Epi-Pen policyRegister Today!
- by MinnieMomRN Jan 5, '12Do you ask for 2 pens -- one for the health office and one for the teacher? I am currently doing this and it works well for the elementary students. For the middle school grades, I'm not so sure. They change classrooms throughout the day. The Epi-pen stays with their homeroom teacher, and the classrooms they switch into are in the same corridor for the most part. That's not too bad, but Art and gym are in a different part of the building. I am just wondering how you handle this in your school.
- Jan 5, '12 by JolieAll meds in our buildings must be kept in a locked cabinet. Usually, that is in the health office, which is located (centrally) within the main office.
This is where most Epi-pens are kept, and they can be retreived and run to any area of the building within a minute or two.
We have some special ed students whose Epi-pens are kept locked in the special ed hall, since they spend most of their day (including lunch) there.
Because Epi-pens are terribly expensive, and most insurance companies will only pay for 2 at a time, I only have had 1 student with multiple Epi-pens at school. This was a child who was so highly allergic to so many foods that we feared for him just walking past the cafeteria. He carried one in a fanny pack at all times, in addition to one in his classroom and one in the office.
Our state law allows for children of any age to self carry inhalers, Epi-pens and diabetes meds with parent and physician authorization. Many do so for asthma and diabetes management, but most parents are feaful that their child won't be able or willing to self administer Epi-pens, so I've never had a family opt for that.
- Jan 6, '12 by FlareI work in middle school. Typically, I only ask for one. As Jolie said, the meds really need to be secured (though the epi does need to be accessable if your state allows for delegates in your absence). I keep mine in my typically locked in my office in my med cabinet, though i have some un assigned stock epipens that are kept in a secure but unlocked place in my office. The problem with me asking for 2 (beyond the cost and insuranse issues that may burden the family) is simply a matter of space and disposal. It always seems to me that parents think it's my problem to get rid of their expired epipens. I could probably fill up a sharps container in no time with the expired epipens i accrue in a year.
- Jan 6, '12 by donnaceeMiddle school we have one per student. But my concern, if the student is having a possible reaction in class and is poin need of an epi-pen, shouldnt the nurse be there to assess before a teacher injects an epipen? Is the teacher trained properly and why is benadryl not given first?
- Jan 6, '12 by JolieQuote from donnaceeI'm short on time, so I'll give you my Reader's Digest answer.Middle school we have one per student. But my concern, if the student is having a possible reaction in class and is poin need of an epi-pen, shouldnt the nurse be there to assess before a teacher injects an epipen? Is the teacher trained properly and why is benadryl not given first?
In a perfect world, there would be a nurse available to every individual having a health emergency in every school. Time and money constraints don't allow that, so we must do our best within our resources. School is a preparation for real life, where no one has a personal health attendant at all times, either, unless you are Michael Jackson, and that didn't work out too well.
Seriously, there are 2 different scenarios in which an Epi-pen may be needed. The first is an individual with a known allergy who has a detailed plan of care worked out prior to the start of school between the healthcare provider, parents and school. In this case, there may be a progession of meds to follow. Possibly Benadryl first, then and Epi-pen if needed based upon an assessment by the trained responder (nurse, health assistant, teacher, administrator, etc.)
The second scenario is an individual experiencing a severe allergic reaction who either has no known history, or despite a known history, has no plan of care in place. In that circumstance, we follow our state mandated protocol, which calls for admnistration of an Epi-pen first, followed by nebulizer treatments if needed, until EMS arrives.
I am lucky fo live in a state which has such a protocol. Every school in Nebraska (public and private) must have a stocked emergency kit and trained responders capable of carrying out the mandated protocol while awaiting EMS.
More information here:http://www.education.ne.gov/legal/we...RULE592006.pdf
The last page of this file provides a good summary.
- Jan 6, '12 by MinnieMomRNThanks to everyone who responded. It's interesting to see how other states deal with this.
I am in Massachusetts. We apply through DPH for medication delegation approval -- we must apply and be approved every two years. I do complete staff training for all teachers on LTA's and Epi-pen administration twice a year. Each teacher receives their student's Epi-pen along with a copy of the emergency care plan (lists allergens and the MD signed plan of care) and this is kept in the classroom emergency bag as confidential in the teacher's possession.
In Mass, a teacher can administer Epi if they have been properly trained, but only for that student who has been determined to have a LTA and has an emergency plan. Unknown allergies require a nursing assessment (me, or immediate 9-1-1), and that Epi administration falls under the standing order I get from our school MD at the start of school.
I have roughly 6% of my school population with a LTA, so we are at the national average. Currently, I have only 1 student whose emergency order states to give Benadryl as a first line. Most providers seem to be following the newest research which says we go right to the Epi for a suspected systemic rxn.
My meds are locked (even Tylenol), and the controlled substances are double locked. Epi, however is only secured by the lock on my office door when I am out of the building. During the school day, I have one of those clear plastic shoe storage things that hand over a door next to my desk. I have each kids picture in a pocket with their Epi and the MD order directly behind it. Grab and go style.
We have this year re-written our emergency policy, and I think it's still a work in progress, so comments are welcomed. I am thankful to all of you for taking the time to reply, and all of you who may reply after this post.