Gave my first epi-pen yesterday...

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Student ate a granola bar and a bag of flavored chips. Then she broke out in hives. I gave her Benadryl. Then the hives got worse. No other symptoms. I gave her more Benadryl and called mom to come get her. As mom was on her way, student started c/o shortness of breath. "I feel like there's a bubble in my chest." Epi-pen given. Called 911. Called mom again so she would know what happened and so she wouldn't panic when she saw the ambulances in the parking lot.

I worked in the ER, so I have treated many allergic reactions, but I have never actually used an Epi-pen before. I guess I can check that one off my bucket list (?!?) now.

I'm surprised you haven't been hammered already by Far, the ellipse police here. You were clearly in violation with the group of 4 after though. I will pray for your ellipse rule violating soul :blink:

Oh my. I did get carried away. I usually stick with ...

(Holy crap. Do I really have to wait 900 seconds between posts?!?! 76 to go)

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Specializes in IMC, school nursing.
I asked my nurse coordinator and she said the physician that does our standing orders chooses to use the vial because it's cheaper and the vials last longer. Bummer. Pre-filled syringes would be ideal.

And, thanks, OldDude! I actually have vials of benadryl along with epi. I don't know when/why I would choose to give the benadryl rather than the epi though....

P.S. Although I don't know the details, I saw some talk about ellipses... I love them.

Free is the cheapest you can get, they replace the used doses, too.

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Specializes in ED, School Nurse.
Oh, this reminds me of another part of my story of the mom being pissed that I didn't give epi. The student told mom that she asked for epi and I gave her a second dose of Benadryl. What actually happened was that the student came in (has well documented multiple allergies) and told me that they had been exposed to the allergen. Not wanting to waste time, I grabbed the Benadryl and immediately gave 2tsp. Then I opened up the student's allergy action plan and saw that the doctor had written that 4tsp needed to be given, so I gave the other 2tsp right away.

Jeez. This whole situation kinda sucks for you, kidz.

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Jeez. This whole situation kinda sucks for you, kidz.

This was several years ago. I was worried for a bit that the mom would take it to the school board and I would lose my job (I'd only been there a couple months). Never happened and as I got to know the family more we were friendly but I was always cautious with that student and then with a sibling that came through the next couple years.

I would have handled it so much differently now that I have the experience. I would certainly have been very assertive about asking why the mom did not administer epi if she thought I should have. Instead I was very passive in my meeting with the superintendent.

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Specializes in Developmental Care.
the doc said most people wait too long to make the decision to epi,!

Last time I was in the ER personally for anaphylaxis, I was told I waited too long to give epi. This is important to always remember.

It's better to give it a little early than to have waited too late.

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Specializes in School nurse.

I gave epi the first time this fall to a second grader with only mild previously known allergies. She howled like a banshee and then told everyone that I stabbed her.

YES I DID!

911, EMS and a ride to the hospital. I don't know if it's just around here but the EMS guys always like to act like they are super duper incredible and coming to the rescue of the poor little helpless school nurse.

AHEM

Hey guys, I have a BSN and 14 years experience and it was my assessment that led to this intervention thankyouverymuch.

But I have to say that it was pretty incredible to watch the hives fade away like you hit rewind on the VCR. I mean right in front of your eyes. WOW.

So then of course the EMS guys are like "Well, golly gee. She looks ok now."

Yeah - duh - BECAUSE I GAVE HER EPI!!!!!

So anyhoo..... turns out at the ER they ended up giving her a second dose and of course prednisone and ATC benadryl for several days. I strongly encouraged mom and dad to have allergy testing redone. But have they? No. ARGH!

And we have a medical director and standing orders for Epi and a few other things as well. She had shorts on so I didn't have to deal with clothing.

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Specializes in School nurse.

UGH

Just noticed my ellipses infraction.

SORRY!

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I have my eyes on all of you.

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Specializes in Pediatrics Retired.
UGH

Just noticed my ellipses infraction.

SORRY!

Too late. You stepped in it. Now you have to pay the price. I will also pray for your poor ellipse rule breaking soul.

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Too late. You stepped in it. Now you have to pay the price. I will also pray for your poor ellipse rule breaking soul.

You are certainly good at talking up my punishing ways.

I was just going to say "Stop it!!!"

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Last time I was in the ER personally for anaphylaxis, I was told I waited too long to give epi. This is important to always remember.

It's better to give it a little early than to have waited too late.

I wish someone would tell this to the mom of the child I gave the Epi to. Or the childs doctor. I had a child who collapsed in class, had shortness of breath and whose lips were turning blue. Yet the mom says I did the wrong thing and the doctor I spoke with on the phone a few hours later sounded doubtful. All this second guessing from people who were not even there.....

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I wish someone would tell this to the mom of the child I gave the Epi to. Or the childs doctor. I had a child who collapsed in class, had shortness of breath and whose lips were turning blue. Yet the mom says I did the wrong thing and the doctor I spoke with on the phone a few hours later sounded doubtful. All this second guessing from people who were not even there.....

Maybe if you let him go and then shocked him back to life with the AED?

Good lord. They should be thanking you.

I'm sorry.

I'll even forgive your 5 ellipses.

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