Stock Epinephrine

Specialties School

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We are in the process of setting up our stock epi policy. Our state law says that a lay person can administer epi to student/staff/visitor with signs of anaphylaxis if they voluntarily become trained in signs/symptoms and demonstrate knowledge of how to use the epipen. I am not sure I like the idea of delegating responsibility for "diagnosing" probable anaphylaxis in someone who has not been diagnosed by a doctor. I'm fine with them recognizing symptoms in someone who has been previously diagnosed ie they have an epipen but not with them. Your thoughts?

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Specializes in Peds, Oncology.

I have multiple schools. This task is delegated to my secretaries when I'm not in the building. They have access to me via the phone all the time and I trust that they would call before they injected someone with epinephrine. I can't be in multiple places at once, and I have trained them so I trust they could make a good judgement call with my direction and/or the direction of 911.

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Are you by chance in NC where the new epipen law went into effect 11/1???

Our school district decided only those that are CPR certified can administer the med.

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I am not sure I like the idea of delegating responsibility for "diagnosing" probable anaphylaxis in someone who has not been diagnosed by a doctor. I'm fine with them recognizing symptoms in someone who has been previously diagnosed ie they have an epipen but not with them. Your thoughts?

Between 20-25% of Epi used in schools is for a previously undiagnosed allergy, and school age kids and teens are at the highest risk of fatality in anaphylaxis.. The reality is, we HAVE to start training non-medical people to recognize the symptoms and act quickly. As long as you include "have one person call 911 while another stays with the student and administers the Epi," I don't see why you would hesitate to train more people. (Source)

Think of it this way: what's the worst that will happen if someone gets Epi and doesn't actually need it? And what's the worst that will happen if someone truly does need it, but doesn't get it?

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Specializes in School nursing.
Between 20-25% of Epi used in schools is for a previously undiagnosed allergy, and school age kids and teens are at the highest risk of fatality in anaphylaxis.. The reality is, we HAVE to start training non-medical people to recognize the symptoms and act quickly. As long as you include "have one person call 911 while another stays with the student and administers the Epi," I don't see why you would hesitate to train more people. (Source)

Think of it this way: what's the worst that will happen if someone gets Epi and doesn't actually need it? And what's the worst that will happen if someone truly does need it, but doesn't get it?

THIS. I would rather have something give Epi when in doubt. If they do and the kid doesn't need it, really not much is going to happen. If they do need it and they don't get it, the repercussions can be deadly. Give Epi, have someone else call 911.

I mention this every time I train staff; I don't currently have stock Epi-pens - wish I did and am hopeful I can have them soon!

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This same kind of law passed in CA and will take effect in Jan 2015. We are scrambling . . . . no doc wants to write the Rx for us. They didn't consider that when they wrote the law although other states did.

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Specializes in kids.
THIS. I would rather have something give Epi when in doubt. If they do and the kid doesn't need it, really not much is going to happen. If they do need it and they don't get it, the repercussions can be deadly. Give Epi, have someone else call 911.

I mention this every time I train staff; I don't currently have stock Epi-pens - wish I did and am hopeful I can have them soon!

Have you looked into the Epipens for Schools program? We have got them the past three years, free!

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Specializes in School nursing.
Have you looked into the Epipens for Schools program? We have got them the past three years, free!

I have, it has just been a trial getting the new orders signed by those that need to...long story. But working on it :yes:

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Specializes in kids.

Good luck!

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Specializes in Maternal - Child Health.

You might find this link helpful. This is a 45 minute video on training school staff on state law "Rule 59" which was implemented in Nebraska.

School Nurse (special): Rule 59 Protocol in Nebraska Schools - General Staff Education | Answers4Families

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Um, pts with food allergies (and their parents) are lay people who aren't trained to know what anaphylaxis is but use EpiPens when needed. I'd rather have a lay person administer an epipen than a stock bottle that had to be drawn up and injected. Most states are a right to carry state.

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Specializes in retired LTC.

I'm thinking New Jersey is looking into the epi pens also. I read it somewhere?

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