I got this from abcnew.go.com. I am a substitute teacher and I have 3 children in public school. This is why I would not send my child to a regular school if they had serious/fatal food allergies. Schools cannot function as hospitals. Schools can barely handle behavior problems and teach kids at the same time. Regular schools do not have the resources to watch what a child puts in their mouth every minute of the day.
Johnson ate the peanut on the playground of her Chesterfield County elementary school, Hopkins Elementary, during recess. After noticing hives and shortness of breath, she approached a teacher and was taken to the school clinic. A clinic aid was trying to help her when she stopped breathing, according to police.
"When emergency crews arrived, she was already in cardiac arrest in the clinic," Lt. Jason Elmore, a spokesman for the Chesterfield County Fire Department, told ABC News.
An investigation by Chesterfield police concluded that Johnson died from cardiac arrest and anaphylaxis, and that no crime or criminal negligence was committed by the child who shared the peanut, school personnel or Johnson's mother. ...
...Johnson's death raised questions about how schools and parents should handle severe allergies. Experts say Johnson could have been saved by an EpiPen -- a device that injects epinephrine to reverse the symptoms of anaphylaxis, currently available only by prescription. But Hopkins Elementary had no such device on hand for Johnson. ...
Also, I feel that in modern schools, albuterol and epipens are ubiquitous enough that the original packaging shouldn't be required.
I appreciate your feeling on the subject, but the State Boards of Nursing, Pharmacy and Medicine "feel" differently.
Medications administered in any setting other than the home by anyone other than the patient/family are legally required (in our state, and I assume others also) to be provided by the responsible party in original packaging, with original labeling/instructions and accompanied by a valid prescriber's order or standing order.
Inhalers and albuterol are manufactured by multiple companies, all with different appearances, packaging, method of administration, etc. Epi-pens, while not available as a generic (to my knowledge) have undergone a change in packaging and administration technique within the last few years. I imagine that some of the "old" model are still in date and in use. Without the original packaging of ANY of these medications, it is not safe or reasonable to assume that the person responsible for giving the med (especially in an emergency) could promptly identify it and administer it correctly to the right student.
As I asked before, would you accept responsibility for administering medications to 100 adults on a LTC floor if those meds were removed from their original packages and/or not labeled with names and prescribing information?
So requiring life-saving medication to be sent with its original packaging, labeling and instructions is not a matter of a school being unreasonable. It is a matter of following the law and taking common sense steps to prevent medication errors. If that is too much of an inconvenience for parents, they have no right to expect others to assume responsibility for their children.
Oh, I understand that. That's why I hope they pass the new law allowing schools to stock and administer epipens in emergency situations without a prescription.
"If you witnessed a child in anaphylaxis, would you administer another child's epi pen?"
I heard of a story where there was a field day at school, and a nurse used another child's Glucagon to help a diabetic child in trouble. Unfortunately, the child whose Glucagon had been used also ended up needing the Glucagon. Because of that, the 2nd child ended up dying. I would hate to be that nurse!
I wanted to comment on the person who asked if the epi-pen would be too far away in the office. At least in my state, there's a law stating that children who need them should be allowed to carry their epi-pen or inhaler. Of course, we have to get that on their doctors' orders, that they've been trained and that they're allowed to self-carry. And the school nurse has to approve that they can do this safely. As long as the student is responsible enough to handle it, I think that would be a good solution for someone who is super-fast on their anaphylaxis response, or, for that matter, anyone who's very anxious about it and is afraid help wouldn't arrive in time.
I understand all the rules and regulations, and the reasons for them. But what about the "emergency situation" ? What about the Hippocratic oath (practitioner protection)? What would have happened...if...the staff-member in that health clinic did reach over and use another child's epi pen - as a last-ditch effort - to save this young girl's life while she was slipping into anaphylaxis ? What would you have done?
There is no way I would send my child to school without THEIR OWN epi-pen knowing that they suffered from fatal allergies. If the school didn't allow an epi-pen, my child would not attend that school. If the original packaging and doctor's orders was required by the school, then I would try my best to provide it ASAP.
There is no way I would send my child to school without THEIR OWN epi-pen knowing that they suffered from fatal allergies. If the school didn't allow an epi-pen, my child would not attend that school. If the original packaging and doctor's orders was required by the school, then I would try my best to provide it ASAP.
Per federal law, a public school can not refuse a student's Epi-pen, as they can not refuse to accept and care for individuals with disabilities.
In some instances, private schools can (and do) refuse to accept this responsibility.
Also, I heard the mother say in an interview that the epipen was refused by the school earlier in the year when she tried to leave it. If that's true, it was probably because of the county rule that all prescription medication be in its original packaging with the prescription or pharm label attached. I had a child in this district who needed an inhaler and they refused when i first tried to drop it because we no longer had the box it came in with the pharm label attached. We had to have a new script written and pick up a new one before they would take it.
I have refused to accept an epi-pen in similar circumstances. The parent claimed the student had a life-threatening allergy to insect stings. She brought an epi pen, not in the original carton with the pharmacy label indicating the child's name, and no permit from a physician (both of which are required per district polict and state law). You bet I refused it. The child has been here 3 years and I still don't have it, after requesting numerous times by phone, in writing, and in person. I offerred to contact the prescribing physician and parent would not provide his/her name. I strongly suspect this epi-pen was for someone other than the student in question, but either way there is no way I am putting my license on the line by accepting an epi-pen that by law I cannot administer.
I am willing to bet money if the school refused the epi-pen in the case above, it was for similar lack of required documentation.
I work for a large urban public school district where each high school as one full time RN in the building who is a certified school nurse, and may have one or more assistant school nurses (RNs or LPNs) depending on if that high school has a special needs unit for medically fragile children. Thankfully, the school nurses have a bargaining unit within the teachers union and are able to collectively bargain for staffing and working conditions. In our district, the school nurse trains the staff on emergency procedures and on life threatening food allergies. We have a no shell fish and no peanut policy in our district, which the school nurse instructs the staff on in the beginning of the school year. There is a sign in each teacher's classroom and the cafeteria with a picture of a peanut with the NO sign around it.
The local Catholic high schools where I live rely on volunteer nurses and they do not need to be certified by the state. They generally do not have an RN full time at the school. The charter schools, many of which are for profit, do not see the need to have a full time RN, and the teachers and school nurses are not unionized so they do not have the right to bargain for a full time RN in the school. From a business/corporate point of view school nurses are expensive and take money away from the CEO or administrators. From a parent, grandparent, or teacher's point of view...school nurses are needed to keep our kids safe and healthy and worth every penny for a good one.
I would not want to see my granchildren or my great grandchildren go to a school where the teachers and school nurses do not have the right have a voice or collectively bargain for the safety of their students. IMHO, the safest schools are the public schools that are in states that allow their teachers and school nurses the right to collectively bargain.
I work for a large urban public school district where each high school as one full time RN in the building who is a certified school nurse, and may have one or more assistant school nurses (RNs or LPNs) depending on if that high school has a special needs unit for medically fragile children. Thankfully, the school nurses have a bargaining unit within the teachers union and are able to collectively bargain for staffing and working conditions. In our district, the school nurse trains the staff on emergency procedures and on life threatening food allergies. We have a no shell fish and no peanut policy in our district, which the school nurse instructs the staff on in the beginning of the school year. There is a sign in each teacher's classroom and the cafeteria with a picture of a peanut with the NO sign around it.
Not to get off my own subject, but how is that policy fair to students that do not have such allergies? The only way I see that being fair is if the school is providing free lunch and snacks for ALL students (in my area, school lunches are bad enough), no matter what their family's income level is.
I heard a person talking about having serious allergies to citrus fruits. He went to a school where they were very sensitive about peanut allergies, but almost nothing was done about his citrus allergy. He couldn't even stand to be in the cafeteria when it was being served. How many food are we going to eventually ban, that are actually healthy foods for most of the population?
Since first posting this subject, I have started substitute teaching at a school in my district that is geared towards students with special health needs (most of the students there have no special physical or health needs). When I first posted this subject, I didn't know we had such a school in our district. Tuna fish was one of the lunch choices, and there was a girl in my second grade class who told me that she was allergic to it. She said she was not allowed to sit next to anyone eating tuna fish and the children who ate tuna fish were supposed to sanatize (sp) their hands after eating it. I told her that was fine and to do what she usually does when tuna fish was for lunch. This was my first day subbing this class, so I had my hands full. When I notice her, she is sitting smack dab beside a girl eating tuna fish and TALKING to her. I tell the student that she is sitting next to someone eating tuna fish. "Oh, I forgot," she says. Then the students around her say that she is okay as long as no one eats tuna fish and touches her. WHATEVER. If I was that sensitive to a food, I would have paid more attention than that.
I do believe in making allowances for students that need them, but I think banning a food (in a public place) that is healthy for most of the population is going too far.
caregiver1977, Thank you for raising an interesting point. There are a number of schools that have gone to the (unnecessary) extreme of "banning" certain foods in the mistaken belief that they are protecting allergic students and themselves legally. This couldn't be farther from the truth.
For starters, the Americans with Disabilities Act requires schools to make accomodations for children with disabilities (which includes those with severe allergies), but it does not require other students to make accomodations for their classmates. This is an important distinction because banning foods can make it downright impossible for other parents to feed their children an appropriate lunch, whether due to picky eating, food aversions, special dietary needs, etc. There have been some interesting legal arguments and articles written on this subject. I am not aware of anything progressing to the point of a lawsuit, but after reading the articles, it is difficult to see how a school would prevail in such a case.
Secondly, "banning" foods never works. It is simply not possible to police the contents of every lunch bag, snack, treat, school party. In my experience, most parents do their very best to comply with reasonable requests for peanut free treats when something is being shared with an entire class, but they tend to get their hackles up when told that they can't send peanuts (or whatever the offending food is) in their own child's lunch for his/her consumption only.
It is not difficult to set up a peanut free area of the lunch room for students who need this accomodation. They are able to sit with friends whose lunch has been checked by the staff or who purchase school lunch, for which the ingredients are known. Hand sanitizing or washing on the way out of the lunch room is becoming the norm in lunchrooms, both for allergy protection and infection control. This set-up requires parents to share their child's allergies with school staff (believe it or not, some object to doing this), and knowledgable staff to oversee lunch. Again, not rocket science.
The other problem with having an "allergen-free" school is that it lulls staff into complacency. They easily assume that no allergens are present in the building, so they are utterly unprepared when someone is inadvertently exposed. Far better to have a well preapared staff who know how to seat children safely at lunch tables, clean the area, check lunches and implement an emergency plan in the event of an unfortunate exposure.
I'll give you an example: My sister teaches in a specialized preschool program that enrolls youngsters with a wide variety of physical and intellectual challenges. A number of kids have allergies to peanuts. When they moved into a brand new building a few years back, the principal (against the advice of the nurse and staff) insisted on a peanut free building. Allergy emergency training was non-existent for the staff because the principal was certain that it wouldn't be necessary in this new, safe building. The school stocked a number of snacks in the kitchen, purchased at Sam's by the principal. My sister went in one morning to choose a snack for the day and came across Honey Nut Cheerios, which had already been opened and obviously served to at least one class. Fortunately, nothing had happened, but because nothing containing nuts was to be in the building, someone had incorrectly assumed that this snack was OK to blindly serve to everyone in a class. When my sister brought this to the attention of the principal, she wanted to use up the rest, so as not to be wasteful. My sister consulted the nurse, who asked her to remove the package from the building and had to go inspect the ingredient list of all the other snacks in the kitchen. I don't think the principal had any clue as to how lucky she was.
jt43
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Also, I feel that in modern schools, albuterol and epipens are ubiquitous enough that the original packaging shouldn't be required.