How many have actually had to administer epi?

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I'm just curious, I've never had to *knock on wood* but I'm sure if I stay in school nursing long enough, the day will come. I run the scenario through my head all the time---if you have had to, I'd love to hear about your experience.

Also, the Illinois School Nurse Guidelines say a repeat dose can be given in 10 minutes if needed and the American Academy of Allergy, Asthma, & Immunology says 5-15 minutes depending on response up to 3-4 doses. Does your school have clearer guidelines on how long between doses? Our action plans don't really have a place for physicians to indicate when to repeat the dose. Thank you!

Specializes in Psych.

Not a school nurse... But ive dosed myself with Epi... dang wasps. My instructions are if reacting to inject and go to er if needed. For a kiddo, Id be calling and shipping.

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I've given many many times, thankfully never as a school nurse! I worked in EMS prior to becoming and RN so I gave Epi often for many different reasons. I carry my own Epi pen as well and have had to use it a couple of times, first time I did, I was off to the ER. Second time I used my Epi I didn't go to the ER, just rested a few minutes and then continued on with what I was doing.

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Specializes in kids.

Twice to teachers and once to a student. All unknown allergies! Scary, but grateful they all had a good outcome. ANY epi administration is a 911 and transport.

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Specializes in kids.
akulahawkRN reminds us of a very important element of treating anaphylaxis; don't forget to treat the cause. About 10 years ago I could hear "raspy" breathing walking toward my clinic and in walks a teacher whose face reminded me of a Klingon from Star Trek it was so swollen. I gave her epi, benadryl, and some tagamet I had on hand. "

Eeek, I concur with Benadryl and Epi, not sure I would have the nerve to give Tagamet. !) I dont have it in hand 2) It was not prescribed for them and 3) It was prescribed for somebody else....that could get a little dicey.

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Specializes in school nursing, ortho, trauma.

i'm just going to knock on wood **. i spent yesterday training staff during PD day in how they can give the epipens - so i have a good back up team too.

I am hoping the copious amount of times i've had to give diastat have given me a pass on giving epi any time soon!

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i'm just going to knock on wood **. i spent yesterday training staff during PD day in how they can give the epipens - so i have a good back up team too.

I am hoping the copious amount of times i've had to give diastat have given me a pass on giving epi any time soon!

I have a Diastat gal. Have yet to use it, but eeeeeek on that!

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Not a school nurse, but Yes I have given it several times before as a Nurse. Not fun in peds pts. If epi is given it is ALWAYS a trip to the ER per our policy. I have been lucky enough to have dodged giving diastat thus far ::knocking on wood:. Darn kids are just plain scary. They can turn bad in a second and not give any warning signs ahead of time. It's a good thing so many of them are cute.

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Specializes in kids.

Love that my two former Diastat kids now have Midazolam (intra nasal) Woot!!!

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Love that my two former Diastat kids now have Midazolam (intra nasal) Woot!!!

How does that work if they are having a seizure? Is it an inhalant? Are there airway issues? I have to Google Midazolam.

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Specializes in school nursing, ortho, trauma.

i have one on midalozam now too - doesn't seem to do much - but to be fair the diastat never seemed to stop this poor kiddo's marathon 25 minute long seizures either.

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Specializes in Emergency Department.
Love that my two former Diastat kids now have Midazolam (intra nasal) Woot!!!

How does that work if they are having a seizure? Is it an inhalant? Are there airway issues? I have to Google Midazolam.

Intranasal midazolam needs to be pretty well atomized to work... you stick the syringe with the atomizer device on it into the nares and you have to squirt it into a mist and get it up into the turbinates of the nose. Its onset is supposed to be about the same as IM. These are pretty low volume doses (for the mg delivered) so be careful about that as the dose is usually supposed to be split 1/2 in each nare. Since the kid may not be breathing effectively during a seizure, you may have to actively aim the atomizer toward the turbinates instead of relying on inhalation to carry the dose to the right spot.

Disclaimer: I've been trained on this route, haven't used it yet. Most of the paramedics that I know that have used IN midazolam seem to like it and it's much safer for the provider as there are no needles...

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Never given Epi in a school setting but had to give to my own child once. Our policy is that if we give Epi we call 911 - if parents are around they can decide whether the child is transported or not; but if parents not around the kid goes.

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