No care plan but school trip tomorrow.

[mumbar]

OK, I am willing to admit IABU and overthinking this but heres the story.

DS has previously had mild reactions to ketchup and hayfever. Last year his hayfever was fairly bad. Took a while for the school to accept he had allergies (another thread) and after the secretary one day refused him puriton when he asked for it and a complaint it was sorted.

Since then DS has had 1 severe reaction. No-one knows what to or why. It affected his breathing (very rapid/wheezing) as well as very red flushed swollen face, lips, eyes and an intense feeling of cold.

Cons Pead had prescibed DS epi-pens and he is currently under her care.

I gave the school the epi-pens and the secretary informed me all staff are trained.

There was a parents evening that night and I said I could/ felt I should meet with the HT to discuss a care plan for DS. Secretary rang me and left a message, (didn't listen to message but rang back). She said she'd spoken to HT and DS teacher and they had rung School community nurse who would come in and do a care plan after 1/2 term. She said I 'may' get invited.

The secretary 3 times on the phone said 'so tonights meeting with the teacher is purely aceademic'. I bit my tongue hard so as not to tell her to fuck off.

So no care plan has been drawn up. School will only give a dose of 5ml puriton for a reaction which won't touch DS, the care plan should say 10ml which the cons pead will back up.

DS is going on a school trip tomorrow an hour away. Now I know the chances of anything happening is extremely small but I can't help thinking instead of repeating 'we are all epi pen trained' they should actually be taking the time to talk to me about DS symptoms and how to treat them.

My mum whos a teacher has said that they are not breaking any rules to do this and if I refuse him to go I'll upset him and lose my £9.

AIBU to think they are BU or am I over reacting as I'm still getting use to the whole allergy thing?

Be gentle please.

We don't have the letter yet. I know the school won't give any more than 5ml. They insisted last year on having 2 bottles of the same medicine. 1 said 5ml 4xday and the other 5ml every 4-6 hours. They would only give one for his regular lunchtime dose and 1 for if he needed it.

I know and agree care plans do have to be drawn up by school nurse. (I work in a SEN school) but they haven't and almost refuse to discuss his symptoms and treatment with me. Therefore in the meantime I would consider him to be a mild risk.

I did give his teacher a copy of his care plan I have written which he carries in his allergy bag. It states it is written by menot a medical practitioner.

My concern is (although since the complaint I doubt they'd do it again) that they have refused DS his puriton once when he asked for it. He was itchy - no sign of rash but it is usually his first symptom. By the time he got home from school his eyes were swollen and very red/ black underneath. Now I took a photo and sent it in with the complaint. (the secretary said to me 'I won't medicate your son willy nilly on your say so' )

This was when they had a bottle of puriton saying every 4-6 hours as required. Hence why they have 1 saying 4x a day as well now. (except he now on another AH once daily!!)

How old is DS? I carried my own epipen and knew how to use it when I was 9. Otherwise can he carry it himself and presumably there will be a teacher there who will use it if necessary. Can he carry his own piriton and self administer? Just make sure he knows the right namount to take.

Also, if his reaction is that bad they'd need to call and ambulance anyway and the paramedics would have an epipen. It only buys time and, if used inappropriately, can cause problems. It contains adrenaline, not an antidote as such. I think you're right the risk is mild, given he's had one episode or wheezing I'd almost be of the opinion the epipen prescription is overkill.

If he's on an AH daily his chances of a reaction are far lower too.

He is 6yo.

He had epipens as it affected his breathing - rapid breathing, and complained of 'sore throat' and was clutching it - its considered it could be swelling. Also the drunkeness behaviour and semi-concoiusness is signs of anlyphalatic shock combined with other symptoms. (apparently, I'm not a Dr tho!!)

School would not allow him to carry his own pen.

Yes they would have to call an ambulance, which I have told them, but he is usually OK if he gets higher dose of AH and then another dose.

ATM he is not on daily AH (sorry above was misleading) but will start a different one daily when his hayfever starts.

Might give him AH in the morning just to be safe.

Ds's care plan wasn't done by a HCP. I did it based on the consultants letter with bits stolen of misdee's dd's which I think is standard for the PCT where they live.

I don't understand how they can have a child in the school with a medical need without having a care plan. If they have a diabetic or epileptic child do they wait months/years before writing up a care plan?

Re ambulances they have to state they need paramedics and adrenalin for anaphalactic shock. Not all ambulances have paramedics and ambulance technicians won't administer adrenalin. It should be in the care plan because its not common knowledge and whoever phones for the ambulance may not know.

I would send him with an interim care plan and tell them he must have 10mls.

the problem we have in schools is that we are open to complaints/being sued etc. Therefore if the 'normal' suggested dose is 5ml, we can not unless we have a doctors letter give any more.
you have said

"I did give his teacher a copy of his care plan I have written which he carries in his allergy bag.

with all due respect you could someone who is looking for attention etc through their child and therefore suggesting treatment that is not suitable.

Although the secretary could have handled the situation better, she is correct in not giving in to all whims unless there is a definite medical care plan in order. The amount of children that say they feel this/that etc and within 2 seconds are running around the playground is unbelievable.

Whilst I understand that you are concerned about your son, the school is actually in the right - think about if they just followed any orders etc without question; how many abused children could be hurt without the abuser actually creating the harm in the first place?

cricketballs your DS dr secretary aren't you.

FWIW - the school were wrong and admitted it. They had no choice really faced with a GP visit and photos. AND they didn't suggest a care plan when just AH, so yes they should listen to a child - they admitted he was aggitated and quiet all afternoon after they refused it.

And how the fuck does a child get prescribed epi-pens becuase the parent is looking for attention. They don't hand them out like sweets you know. I'm trying to protect my child not attention seek through him.

I agreed they can't give the increased dose without a letter - hence why I have asked for one.

straightbat Thanks, thats exactly what I'm getting at. The secretary says - we are all trained, updated yearly so all is fine and I'm meant to just take their word for it, but me, his parent, according to the school what do I know?

you phone your local community school nurse and take her with you to an appointment with your head of the school.

this will by pass the secretary, who should follow the heads advice .

talk about the life threatening aspect of being prescribed epi pens. etc and need for a treatment plan, and action plan.

get the nurse to look up in advance who has been epi pen trained in the school, and when that happened.

as part of your action plan add that epi pen trained teacher should attend.

as extra layer , pay for a letter from gp outlining need for epi pens and treatment plan. send a covering letter to the school head, and the goveners and the local education authority.

this should get you were you want to go.

if you are not convinced that they will be able to administer the epi pen, and recognise a reaction when its in front of them, after the school nurse has taught them, then you may have to remove the child from the school. feel free to inform the local educational authority, and goveners and local press.
latter is last resort.

dont send your kid on the school trip without getting this sorted, as safety comes first.

My son wasn't could not go into school until all the staff updated their EpiPen training. The school wouldn't have him there. They had to call an ambulance one day and since then have been very careful.

all school staff are epi-pen trained. That I am sure of. What I am unsure of is when they will use it. I know a high dose of AH will (or has done) stop a reaction eventually, although medical assistance will be required. My actual concern is they haven't recognised DS need for AH previously which ended up with him being worse, and also they will just use the epi-pen when AH should/ and has been sufficient in the past.

Despite the above comment about attention seeking I am trying to avoid DS needing the epi-pen which so far has worked. The epi-pen is for when/ or if the previously used methods fail - not an alternative.

I did not/ do not call for ambulance for respiritory distress as I am trained and know when it static as oppossed to worsening. I just give more AH. I do call OOH GP/ my GP for advice.

Eurgon Thanks for your comments. I will ring cons pead PA tomorrow and see where we are with the letter. When I have it I can take it to the school with the puriton labelled - as directed by consultant - and demand request they arrange care plan asap.

I am just ed that they can't see that when they are in loco parentis of my child I need to be able to trust them to do the right thing - and that I know what that is. And that I need to know what they will do.

mumbar - I was pointing out the schools view point in general - there is no need to get rude when you have asked for opinions.

In terms of the epi-pen you DS has prescribed then yes, a school will administer this and all school staff have training on this.

But, as I said before, unless there is MEDICAL guidance (i.e. completed care plan by medical staff not a parent) we are not allowed to administer anything other than a basic paracetamol etc.

Whilst we are 'loco parentis' we also have to abide by several legislations and regulations to ensure the safety of every child in our care.

Sorry cricketballs I know you weren't saying it about me, but that is pretty much what the school secretary implied even when presented with prescibed medicine - which she then refused to give when DS asked for it as she didn't have a care plan to indicate his treatment and symptoms. They didn't even mention one at this point.

I do know the care plan has to be by medical professional, and that it can take months. It is not the whole 10ml thing I'm bothered about. I do know they can't give more, hence the letter.

And yes, I should have asked at the appointment but it was a lot to take in with epi-pens etc I forgot. And dealt with it straightaway after.

But you'd think they'd at least listen to me telling them his symptoms so they can treat accordingly with the meds and doses he has.

I get that loco parentis, safety and regulations are there, I also have to bibe by them, but I also know that we are allowed to do ahet is reasonable to protect the welfare of a child in our care.

At breakfast/after school club they will give him 10ml, I have completed a care plan there and when I said I was waiting for letter re 10ml I was told as long as I signed it then they would administer it - as they had my permission.

I do need to sign the care plan, and it should be done in conjunction with me, so I can't understand why school want to shut me out.

I work in SEN school, care plans are rife. They are done by the school nurse and agreed by the parents. I understand the proceedure and the school nurse in my school thinks DS school are behaving badly/ irresponsibly.

My whole concern is that having refused his AH once before when he needed it and he got worse slowly, that now his reactions are quicker and more serious to refuse it could have bigger consequences.

DS class teacher will be with him on the rtip - she is brilliant and I have faith in her completely, I'll pop a note in his bag asking if he can be in her group - think I'll worry less then.

I might just add our school nurse is also my friend, she wasn't being unprofessional, i was at hers out of school when I recieved the 'discuss aceademic only' phonecall.

sorry one more thing, I totally agree there needs to be written evidence of double doses and medical professional to agree it. BUT when the school won't allow my involvement how am I supossed to tell them this - for it to be agreed by the medical professional??

I am hoping the letter will come soon, and before a care plan is drawn up.