Have any of you considered .....

Posted on: Sat, 08/10/2002 - 12:49am
katiee's picture
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Joined: 05/09/2001 - 09:00

pI have been thinking over the number of times I have been faced with medical personnel (ER specifically) who are seriously lacking in education when it comes to Anaphylaxis and the steps to follow when faced with a child having a reaction./p
pWe happen to have a pediatric allergist who truly gets it. I am thinking of asking him for a letter stating what should be done at the hospital when presenting with anaphylaxis. Too many times (notably Wade's last reaction in May where the triage nurse said when I came running in with an unconscious Wade in my arms "he seems fine now" and had us wait to be seen) we have encountered staff that just don't seem to be aware of how to proceed. I know that a large number you have faced the same situation./p
pSo here is my question:/p
pIf we had a letter from our allergist on the allergists letterhead stating what was to be done in the event of an anaphylactic reaction and after the epipen has been given (ie: how long to keep child in hospital, what to do if child is also asthmatic, uncommon symptoms of anaphylaxis, etc), would medical staff be more co-operative? Would our kids receive better care?/p
pLet me know what you think./p
pTake care,/p
pKatiee/p

Posted on: Sat, 08/10/2002 - 1:04am
AJSMAMA's picture
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Joined: 06/12/2002 - 09:00

I am thinking that they would. I know that in the ED at the hospital where I work, the doctors are very good about communicating with the patient's primary caregiver and coordinating the patient's care together. I am confused as to why your child would have to wait in the triage area at all. Had you called the squad for him (I am sorry I am not familiar with your son's reaction story)? Even if you had taken him there yourself, an allergic reaction at my ED is considered an URGENT or IMMEDIATE LIFE THREAT patient and they are taken right to the back for treatment. (there are four levels: non-urgent, stable, urgent, immediate life threat). If you have not already I would contact the ED Administration and/or the patient relations staff at the hospital you visited. Ask what the protocol for allergic reactions is there(get in writing by the medical director of the ED). Next time (which hopefully there will not be) call the squad. No ED is going to have squad patients sit in triage. Arm yourself with the letter from the hospital and letter from your pediatric allergist as to how your son's case is to be managed. Also make them send you a copy of Patient Rights.
Jaime

Posted on: Sat, 08/10/2002 - 1:34am
katiee's picture
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Joined: 05/09/2001 - 09:00

HI Jaime, and that's for the input. Wade's reaction last May was an education for us. It happened at a wedding in downtown Ottawa during a spring festival that required the closure of several downtown streets. It took us over an hour to arrive at the reception (should have been about 15 minutes). Wade did not have a typical reaction, he went from saying him mouth and throat hurt, to vomitting at which poit I decided that he was having some kind of reaction and we were goig to the ER. I did not call 911 because I believed that we would be able to get him there sooner (optimum ambulance time here is 15 minutes). I know better now, it was a lesson learned. I had to administer the epipen in the car after which he lost consciousness.
We arrived at the hospital I ran in with Wade in my arms, he was somewhat alert. I informed them that he had an anaphylactic reaction to peanuts and was asthmatic and I had given the epi. When the triage nurse checked him over, looked into his throat all she said was "he looks fine now" and wanted us to go and wait in the main waiting room which is NOT peanut free, I refused and she had us wait if front of the treatment area. It was only when he began to vomitt (more that I have ever seen in my life) that she took action. We ended up in the ressusitation room because he was having episodes of apnea and an irregular heart beat. After an overnight stay we went home.
I guess it did not occur to me at the time to complain to the hospital patient advocate, I was just so overwhelmed and relieved that he was OK that it did not occur to me to do so.
I have had a number of bad encounters at this hospital usually dealing with Wade and asthma or severe croup. I find that treatment is inconsistant and depending who is working that night will determine how Wade does. For asthma the protocol is 3 nebs back to back and then determine what else is needed. Unfortunately this is not always the case and we get discharged after one mask, which means that he rebounds and we end up back at the hospital.
I guess I'm going to have to learn to be more vocal and speak up when I feel they are wrong. I was thinking that having the letter would demonstrate what action is needed.
I apologize in advance for the length of this, I just wanted to make sure you understood. I thank you for your input and advice.
Take care,
Katiee

Posted on: Sat, 08/10/2002 - 3:13am
AJSMAMA's picture
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Joined: 06/12/2002 - 09:00

Katiee-
Wow-I am sorry you had such a scary experience! Luckily I have not used the epi on my son so I cannot know what you must have gone through in that instance. I was a patient rights advocate for many years before taking a hiatus from full time work to raise my son. I now do physician billing for the Emergency Department at the same hospital where I worked before. I do know that at least in the US they would be required to tell you what the protocol is and they are also required to follow it. If you don't get satisfactory help/answers from the Administration of the ED/Patient Advocates I would suggest that you contact the Risk Management Department at the hospital. It is amazing what they can get done.
By the way, this is a tad different but I know that people who have chronic pain often bring in letters from their doctors explaining what medicines they are to receive in the ED. Without this letter they are often labeled "drug seekers" and not given any drugs. Just something I thought of in support of your doctor letter idea.
Jaime

Posted on: Sat, 08/10/2002 - 6:07am
Dawn's picture
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Joined: 02/22/1999 - 09:00

I am thinking they would, too, and am going to ask for a letter at our next appointment!
When I gave Josh the Epi and drove him myself to the ER, we were virtually ignored!! I kept asking for help and they kept telling me I needed to wait my turn. I was frantic. I wish I'd thought about a patient rights advocate. However, when Josh was brought to the ER (different hospital) by ambulance, he was seen immediately. I always tell people that if the Epi is given, call 911 so he can go by ambulance.

Posted on: Sat, 08/10/2002 - 9:59am
katiee's picture
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Joined: 05/09/2001 - 09:00

Hi Dawn, this is exactly what I was talking about. I think that the letter might make all the difference in the treatment our kids receive in the ER.
Thanks for your input.
Take care,
Katiee

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