HELP! school tried to give epi-pen when no reaction

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What would you do?

My child is 6 and apparently having issues with the fact that she has a nut allergy. Normally she is great about her allergy.

She grabbed and ate a cupcake made on shared equipment in the classroom, when the teacher saw what she had done, ran her to the nurse. The nurse was trying to administer the epi-pen when she had no signs of a reaction. Why??

I know I have to go in and educate the school again, but what would you do? Obviously lecture the kid about not allowed foods again - she grabbed the cupcake "because it looked fine." But what about the school? How do you straighten this out. They were not even looking for signs of a reaction - just giving the epi-pen almost as a preventative.

HELP!!!

On Apr 19, 2007

Shouldn't the nurse have orders from the doctor for the use of the epi-pen? Ours are very specific--what to look for and when to use the epi-pen or Benadryl. Under the circumstances you described, it might be reasonable to administer some Benadryl according to our plan.

I'm not sure what you mean by "trying to administer the epi-pen." Did someone stop her? Were they on the phone with you at the time? Did she have second thoughts? Did the epi-pen fail?

If I were in this situation, I'd talk to the teacher about not allowing access to any foods that are questionable. Seriously, why did your DD even come within arms' length of these cupcakes? That would be my real concern. For the epipen, I'd just ask the nurse if she didn't understand the doctor's orders and maybe she'd like to talk to the doctor to have them clarified. If you don't have a written protocol in place, you need to get one.

But overall, except for the incident that led to the trip to the nurse, I wouldn't be terribly worried--getting epinephrine administered when you don't need it isn't a horrible thing (my DD gave herself an accidental injection last summer) and is WAY better than the alternative of having a nurse who hesitates to give epinephrine when it IS indicated.

Sarah

On Apr 19, 2007

Perhaps you don't know this, but if your child has ever had a very severe anaphylaxis episode, this [i]is[/i] the recommended course of action.

(To use EPI prophylactically when a suspected ingestion occurs, that is.)

I certainly sympathize with your daughter's desire to eat what looks wonderful, but her behavior was the problem here, IMO, [i]NOT[/i] the school's immediate response to it.

If the cupcake HAD contained peanuts as a hidden ingredient, they might well have saved her life by not waiting to see what happened.

The bigger question in my mind is how such a thing happened to start with-- why was your daughter able to reach out and grab a cupcake she should not have had, and then, before action was taken, [i]consume it??[/i]

At the very least, it sounds like preventative measures in place need some work. Are her classmates educated about her allergy? If not, it might be a good idea to work on 'no food sharing' as a part of food allergy awareness on the part of her peers.

On Apr 19, 2007

At 6, is your child being asked to trust a lot of people to read labels and judge food safety for her? If so, it might be time to examine that policy and see if that is making it hard for her to understand 'the rules' about what foods have been properly approved and which have not.

It sounds like she made her own judgement about 'safety' here instead of deferring to an adult. Is it that she is used to a variety of people handing her 'safe' food? Might she be confused about the rules? Who is it okay to accept food from? Is she supposed to decide whether or not it is safe to trust a particular adult's decision about food safety? If so, it might help her to have simpler rules about what is okay for her and what is not. At least until she's older.

As I said, though-- the scarier thing is that there was unsafe food in her environment with inadequate supervision regarding it. Asking her to 'know better' may not be entirely appropriate for her developmental age. She [i]is[/i] only six, after all. Her impulse control may just not be up to the task. Particularly if she doesn't understand the consequences very well.

On Apr 19, 2007

I agree with Corvalis Mom...from age 4 (time of diagnosis) my son would not touch, eat or accept ANY food that he had not asked the adult to read the label or that one of his parents hadn't approved.

You have to educate your child how to manage her allergies. That there are rules for food, this is very important.

You have to empower your child to make decisions about eating and teach her in a way that she doesn't become afraid...when the rules are clear, I feel that children are less likely to be afraid of food etc.

I don't know what to think about the nurse trying to give the epi pen...why did she stop, can you offer more details about this?

On Apr 19, 2007

She is 6 and very well behaved, which is no doubt part of the problem today. Her behavior today in unheard of for her - grabbing food, not asking if it was safe first, unheard of for her. Her teacher is her classroom contact to check foods. She has a safe snack bag in the class. She brought a safe snack for the party today. She just wanted to be like everyone else for the party. Sucks to be different and it sucks to have food allergies.

She tells everyone about her allergy. She asks adults about the labels. She tells aunts and uncles who offer food that they need to talk to her mom first and then she brings them to me. Overall, I could not ask for a better child when it comes to dealing with her allergy.

However, she is apparently having issues with allergies and other people having different allergies at home. We have a new food allergy that is limiting our food choices and she is having a hard time adjusting. Several comments have come up recently - including last night - about wishing she was allergic to something else...

I understand what happened in the classroom. Yes, teacher needs tighter control about the food. Yes, the child needs to follow the rule about food. She broke the rule. She grabbed unauthorized food and ate it. It is a shared facility item - cupcake. She did not have a reaction. I do not allow her to eat shared equipment foods. She knows this.

The nurse has an emergency plan from the doctor. It was not used. The plan is Benedryl for this type of problem, epi-pen for allergic reaction, then call 911, then call parents. So the emergency plan was tossed out the window today.

Heck the whole discussion about allergies and food rules and general behavior went out the window today. But, I am not at the hospital with her and she is fine, so life is good. We just need to clear up the process so next time we follow the emergency plan.

I really would like opinions about this episode so I can have a better idea of what to talk to the school about tomorrow.

On Apr 19, 2007

But, what kept the nurse from administering the epi pen?

On Apr 19, 2007

Ahhhhhhhh... I see.

So the teacher is [i]depending upon her[/i] to consistenly behave in a manner which is habitually more mature than her peers.

The problem was that she didn't. In this case, she behaved EXACTLY like most six year olds. [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img]

I know [i]precisely[/i] what that is like. BTDT.

Time to remind the teacher that your daughter is NOT ten. She's six. While she may [i]act[/i] more like a 10 yo w/r to her allergy [i]most[/i] of the time.... this incident shows very well why it is not very responsible of the adults she's with to [i]assume[/i] that she will. Which is the fundamental reason why she was [i]able[/i] to do what she did.

I'm sorry for your daughter. My daughter also has periods like this... where she feels deeply resentful and defiant about the differences between herself and her peers. Sometimes it helps her to hear that I understand how she feels and that she can [i]feel[/i] any way she wants to-- as long as she doesn't turn those feelings into inappropriate actions. This is a work in progress at our house, too. [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img] I have to remind myself that my child is NOT as old as her behavior would often indicate.

I must say, I can see how resisting a lovely bakery cupcake must have felt cruel and grosssly unfair to her. Just too much, you know?

hugs}} to both of you.

On Apr 19, 2007

Did the nurse actually administer the epi-pen? I read she was 'trying', but what did the nurse actually do?

How scary for your daughter that the nurse showed confusion about what to do.

I think this is right on: [b]So the teacher is depending upon her to consistenly behave in a manner which is habitually more mature than her peers.[/b]

This exact scenario happened to my DD is 5th grade. She ate a "may contain" food that she thought the teacher had approved, but hadn't. The food wasn't even supposed to be in the classroom. When the teacher realized what happened, she marched Mariah down to the nurse who immediately gave her benedryl. Not terrible, but that's [b]not [/b]what our plan stated. My daughter was very upset on several levels, and we ended up having a few meetings with staff to address it all.

On Apr 19, 2007

Let me clarify. The teacher called me from the nurses office. Explained that the nurse was about to administer an epi-pen. Without reason or signs of a reaction I told them to stop. She is not as severe as some other kids. She does not have contact or smell reactions she never even had a second reaction, but she is allergic and anaphylactic. Her first reaction was anaphylactic and it was years ago.

Part of my problem is I was told they did not have benedryl for her. Later when they called back they did have her benedryl. It was supplied in the beginning of the school year. .they gave her the benedryl.

Our emergency plan states: benedryl for this type of problem. Possible ingestion/cross contamination problems. Epi-pen and 911 for active anaphylactic reaction.

Yes we have some issues to address with the child and the school. Just a little upset that the school seemed so flustered and unsure about what to do. Why were they on the phone with me? Should have been talking to 911 if they had the epi-pen out. Why did they not follow the plan and give the benedryl first? why was I told they did not have benedryl for her?

days like this just make having kids with these allergies a nerve wracking experience.

And I am sorry to say this but I am mad that my daughter broke the rule and ate the food. She knew what she was doing. She explained it to me. I am mad today. She risked a lot and unfortunately she will do it again because nothing bad happened. So today life changed again - new rules.

And yes, days like today are why you carry and epi-pen even if your kid is good about their allergy and even if they have not had a reaction in years.

Thanks for the comments and advice

On Apr 19, 2007

I am [i]totally[/i] sympathetic--

I've been plenty mad at my daughter too!!

Even when I [i]know[/i] my expectations are soooo not age-appropriate... we have those expectations for a reason, you know? She sometimes just [i]has[/i] to be that responsible.

I also find that some of that anger is misplaced frustration at the world I inhabit being such a place that the adults I know can't be trusted as much as my little girl.... ugh. Makes me want to stomp my feet too. [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img]

[i]What? You're too STUPID to get it??? Or is that just 'too lazy to bother?' So my kid has to have the critical thinking skills of a college professor to make up for YOU??? She's supposed to anticipate all the crazy cr@pola you might not think about.... Who's robbing who of a childhood????[/i]

So some of my anger is invariably misplaced on my daughter. ( But not all.)

Anyway.... ranting over-- I definitely feel your pain. And I agree that I would definitely want to know why your physician's plan wasn't followed, and why the HECK they thought [i]calling YOU[/i] was the thing to do??? Maybe your 6yo is supposed to remind them not to do so if she needs EMS??? [img]http://uumor.pair.com/nutalle2/peanutallergy/tongue.gif[/img] LOL.

On Apr 19, 2007

Yes, I agree. It is very disturbing that they were not clear as to whether or not to administer the epi pen. Our plans are similar to yours, administer benadryl for suspected ingestion or itching/hives if symptoms persist and a second symptom appears, to give epi pen. Call 911, request a paramedic, call parents. Is the lady a RN? I would be worried. Sorry I focused so much on what your child did in my earlier post. I guess that I continue to feel that this is such an important rule for our pa kids.... You definitely are owed an explanation from school! Hang in there!

On Apr 19, 2007

I've asked my school to do mock-reactions to see how everyone handles the situation...almost like a fire drill(but no prewarning)...they won't do it. You don't know if everyone will do what they are *supposed* to do until it actually happens. In a way, this was a good practice run, your daughter was thanfully not in serious danger, so they messed up, they messed up bad severeal areas and times....they need to fix this now! I would write down what happened, play by play and have a meeting with the nurse, principal, teacher everyone involved with this. Write down step by step what happened and what *should* have happened, all agree together what needed to be done in this situation....I think the only way to prepare them for the enxt time, the possible *real* emergency is to practice and correct what happened! HUGS

------------------ Chanda(mother of 4) Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma) Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma) Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig and EE) Savannah-1 (milk and egg)

On Apr 19, 2007

I think the most concerning thing is that they said they did not have the Benadryl when they did. It is way too important that they know where the meds are. Isn`t there some sort of designated place to keep them? And if your action plan says this is not an epi moment, then for them to use epi because they cannot find the Benadryl is unacceptable.

On Apr 19, 2007

I just went over this again with our nanny and our teachers at school. I would want them to administer the epi if my child ate something that was on shared equipment. This is also the recommendation of our allergist although our last reaction was 4 years ago. This is on her emergency plan.

On Apr 19, 2007

[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

[This message has been edited by NicoleinNH (edited June 10, 2007).]

On Apr 20, 2007

Well unfortunately the discussion last night was with a 6 year old who is just a kid behaving like a kid. She wanted that cupcake because it looked soooo good. And because nothing happened, she will do it again. She used logic to decide which cupcake to eat to minimize her risk! After all, she got the food she wanted, hung out with the teacher all day, then hung out with mom for the rest of the day.

What is the down side using kid logic? none. No amount of discussion gets past the statement of "it just looked sooo good". How do you punish that? She has no clue and sees no downside to yesterdays actions. What can I take away - food she already can't eat?

Unfortunately the defiant years have started at age 6!

On Apr 20, 2007

I suppose that based on everyone's history and individual child's personality, this can be a difficult point to drive home. My son had just turned 4 when he had ana reaction. He still remembers having a "hot" tongue, not being able to breathe, having about 15 doctors and nurses poking him and hooking him up to iv's. So I guess that experience has stayed with him and it is one he has a lot of motivation to avoid. Without that experience, I think I would be having a hard time helping him understand the consequences. KWIM

On Apr 20, 2007

DD became PA at 18 yrs. That was tough. Many things she'd eaten for years were now off limits.

She spent some time eating 'may contains' or things with obvious cross-contamination possibilities. Only minor reactions - sometimes. And because she's out so often, I don't hear about these reactions at the time.

Makes me worry, but DD is now realizing that it's an unnecessary risk (she's reacting to more nuts now) and is much more careful.

I still hear the 'it sucks to be allergic to...' from her. I agree, but that's her life now.

She was TNA years ago, (still is), I didn't know much more than an epi-pen at school, but she never has had to use it.

I guess that if a child has never had or doesn't remember a serious reaction, they are more willing to take chances.

On Apr 20, 2007

I find it very scary when you say "She will do it again." I know kids are defiant but PA defiance has a whole different set of circumstances doesn't it?

Maybe it is time to tell her a few very carefully edited stories about kids who did not do so well. That little girl in Canada comes to mind. The FIRST day she decided to try the fries in her cafeteria. Her mom was worried as she gave her the money for the fries but She reassured her mom she'd be fine. She wasn't and her epi pen was not close enough to save her life.

The spoon the fries was served with was conatminated with milk, her anaphylactic allergy.

My son is 22 but two years ago we had a BIG fight over a drink he had at Starbucks without asking ingredients. Some silky chocolate thing in a very small cup. He said "Peanuts in coffee?" It was not coffee and my gosh it could have had anything in it.

Don't punish your daughter but give her a new BIG rule. [b]You may not take any food that did not come from mommy or daddy. PERIOD. Even if you starve, even if it looks YUMMY. [/b]

We'll make yummy SAFE cupcakes once you get home from school to make up for the cupcake you did not get.

I don't know how it happened but my son never discussed deprivation with me. I don't think it happened that he watched the other kids eat their yummy stuff and felt he should have some too. He knew from K that an unsafe food could hurt him very badly.

I found many many ways to reward his restraint, a closet full of LEGOS comes to mind and my baking skills also increased trememdously over the years.

I know he's angry about his PA but he's also alive and about to graduate college.

Peg

On Apr 20, 2007

I forgot to mention the school. We scare them to death when we tell them about PA. I think I'd rather have them give the epi than hesitate. But maybe you can get her Benadryl at least in the classroom? Peg

On Apr 20, 2007

I think when a child can remember back to a scary reaction, it helps them look at cupcakes and say *it's just not worth the risk*....but without something to draw on, it's hard to *imagine* what would happen by just eating a yummy cupcake. My son has had some neck squeezing reactions(we didn't use the Epi..don't get me started, I didn't know any better) but I do play the *remember when your neck squeezed* card as often as needed. I do also share some stories with him(all my kids) about deadly reactions(like Sabrina Shannon)....I don't go into gross detail, just that a girl ordered french fries at school and they had been touched by a spoon with cheese on them, she had a reaction and didn't have her Epi...and she did die. I've shown him and my daughter her picture, so they know she was just a regular kid like they are....I am not adivising you do that, by no means(comfort level). I have and it helps him stay in check. He is still 6 and argues as to *why* he can't eat the classroom cupcakes, but it's a little easier for me to *remind* him of what we've learned about how we don't take chances...ever! Good luck and HUGS

------------------ Chanda(mother of 4) Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma) Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma) Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig and EE) Savannah-1 (milk and egg)

[This message has been edited by chanda4 (edited April 20, 2007).]

On Apr 20, 2007

One helpful tip-- it sounds like you are dealing with a DD who is very self-determined and stubborn beyond all human expectation. LOL. Not that I would know what [i]that's[/i] like. [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img]

Ummm.... anyway.

My then 6 yo DD began doing some of these things too. NOT taking food, BTW.... ohhhh, so-scary.... but 'forgetting' things and just being a little bit defiant. She'd had enough and didn't feel like taking it anymore. You know?

At any rate, we also were battling with her 'kid logic' (which wasn't exactly unintelligent as far as that goes, but was still 'kid' logic) which said that 'nothing bad happened.' We realized that she had NO recollection now of her near-fatal reaction when she was 2. For years, she [i]did[/i] remember it. Vividly. And it made her [i]very[/i] careful. But then that wore off right about the time she decided that being FA was a pretty big PITA and she didn't [i]feel[/i] like it.

So my tip for you is that if she's tuning you as parents out, it is time to scare her straight with your allergist's help. Line up an appointment with him/her for the [i]express purpose of discussing this incident at school.[/i] This puts appropriate emphasis on how serious this infraction [i]might[/i] have proved. And maybe she'll hear it better if it comes from another authority figure. DD 'hears' some things much better if they come from 'Dr.' 'Mr./Ms.' than she does from us.

Once our allergist addressed the need to keep epipens ON YOUR BODY all the time, we have had [i]far[/i] fewer problems.

We also had a kind of 'natural consequences' strategy about it-- if you can't assume a certain responsibility, then an adult will have to. But that comes at a price, right? The price being reduced freedom and autonomy. Which my iron-willed child [i]definitely[/i] does NOT like. (heheheh)

It's a personality thing. Just grit your teeth and remind yourself that this stubborn streak may be her best friend when she's 13. She won't be anybody's pushover, blindly following along! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

The school is another matter. Is it possible to address how she was able to 'grab' unsafe food to begin with?? (I mean, yes, ideally she'd be responsible enough to [i]never[/i] do that.... but I think that may not be realistic under the circumstances....) See my point about 'adult assumption of responsibility you aren't demonstrating' above.

Addressing why the school didn't do what they were supposed to is an entirely different kettle of fish.... Ugh. Keystone Cops, it sounds like.

Good luck!!

[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Apr 20, 2007

hahaha Corvallis Mom you know my child well. Sounds like you have a stuborn one too!

She is very smart, extremely stuborn, clever, and very sensitive. I like the stuborn/obstinate streak - as you said she is no ones pushover. She would rather starve than eat a veggie. Yes, we have tested this. For life with allergies a little bit of stubornness is required [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] But feelings get hurt and that part is hard especially when you are 6.

In our school district she is old enough, at 6, to carry her own epi-pen. If she carries, she is responsible for administering it herself. I think that is just too much responsibility to give to a 6 year old who has no memory of her first and only peanut reaction. So for a few more years at least her epi-pen is at the office with the nurse. BTW The teacher is not allowed to have Benedryl in the classroom.

But yes, knowing my child her stubornness and cleverness, she will eat something else that she is not allowed before the summer is over. It is just a matter of time. Until it is proven to her that she REALLY has the allergy, she will test it. That is just her personality.

Can anyone recommend a good book for elementary kids about Peanut/tree nut allergies? We have Alley the Allergic Elephant, but out grew that years ago.

On Apr 20, 2007

My dd had her one and only epi moment at age 2 1/2, so she doesn`t remember either (she is turning 12). What about telling your dd about the consequences in terms of riding to the hospital in an ambulance, getting a bunch of IVs and shots? That worked for my dd. One time when she was 4 and in preschool, I had taped her photo inside her lunchbox, since so many girls had Barbie lunchboxes. I had told her if your picture is not there, you cannot be sure it is your lunch and so you cannot eat it. So one time the photo came out and the preschool teacher taped it back in. But dd had seen the photo out and based on my rule was not sure this was truly her lunch. How did dd know that the teacher had taped the photo in the right lunchbox? So dd did not eat all day. I ws so proud of her for not taking the chance. I`m with Peg541, better to let your child starve than to have a reaction. The consequences are just too dire. I think I would try being very descriptive about what exactly will happen if your dd has a reaction, the ambulance ride and all the needles. If you present it as extremely unpleasant, then hopefully your dd will decide on her own that it just isn`t worth it.

On Apr 20, 2007

Urgh. (Sorry, my cage has been rattled pretty good this week with DD-- not posting as clearly as I might have.) Yes, I have one of [i]those[/i] kids too. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

I wasn't thinking that self-carrying is something for your allergist to address. Sorry! (That was specifically related to [i]our[/i] little 'issue' with my DD.)

I was thinking of having him 'talk' with 'your family' about unsafe foods might help. Set her straight about whether or not this is 'okay' with him/her.

I was thinking that if a very solemn, worried looking allergist were to point out to her that such a thing must NEVER EVER EVER happen again, she might listen better than if you keep telling her.

(Even when a mom is "Dr. Mom" it just seems to have more authority/impact coming from someone else.... sigh)

On Apr 20, 2007

My nightmare would be if the allergist turned to YOU and said "You are too worried, she's doing fine" or something stupid like that. Then what do you do? You never know what they are going to say.

I know people who never trust their instincts, they always say things like "that's OK isn't it?" about EVERYTHING or like my MIL never really trusting DH's decisions, always going behind him and asking other people what they think. Or people who giggle at the end of every single sentence they utter, I see them as so not trusting of themselves.

Wrong or right I made sure my children knew I was the law. If I turned out to be wrong I apologized and we worked it out together. If it was not going to come from me then they would soon begin to see their peers and others as those to follow instead of a kind loving smart mother/father and eventually their own smart selves.

I remember once my DD at a very young age tried something like "well if you don't ____ then I'll ____." I looked her in the eye and said "I'm not afraid of you." I was amazed at what I saw in her face then. She got it.

We had good relationships, still do. Very good in fact. They knew that what came from me was the truth and especially in DS case it was safe. So he was easy.

I know it isn't always this way I was working by the seat of my pants back then.

Be careful you never know what the allergist of another authority figure will say. You want to be the ultimate authority.

Peg

On Apr 23, 2007

Reading this post has made me think about a situtation that happen this weekend, so I just asked my son what he thought about it. First I'll tell you what happened. We were at my Aunt's BDay party and after we sang she reached on the cake and took off a strawberry and handed it to my PA/TNA son. Thankfully I was standing there and as I grabbed it off of him and my sister in law was screaming NO. Now my Aunt knows all about his allergy and is well aware of it, I have trusted her many times watching him. Her response to the outbreak was "Why can't he have it?" What! we don't know where the cake was made or what is in it. She says she didn't think. Now, this is a probably I am going to have to address. They need to always think.

So anyway because of this post I asked my son about what happened and I told him why I took the strawberry off of him, and he says "but it looked fine, it had white icing and strawberries there were no peanuts on it". I told him when you bake some times there are hidden things in there that you can't see, so just because the peanuts are not on top of it, it doesn't mean that there isn't some hiding inside. I never thought he would think like that, "well it looks fine". He is 5 yrs old and starting school soon. This post opened my eyes on how much more I need to teach my son.

Maria

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