To worry about allergic reactions in schools

[PinkBottledWater]

I work in a school where I am the lowest paid, know the children the least but highly likely to be first on the scene if a child suffered an allergic reaction.

I work over lunchtimes only in a large playground.
I asked to see where the epipens were kept, and have had training.

When I asked to see where they were, I was told by the manager ‘don’t worry, someone else will deal with it - if anything like that happens’.
Except yesterday I was on duty while the teaching staff were all in a meeting. This happens frequently.

I often feel that me - as least qualified - would be first to deal with an emergency situation, and would be the most accountable in the way that I respond to that situation.

It scares me and I think there needs to be a better way.

@ChateauMargaux

It is that incident that has prompted me. And the report I read yesterday, the TA seemed to making the brunt of the decisions and hadn’t seen the child’s management plan.
People are prone to panicking in situations like that, and it concerns me that someone needs to act.

I would want to act, but then could never live with myself if I’d made a decision based on the wrong info or procedure.

And I know a lunchtime supervisor who dealt with a choking incident. There just wasn’t time to find someone first aid trained. She acted immediately, did the right thing and the child was ok.

At my school, all staff have to read the care plan for anaphylactic students, and sign that they have done so.

The epi pens are kept in an unlocked cupboard, in a central location of the office, that is really clearly marked with giant pictures of the epi pens. This location is on the care plan. Even supply are shown this location.

Then we have epi pen training about every 3 years for all staff allowing for staff churn, with key posts all being trained.

The training is much more about spotting when the pen is needed.

If you are first on the scene you may well be sitting with the pupil and sending for help. But again at my school, all lunch time supervisors have a red card they can give too a pupil if no other staff are there. They would run to the office and the red card symbolises get your arse here with a phone and the epipens.

I think your school needs to rethink this.

No, many allergic REACTIONS are not fatal. All allergic reactions have the potential to be fatal.

I completely disagree. Lunch time and break times when children are eating are the most high risk times for allergic children.

Both my children have severe dairy and egg allergies. Both have had accidental contact with their allergens at lunch time. One had a very severe reaction.

School is one of the most common places for a child to have an allergic reaction and the most likely time will be lunch time or break time.

All staff should be EpiPen trained. And EpiPens should be near the child not tucked away in a cupboard

https://www.anaphylaxis.org.uk/six-year-old-school-girl-wins-compensation-after-suffering-severe-allergic-reaction-at-school/

17% of severe allergic reactions happen when a child is at school.
Most of those will be at lunch or break time.

Of course teaching assistants and lunchtime supervisors need to be trained. And of course the EpiPens shouldn't be sat in a cupboard far from the child.

I've never known a school not do whole school training. I can imagine the odd one or two will do but most will do whole school.

I have been thinking about this a lot lately and have been following the inquest into the tragic case in the news.
I was a teacher for 10 years and had the training several times, but I believe there are operational issues which lead to these sort of incidents. Of course most allergic reactions will happen around meal or break times, where teachers are usually not around and it's the lunchtime staff. In my school, the lunchtime staff turnover was huge and we were often borrowing staff from the lower school for the upper school etc. So that staff member might not even be aware of who the child is or what their allergies are. Sending a child to go and get someone is good in theory but this can take time too and in my school the office was miles away from my classroom. I wouldn't feel confident in anyone except a bright year 5 or 6 pupil doing this. Again, vital time ticking. Lastly, we campaigned again and again for there to be an EpiPen in every classroom but they have to be prescribed to a pupil so 'spares' were not allowed. Throw into the mix that it was taken downstairs for lunch, then the TA that usually brings it back was tied up in safeguarding issue for example, and you have a perfect storm of events that could lead to potential preventable tragedy.
I've just been to my daughter's reception induction and there's a little girl in the class with severe allergies. I know that the family haven't been able to take her to any playgroups, soft plays, events, parties etc because of how severe they are. Her parents must be so worried.

I think it is reasonable in light of the inquest which is in the news, that all schools consider giving all school training on the use of epipens, to protect their staff.

The death in question, was a tragedy, there should be an inquest, but I do not believe that the teaching assistant and teacher should be put under public scrutiny, before the conclusion of the inquest (or at all in this case but I am not privy to all of the details of the case, nor am I a lawyer) as is currently happening in the press.

I agree with that to some extent but it is also the only way for lessons to be learnt.

But this is also the reason my daughter's school eventually realised that when I was pushing them to improve their procedures in relation to allergies it was as much to protect them as her.

When she first arrived they did a lesson in school involving her allergens without sending a letter home to parents or checking with me. When I asked to see their risk assessment they said they didn't do them for food activities. Wtf.

It feels very much like there is still a misplaced assumption that nuts are the only "real" allergen and that by banning them they have done their duty.

But milk is the most common serious allergen in children and at lunch and break time in any schools there will be swarms of children eating cheese , yoghurt, chocolate biscuits etc. So it is beyond foolish not to ensure all lunchtime staff are trained and have ready access to EpiPens.

No criticism of these individuals, my heart breaks for them as well as for the family of Benedict. We can't know what we don't know. School management have a duty of care to ensure all their staff are properly trained.

Every school also needs to make sure they have EpiPens available for children who aren't prescribed them too. People can develop new allergies or not even realise they are allergic to something.

kittmedical.com/

One of my children carries an epi pen and when he goes for lunch, his box that's labelled with his name and also has a picture of him on goes with him.

We always used to carry a bumbag with the epipen inside it when we were on duty. The person carrying it was trained to use it and the one responsible for said child on that day. To keep this stuff in the office which could be a good few minutes away isn't the best idea.

@mumto4boys16 @Sunshineismyfavourite it's really encouraging to hear about schools that are getting this right

I forgot to say that there was also a an epi pen that followed the child in a bumbag too. But we actually had problems with this where people forgot they had it and wandered off to the loo for much etc, so the back up cupboard came in.

When I was at school, even the kids were taught what to do as we had a boy in our class who had very severe allergies. We knew where the epi pens where and how to administer it if there was an emergency. He carried one around in a little case and then there was one in the first aid room, one in the classroom and others dotted about, they were in mini cupboards on the wall. I remember it well, despite never having to use one.

It definitely makes me feel more relaxed about it.

I will say though that I know not all teachers are trained in how to use it which does worry me sometimes.
When he was first prescribed it my son was the only one that needed one not sure if it's changed now but I had to keep him off school for 2 weeks while they sorted out out training

We aren’t allowed to call the emergency services from our mobile phones

This absolutely can't be the safety plan in any school.
Hope there's a sensible child around who can go and fetch the head? What if you're supervising Reception children?
Relying on other children to communicate medical information to staff is never going to happen.
School staff are also unlikely to have phones on them.

I know, it's mind boggling. When every second counts this cannot be the plan. The EpiPen should be near the child who needs it.

If I had a child in anaphylaxis (or in need of an ambulance full stop) I would be ringing 999 irrespective of the rules.

That is great. Ive known schools prep the children and staff well. It makes parents confident their child will be cared for and that they've covered every base as they should

I do not believe that examining the actions taken by the TA and the teacher in this case will result in the right lessons being learned.

1. The current school suppliers sell AAIs - which aren't to be given to random kids, they're for those who are already known to have been prescribed them but either the parent hasn't sent them in or they fail - and they are much, much cheaper than that company without being locked into a five year contract.
2. Why the fuck would a locked box be in any way appropriate for AAIs? They have to be immediately accessible to anybody.
3. Half hour online training? It's already in the First Aid training with actual practice pens, not watching a video.

A ratio of 1:20 with 2-4 year olds?! That is ridiculous, no wonder you’re concerned!