8 year old carrying an Epipen at school? Is there an alternative?

[AndOutComeTheBoobs]

Ds has just been prescribed the adult epipen (was children's) because he's anaphylactic to 5 different foods.

We used to have 6 (and lucky to, I hear this is rare) 2 at home, 2 at school and 2 with the childminder.
Now there's a shortage and quite understandably we are only allowed two.

I'm perfectly happy (and would prefer) for DS to carry the epipens on him at all times.

However the school will only pass medicine between adults and won't allow this.

This gives huge scope for error.

It means going to the school office every morning and afternoon. This means I have to go in to drop DS rather than drop him outside.
It means the childminder has to go out of her way to collect the epipens despite having to collect several children from different parts of the school. It means her or I might for get on a Friday and he does the whole weekend without them.

Can I argue with the school that he should carry them on him? It's not like antibiotics or calpol, this is life saving and our situation has changed. Do I have any legs to stand on here?

I've just been reading on the BBC the sad case of a 13 year old who died after cheese was flicked onto him at school.
Apparently it took the school some time to locate an Epi-pen and then it was out of date. Also it seems there was no individual emergency plan for this boy.

His death might have been averted if he had had his own Epipen with him on a lanyard. Poor lad.

Please correct me if I’m wrong but the OP hasn’t said it’s essential it’s on DC’s person at all times, rather that it’s inconvenient for her or childminder to have to go back and forth to the office each morning and night. As a teacher, SENCo and parent, I know that in my setting ALL medication must be signed in and out of the office by an adult and furthermore, an adult with PR for the child. I have had significant battles with the school nurse service about the necessity for an extra epipen. The shortage crisis has been going on for a little while now.

It's an epipen. It needs to be with, or very close to, the person it has been prescribed for.

Mediacation being signed in and out, and kept in a school office, is fine for antibiotics and non urgent mediations. Medications that are required quickly for life saving purposes, like epipens and inhalers, need a different policy. One that doesn't endanger children for the sake of paperwork.

The school should have completed an Individual Health Care Plan, which would include specific risk assessment regarding the epipen and managing his allergy, for your son taking into consideration advice from healthcare professionals. This should be agreed and signed by you. I do understand why they want the epipen kept securely but the risk assessment should ensure all risks are properly considered and addressed.

GirlMama it's essential that he gets the medication sighing in minutes (seconds would better) of anaphylaxis.

So it is essential that the medication is close to him all the time.

I don't pick my son up from school my CM does, if she forgets to collect the meds then that's a night (or a weekend) without something that he needs (within minutes) to save his life.

I'd say that's essential enough.

This isn't about being inconvenience. This is about reality, human error and my sons life.

My son has 2 with him at all times in school (primary); the teachers supervise the handover between different lessons.
The 2nd epipen is supposed to be administered 5 minutes after the 1st; assuming the symptoms aren't improving.
In reality, the ambulance wouldn't be there on a blue light before 2nd pen administration.
The other 2 pens are kept at home
2 points:

1. I'd be very insistent with my GP that 6 pens were prescribed. I would involve he school nurse and the hospital consultant if necessary.
2. the 2 pens need to be in the classroom/playing fields / dining hall with your son going forward NOT the school office. Again, I would get the hospital/school nurse involved. Escalate up to the school governors if necessary. If nothing changes, I'd complain to the LEA. I'd be finding another school that will take his medical issues seriously if all else fails. Don't buy epipens off the internet.

I only comment on medical things on here unless it is really dangerous. This is really dangerous. An epipen (or an asthma inhaler) kept in the office and not near the child is a disaster waiting to happen for all the reasons in this thread. Please use the useful resources PP have linked above to talk to the school.

You have quite rightly identified the potential for error with the epipen not being passed on. Errors happen and it is much more sensible to assume they will and work to reduce the impact rather than just relying on people remembering and being exactly correct all the time.

Unfortunately yes, there is an international shortage of epipens. This is not the NHS’s fault.

shatteredandstressed that is exactly my action plan. I appreciate the outline, it actually gives me something black and white to work with rather than just my frazzled brain.

OP
The reports in the paper today about that poor child have made my blood run cold.

Do you set a 12 month reminder in your phone re asking for new epipen prescriptions? I am pretty sure the GP practice wouldn't have reminded me otherwise.

OP, I fear I’ve not been clear here. I am in no way discounting the importance of your LO needing access to the epipen at all times and I know how quickly it needs to be administered. Nor do I question the value of your child’s safety and your concerns about him. I was commenting on your original post which was about the school needing the epipen to be signed in and out by an adult and how you would prefer for your LO to transport it himself. The ideal situation is that it is signed in initially and left, but I understand, with the shortage that this leaves your LO extremely vulnerable. The school’s medication policy will be clear on why an adult must hand over and receive back a medication such as this. They too have a duty of care and if the pen were to be discharged into another child(as an example) or used in error/ fell into the wrong hands, they would have failed in their duty of care because they allowed a child to be responsible for it. I truly understand your worries and certainly didn’t mean to offend.

I completely agree with the school on this. ( at primary level)

They not only have your child to safeguard but those of others, legally they cannot have children administer medicine independently without adult supervision they would be opening themselves up to a legal minefield.

A child accidentally injecting themselves could result in death (rare) however experience serious side effects.

Epi-pens (was) are at a GLOBALl shortage, manufacturers cannot get a key component to manufacture the medicine. EpiPen is a brand, there is another dozen manufactures who in the same position.

The FDA is involved, shortages peaked in 2016, became national in 2017 and reached globally 2019, its better however they are hyper aware and having to take precautionary steps to lower panic buying.

Epi-pens (depending on exposure to light, air etc) only last between 12-18 months - current guidelines are that even if expired you can still use 3 months past expiry or longer if the epi--pen liquid is still clear when held up to natural light.

FDA approved a generic Epi-pen in 2016 however it sold out within 9 hours... as people panicked and pile stocked, meaning GP, OOH, hospitals etc.. were left without a life saving medicine.

My son (9) has grade 5/6 allergies to ALL dogs, pollen, hay, 8 types of green grass common types) and dust mite, he also cannot digest casein. (also causes anaphylactic reactions, however recent blood tests came back negative) however he still is symptomatic

You need a care plan, yes its a pain dropping and collecting his medicine daily however the alternative is very much worse. I also bought from abroad, (£300) they are currently within the expired guidelines.

Ds care plans - I drop his medi bag off to the receptionist, receptionist hands his bag directly to his teacher/TA, which is then locked in a classroom locker, if he leaves the glass room his medi bag goes where he goes..be that with his teacher, dinner lady, lunch time supervisor etc... Ds school also has AAI(i) AAI(s)

Schools legally have to have Epi-pen trained staff in the same why they as first aiders.

If you want to keep an eye on policy chances please see here they are normally updated mid month Pharmaceutical Services Negotiating Committee or the [[https://www.ashp.org/drug-shortages/current-shortages/drug-shortages-list?page=CurrentShortages current shortages]]

Your not alone OP, however its manageable. (and wine helps)

lyralalala

It's an epipen. It needs to be with, or very close to, the person it has been prescribed for.

I completely agree and made no comment that it shouldn’t be. The signing in procedure is that it is signed into the school and then kept close to the child (in the classroom, medical room, wherever is within seconds of the child should it be necessary to use it. I made no assertion that it would be kept away from him.

Mediacation being signed in and out, and kept in a school office, is fine for antibiotics and non urgent mediations. Medications that are required quickly for life saving purposes, like epipens and inhalers, need a different policy. One that doesn't endanger children for the sake of paperwork.

Again, my comment made no reference to keeping the pen locked in a school office. I would never suggest that as a sensible option. Paperwork isn’t completed as the child is experiencing an anaphylaxis!!!! It is completed with the senco and parent (and often school nurse) when a pen is prescribed to the child.

Apologies for the many errors also, typing on my phone.

A child accidentally injecting themselves could result in death (rare) however experience serious side effects.

Adrenaline is the "flight or fight" hormone produced by every human being. Being accidentally injected by someone's epipen at worst will produce the jitters. It will not result in death.

You shouldn't have to put up with this OP; get the 6 epipens prescribed ( see upthread for advice) then all this signing in /out business will end.

Can I ask a question to those who work in schools? Do you know what to do if the 2nd epipen isn't working , the child isn't breathing and the ambulance hasn't yet arrived?
Do you know that you have to start CPR and get the defibrillator?
These things are all drummed into those of us who work in the medical world...

Wlipens should be administered within 2 minutes. And that's the latest.
Immediately is best and has the best outcome.

Realistically as someone evidenced above you are looking at 5-10 mins if in a locked office.

Quite simply that's fatal.

Haud read back your own post. If a child is idiotic enough to take a child's epipen they are carrying they could be fatally injured. Although death is extremely rare and all consultants say administer of you are unsure.

The child with allergies WILL die of anaphylaxis if the epipen isn't administered in a timely manner.

To say someone can't have their LIFE SAVING drugs on them because someone else may break the law by taking someone else's prescribed drugs is victim blaming at its best.

I hope when a school has to tell a parent it's child is dead due to safeguarding it has a great union and legal team

And I get your child has allergies but you really need to think about the access. And you've said your child's is in the classroom so aren't actually agreeing with school at all you confused me

We’ve had to switch to a different brand. Our GP said to speak to the pharmacy, find out which one they were managing to get and they’d change the prescription. We now have Emerade pens, I think there’s another brand called JetX?

Emerade/ Epipen/Jext UK brands of autoinjectable adrenaline.

as I said rare but not unknown my point still stands! side effects [[https://www.webmd.com/drugs/2/drug-20017/epipen-injection/details/list-sideeffects RARE]]

Op won't get the 6 epipens, you need to meet specific criteria to get these, my ds is a rare exception and we could not get him additional epi pens other than the 2 he was supplied with the NHS.

There is a national shortage, so if OP gets 4 pens that means 2 people are without, advance the math globally... by doing this, the FDA is putting thousands of peoples lives at risk... Yes its an inconvenience but that does equate to putting millions of peoples lives at risk, because it inconvenience you (plural)

Schools legally have to have Epi-pen trained staff in the same why they as first aiders.

Schools only legally have to have first aiders because they are a workplace. They are legally obliged to have first aid provision for their staff. The first aiders then voluntarily extend that care, normally, to the pupils.

This can be an issue if a SMT treat the first aider like shit because that voluntary role can be relinquished.

Girlmama then I apologise. Your post made no mention of the pen being kept with the child, only the office procedures and in my experience it's often the case school staff get caught up in the procedures and forget the need to have the pen with the child. Apologies.

Haud
You can't possibly know that the OP will not get the 6 epipens.
You are not the OP son's Paediatric allergy consultant.

Also, my son has always been prescribed 4 epipens from the off.

Check with local pharmacies, epi pens are very tricky to get hold of but there are other brands of adrenaline such as jext and emerade which can be a bit easier to get hold of so you could if you find a pharmacy with good stock try to convince a gp to prescribe some extras.
I had my reliever inhaler on me from year 3 and that helped me be independent dealing with my own conditions it's silly that schools won't allow children that these days.

No way would I allow this. It's a serious serious medical condition and those seconds/minutes it takes to locate the epipen with the teachers could be crucial. If your son has it on him there's no question about it's whereabouts and it can be administered quickly. And if it's a question of kids messing around then there should be an assembly outlining the dangers of playing with it

I'd also like to see the stats that back up a risk assessment that says epipens and inhalers should be kept in the office for safety.

In 10 years working in various schools (I worked in 2/3 schools a week so a lot of kids!) I've never seen, or heard of, a child taking another child's inhaler or epipen.

I have however seen a teacher panic that an asthmatic child was going to die in front of her when their inhaler couldn't be accessed. I've also seen a child saved by their teacher using two epipens on them to keep them breathing until an ambulance arrived.

I'd put a lot of money on a bet that locking medications away was infinitely more dangerous than having them in the classroom.