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Unassigned Epi Policy

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by OldDude OldDude (Guide) Guide Expert Nurse

OldDude specializes in Pediatrics.

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We're working on putting this policy in place in our district...IF we can ever get a MD to sign off on it for us. I'd like to get input from you guys, who already have this program, regarding your procedure for after school activities, "home" and "away" events, and for bus transportation to and from school.

Thanks!!

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so is this like having a stock epi for use with things like sports that a coach would carry?  We don't have this in place here.  We encourage the children that require epipens and who are on extracurriculars (sports are all at the MS level at my school) to get a carry order. I do have epipens in the cafeteria in the epilocker and i believe that everyone running an extracurricular right now has trained on the epipen with me - they change up, so it's hard to keep up with who is doing detention, homework help, reading club etc.  

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jlrm50 has 18 years experience.

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We have unassigned epi pens for students that may have their first episode here at school.  I train my entire staff on proper usage and signs of a reaction.  It does not replace the need for students to have their own epi pens for known allergies.  The unassigned epi pens do not leave the epi locker though.  They do not go on field trips or after school activities.

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BunnyBunnyBSNRN has 13 years experience as a ASN, BSN and specializes in School Nursing, Ambulatory Care, etc..

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We have stock epi-pens  in the clinic and with the AED.  These do NOT go on field trips.  The student's epi-pen that is kept at school (provided there is one!) and a copy of the doctor's order goes on the field trip. 

All teachers, paras, etc. are trained to administer and call 911.

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OldDude specializes in Pediatrics.

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Thanks for your input. Without actual data to back this up, it seems most serious episodes of anaphylaxis occur away from school like filed trips. Sadly, a few years ago, there was a student, in a nearby district, who died at a sporting event after being bitten by fire ants...where epi was not readily available.

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ruby_jane has 10 years experience as a BSN, RN and specializes in ICU/community health/school nursing.

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The problem is that the stock Epi is for the clinic (and does not travel, unless by written directive). If you have two sets of stock Epi, one can travel. If you only have one set (two pens) you cannot separate them to travel, right? Because the instructions are one dose now, one as needed in 20 minutes.

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OldDude specializes in Pediatrics.

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It seems a snowballing effect...it grows bigger and bigger as you contemplate "coverage." Especially if you try and imagine coverage for bus transportation to and from school.

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one of my concerns with including epipen coverage with my coaches would be proper handling.  A few years ago the municipal alliance got a bee in their bonnet over narcan and woosh, now we have narcan and a slew of delegates (that we didn't ask for or quite frankly need - but that's a different story)  point being that everyone took their little narcan kit and were supposed to put it somewhere safe.  About half of these college educated adults who sat in a class promptly decided that the best place to put their narcan was in their cars.  When i told them not to do that - i was looked at like i had 2 heads.  It says it right on the package.  Epipens are even more fragile.  and more expensive.  

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OldDude specializes in Pediatrics.

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26 minutes ago, Flare said:

one of my concerns with including epipen coverage with my coaches would be proper handling.  A few years ago the municipal alliance got a bee in their bonnet over narcan and woosh, now we have narcan and a slew of delegates (that we didn't ask for or quite frankly need - but that's a different story)  point being that everyone took their little narcan kit and were supposed to put it somewhere safe.  About half of these college educated adults who sat in a class promptly decided that the best place to put their narcan was in their cars.  When i told them not to do that - i was looked at like i had 2 heads.  It says it right on the package.  Epipens are even more fragile.  and more expensive.  

Exactly...the more one gets into it the more one realizes "complete" coverage would be something short of a miracle.

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2 Followers; 5 Articles; 4,094 Posts; 35,028 Profile Views

what type of coverage does your ems provide and what is their response time?  Do they typically carry epi?  Perhaps if they do and generally have a fast response then ems can simply be the plan.  

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OldDude specializes in Pediatrics.

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12 minutes ago, Flare said:

what type of coverage does your ems provide and what is their response time?  Do they typically carry epi?  Perhaps if they do and generally have a fast response then ems can simply be the plan.  

They do and the response time is what would be expected...and you're right, this could be part of "the plan." Out of town coverage "could" fall into this category but here in South Texas you can drive an hour or more between towns. One of our district competition sites is over 150 miles from home.

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2 Followers; 5 Articles; 4,094 Posts; 35,028 Profile Views

hmm... hadn't considered how massive Texas is.  In NJ we're so saturated that a response time of more than 15 minutes is more or less unacceptable for ems and in most places pd will be on scene within about 5 minutes.  At least in my over populated neck o' the suburbs

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