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?

@shatteredandstressed
We have trained first aiders and epi pen training but we arent medics and we dont have a defibrillator. The first aiders know in principle how to do these things, but if/when it happens it will be the first time any if us have actually done it and it would be on a tiny tot that we are really fond of.
There us no-way to get experienced at this unless you are medical. Its fills us with dread that we might have to do it. All medicine / firstaid is done by volunteers and we take it very seriously but we are 'just' admin people, dinner ladies and TAs eith a 1 day course and no actual experience.

youarenotkiddingme

If a child is idiotic enough hmm? no a child of primary school age isn't idiotic!

Have you ever administered 2 Epi pens and given your own child CPR... followed you using a defibrillator, until the ambulance arrived to take over as your child went into acute anaphylactic shock? because I have!!

However that does not mean my child should take away global shortages of medicine away from those in NEED because of poor planning.

No one is saying children should be without Epi Pens, not a single person has said this! however by careful planning we can ensure every one has the medicine in the event they need it. Children and adults have died because of shortage of medicine, people cannot expect to have 6 epipens at a time when others cannot even get one (when the guidelines advise 2 are medically required)

Until the shortage changes, we must take inconvenience measures to ensure everyone has access to the medicine they require, even if it inconvenience them by only having 2 pens at a time

As for schools its a legal mindfeild, and most schools now are using AAI(s)

responsible measures

As a side point, Emerade has longer needles in some of its pens. This is good for an adult but needs to be used carefully with children.

Where a disability/ illness exists the school is legally required to make "reasonable adjustments" this is the specific phrase you must use. While the schools policy for adults to handle medication in instances for pain relief etc these things aren't life threatening. An allergic reaction is life threatening and time wasted running to find an epipen risks his life further in this case it would be a "reasonable adjustment" to allow your son to carry his epipen.

Has your ds ever needed it?

I know people who have been prescribed epipens for years and never needed them, so they have all run out and been wasted. Is the nhs saving money?

As a side point, Emerade has longer needles in some of its pens. This is good for an adult but needs to be used carefully with children.

Major concers with this at the moment as a 15 year old child died just 7 months ago as the needed was not long enough www.allergicliving.com/2018/10/19/experts-viewpoint-on-epinephrine-auto-injector-needle-length-and-dosing-debate/

I know people who have been prescribed epipens for years and never needed them, so they have all run out and been wasted. Is the nhs saving money?

They wouldn't prescribe them if it didn't work out cost effective.

The few pounds for a pen that may not get used is pennies compared to ambulances, a&e, intensive care. Or ambulance, coroner, enquiry etc.

Wasted and stockpiled medication is a huge issue, but epipens and inhalers going out of date without use is a drop in the ocean.

@thelastgoldeneagle
It's irrelevant whether they've ever needed it or not. The OP may just be extremely diligent in avoiding all allergic triggers for her son. He will have been properly diagnosed to have been prescribed adrenaline, it is most certainly not prescribed on a whim.
Your other point about expired autoinjectable adrenaline: you do realise it has an extreme short shelf life of 12 months? Your post insinuates that you think it lasts for years and those at risk of anaphylaxis are stockpiling.
You obviously don't have this condition or have a child with it or you definitely wouldn't be so blasé.

OP you said in your OP that your used to have 6 Epi pens, however your ds has now been prescribed the adult Epi pen...

I’m assuming he had the junior auto injector beforehand?

Presumably your schools policy has not changed, it’s just that as he can now only have 2 epipens due to national shortages you need to plan his Epi pen handover better?

My daughter's best friend is severely allergic to over 17 things, and possibly others that are unknown about. As far as I'm aware she always had her pack of epipens, antihistamines etc in her bag from a very young age. If they were going outside without their bags the teacher always took her pack with them.
I would strongly insist that your child carries their EpiPen on their person as much as possible.

If you need to involve the board of governors do this.
And also add that the rest of the pupils must be educated in it as well - as in don't use other people's stuff, find a trusted adult to help asap, look out for one another etc.
Honestly it's your childs right to carry potentially life saving with them.

Ask the School what their allergy policy is, they should be able to tell you. Our policy is overseen by the community nurse so if the policy is unsafe then they are a good point of contact if School won't listen.

In our school kids meds are labelled and kept in a class bag which travels with the class and is kept by whoever is supervising at the time. We also have emergency meds including epipens in a few locations eg office, canteen, school hall. All staff are trained in allergy recognition and how and when to use epipens. I could lay my hands on an epipen within 1-2 minutes absolute max from anywhere in the school. In most instances I could lay my hands on one in under a minute.

It's madness that they won't give you a proper supply, especially when you need 2 pens per location. It's just not practical when dealing with kids. I hope you manage to get some more but do also check the school policy, hopefully it will give you peace of mind. If it's madness then challenge it, you may save lives.

I've cared for a child with more than 5 food allergies in a nursery. His epipens (&other medication) were in a bag that went EVERYWHERE with him. All staff were aware and would routinely make sure it was with him eg/ out for a walk - head count - check epipen bag - check first aid kit - check & so on. It worked perfectly well.

Sorry OP, I’ve only skimmed the thread, probably repeating what others have said.
When my sons epipens couldn’t be replaced due to shortages, my pharmacist was able to tell me the names of other brands which were easily available. I asked the GP for scripts and they did them for 6 pens.
The school have a back pack in each class. This is a medical back pack, all the necessary meds are clearly labelled (individual boxes with picture of child etc) and the back pack goes where the kids go. Art room, music room, lunch, wherever. So its always there if needed.

Tell the school he is carrying the pen because if he has to wait for whatever trained person to come from wherever they are, get the epipen and then find him, he's already died. Go over the head teacher and speak directly to the local authority. Get his consultant involved.

I had this problem. I told them in no uncertain terms that DD was carrying her pen and if there was a problem, I expected that this would mean that the local authority was going to provide all necessary teaching staff to us as home, as they were the ones preventing my child attending a school safely. I bet they don't take inhalers from asthmatic children.

You need to stand firm and get nasty if necessary. Allergies are seen as less serious. I'm sure you can find a gruesome picture online of someone who has had a moderately serious reaction and whose tongue is so swollen it is protruding from their mouth. I certainly was able to get them back before the internet. Shock tactics are sometimes your only option.

I don't know rules /recommendation for primary schools, but in secondary you must carry epipen as well as school having one; the time it takes for help to be sought, medicine cupboard to be unlocked is endangering life. Presumably if he is big enough to now have adult one he is big enough to administer himself, so him carryi g isnt a problem.

I bet they don't take inhalers from asthmatic children.

@littlecandle You'd be surprised. Many schools do. Only when parents complain does anything change.

@clairedelalune
OP's son won't be on an adult dose -he's only 8 so 300mcg. Children move to the adult dose of 500mcg at 12.

30 years ago I was allowed to carry my adrenaline in my school bag - I carry two epicene at all times but back then it was a three-part assembly needle/syringe - I can’t believe this is acceptable that he can be parted from his meds like this. The time it would take to get his medication in the event of an incident is simply too much time.

OP I’d be standing my ground on this. He carries his life-saving medication on him at all times. School office can carry a backup (and I’d advise so) but he has to have them with him...

Also, yes there’s a shortage but when they’re needed the prescriptions will be given (so my GP explains anyway)

Good luck xxx

*epipen ffs

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

Department of Health and Social Care, as well as the National pharmacy Association and FDA (all global) have put in place global contingency alert arrangements to ensure that those patients with the greatest short-term need have priority access

A dispensing protocol for all pharmacies issuing adrenaline auto-injectors.

A mandatory document has also been issued from the Departments of Health and Social Care giving advice to schools

OP would not be starting her own thread, if she was given additional Epi-Pens... as I said, this isn't a UK issue, its a Global one with strict contingency measures been placed.

@clairedelalune
OP's son won't be on an adult dose -he's only 8 so 300mcg. Children move to the adult dose of 500mcg at 12**

Incorrect, it depends on the grade of the allergy and the size off the child.

Ds has had adult Epi pen since he was 7.

It's madness that they won't give you a proper supply, especially when you need 2 pens per location.

No OP does not NEED 2 pens per location, however it is easier for her to have this in place, speak to the school and have a care plan in place and have a plan at home.

Yes its inconvenient, but not impossible or unmanageable, I do it every day of the week, rain, hail or shine for the past year.

People demanding 6 epipens for their children "just in case" is what has led to the shortage.

I have 2 expired epipens that I had to fight for - note, expired! Not even in date! I think it's so unfair. People are putting their own convenience above the need for everyone at risk of anaphylaxis to have 2 in-date epipens.

One for anaphylaxis to buy time to get to a hospital. One for the backup whilst you're trying to get a replacement for the one you've already used. I think we all deserve that. There have been a few occasions where if not for an epipen, I would have died. Can I get an in-date one? Can I heckers like.

Back on topic, if a child is genuinely at risk of anaphylaxis (i.e. tests have been done to prove they actually have a serious allergy and/or you've found out the hard way), I think that child should be allowed to carry an epipen. You grow up a bit quicker than your peers when you realise how much worse your odds are of suddenly dying. 8 is old enough to understand allergies and to take them seriously - it's unfair not to let an 8-year-old keep an epipen close by just because their peers might not be capable of the same responsibility. They haven't had to learn that responsibility - lucky them.

Just going to put this out there as there's a lot of stuff being quoted from other countries ?USA?
These are the Resuscitation guidelines Uk.
This is what we work to in this country.
These are the doses as per the UK guidelines.
I'm leaving this thread now.

@Returnofthecat Exactly.

@shatteredandstressed, you are aware MN users are from all over the world, not just the UK.

Those doses aren’t iron tight, as I’ve said my ds has been on adult Epi-pens since he was 7, as 2 junior epipens failed, it’s was only when the paramedics arrived that he was given another 2 dosages that they managed to get him back.