to have epi on hand. I think instead you could start with a voluntary compliance push and, eventually maybe, as in the case of airlines, it would progress to legislation. Pie in the sky, yes; difficult, absolutely. Of course there would be resistance. But then there was long-term resistance from manufacturers to have proper allergen ingredient labelling and look what was announced yesterday - the labelling changes we've all been waiting for!

As far as "where does it end" - MattsDad, you mentioned "That would of course mean zoos, rodeos, circuses, football games, baseball games all would have to have them." Well, maybe that's the next step. Like it or not, the U.S. is an overly regulated country - let's use it to our advantage for a change.

And again, like I stated above and in the other old thread under "Manufacturers", I, TOO, BELIEVE THAT EVERY FOOD-ALLERGIC PERSON SHOULD BE RESPONSIBLE FOR CARRYING THEIR OWN EPI. It's the people whose physicians haven't prescribed an epi for them, or the people whose "mild" allergy suddenly turns anaphylactic with an accidental bite of the offending food at a restaurant, or okay, people who usually carry their epi but forget it occasionally. They're the ones I'm thinking of. Just another layer of protection at places where the risk of a reaction is greater.

Is this the most important issue facing our community? No way. But it could raise awareness, and ultimately, save a life.

Well, now that I've said all this, it looks like I'm going to have to put my money where my mouth is and start talking to restaurant associations. Yikes!!! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

[This message has been edited by jh5000 (edited June 01, 2001).]