Epi Pen Organization

[MHDNURSE]

I am wondering what you do with your Epi pens. Are they always in your office? We are in a unique situation in that we are on two floors of a large public building, so I have the epi pens (and 2 diastat pens) in the class rooms specific to those students. I keep the emergency epi pens in my office and in the cafeteria. I am thinking I may change and keep them all in my office next year but not 100% yet.

What do you do with your and how do you store them? The nurse at our High School keeps them all in her office in a shoe organizer.

[grammy1]

But, next year we are doing something very different. Using stock epi for everyone. We will no longer students to provide their own epi pen in school because are epi pens are identical (I work with the older kids, so no Epi-pens Jrs). A stock epi-pen will go on a field trip to cover diagnosed students. (Yes, orders for student with diagnosed life threatening allergies for said epi-pen will still be required.) Per my state, I will be the only one who can administer epi to a student with a new outset and previously undiagnosed food allergy presenting with anaphylaxis. Our school physician fully supports this.

Will they still carry for after school activities (band, sports, etc.)?

in MA, you actually have to fill out four pages of paperwork to report to the state every time an Epi-pen is used

:wideyed::wideyed: O~M~G

[JenTheSchoolRN, BSN, RN]

Will they still carry for after school activities (band, sports, etc.)?

:wideyed::wideyed: O~M~G

Yep. We are the only state that tracks Epi-pen administration in the schools and it is very thorough. Thankfully it is now online and has some drop downs to help.

My school doesn't have band. Students with known allergies that plays sports, like field trips, will be required to self carry. (Like they do now; coaches aware of allergy and where epi is, typically in student's backpack or gym bag.) Only a school nurse can administer stock epi to a student with undiagnosed anaphylaxis and I do not go to sports practices or games. However, there are easily accessed emergency services at the off school site places in which games and practices do occur. (We don't currently have a gym.)

I work after school, so the building has me for activities that take place at school. I will be delegating a stock epi for use by teacher/admin at evening events at the school for a student with a diagnosed allergy. Part of the training for next year, when this will happen.

[GetBackToClassRN]

We have locked medication cabinets in our clinic. One cabinet is used for Allergy Medications (Epi-Pens and Benadryl), one cabinet is for our daily use medications and PRN oral medications, the third cabinet is for inhalers & nebulizer medications.

We do have some students (including my own child) that have gotten approval to self-carry their Epi-pens.

I asked our district nurse manager about ordering the stock Epi-pens and was discouraged from doing so. Our district is concerned about legal ramifications if the stock Epi-pens are used and later deemed that it was unnecessary.

This is my first year as a school nurse, so I don't have a lot of experience in this setting.

[JenTheSchoolRN, BSN, RN]

We have locked medication cabinets in our clinic. One cabinet is used for Allergy Medications (Epi-Pens and Benadryl), one cabinet is for our daily use medications and PRN oral medications, the third cabinet is for inhalers & nebulizer medications.

We do have some students (including my own child) that have gotten approval to self-carry their Epi-pens.

I asked our district nurse manager about ordering the stock Epi-pens and was discouraged from doing so. Our district is concerned about legal ramifications if the stock Epi-pens are used and later deemed that it was unnecessary.

This is my first year as a school nurse, so I don't have a lot of experience in this setting.

I'm less worried about giving Epi unnecessarily vs. not giving it when needed. Not giving it when needed can be fatal. The side effects of epi for a student without an underlying cardiac condition are very few.

I have read articles that talk about over-prescribing of Epi-pens. I have other read articles talking about patients with severe allergies and a history of anaphylaxis that are still afraid to use their Epi-pen if needed.

Students with a diagnosed allergy should have an allergy action plan with guidelines for using Epi. Stock epi should have guidelines for use as well; this is why only an RN can give to a student with undiagnosed anaphylaxis in my state.

If anyone is curious, check out the data from MA: Anaphylactic Events in School

Last report is from 2014, but ~24% of epi-pens administrations were to a student or staff member with no history of allergy, and 40% of administrations to those with no history of anaphylaxis.

I just like having access to epi if it is needed :).

[smudges.blips]

In case you weren't aware- Mylan gives epi-pens + epi-pen Jrs. to schools for free! That is how we got our stock supply. They give a twin pack of each and training info, as well as a big yellow case they can be stored in and wall mounted. If you end up using one you go to their site, fill out the paperwork and they send you another for free. As they outdate annually you just go and ask for new ones. Super simple. We keep them in the health office and one set in my ER Backpack that I can run with. They are only kept in the classroom for our kids with super severe allergies and this one is provided by the parent.

For field trips we require that parents provide one to take with; if they absolutely can't or forget, I send one with. It is very seldom that we have multiple kids/grades with allergies going to different sites during a day.

For the Epi-Pens for schools program check out here: EpiPen® (epinephrine injection, USP) and EpiPen Jr® (epinephrine injection, USP) Auto-Injectors

[monymonsta]

do you need prescriptions for each epipen kept at the school that you order?