Phone call from school; they’re ’not medically trained’ ?!

[mommalaulau]

Dd1 (13) went to school this morning as normal. All fine.

Phone call around 11 from the first aider to say she had “spots on her left cheek and they’re itchy”. I asked if it was hives, they said no. They wanted me to go up, get her, take her to the chemist to “get her checked and give her some antihistamine” and then bring her back to school.

I got there just expecting her to have literally a spot or two and her being over dramatic, she’s a teenager! But she has a cheek of hives and it’s also behind her ears, bottom of her neck and on her forehead. I immediately said to the first aider that it was hives, and she just gave me a smug look as if to say “you’re not trained what do you know”.
I took her straight to the chemist and he said it was definitely hives, for her to take some antihistamine immediately (which he actually went out and got and dosed and gave her) and to keep and eye on her for the rest of the day as she doesn’t know what caused it. He also said it is very concerning the school first aider couldn’t recognise hives and I should question that.

I called school when we returned home to let them know she wasn’t going back in for the afternoon as I was going to be keeping an eye on her, and whoever answered the phone said “yes of course that’s completely understandable”.
I then mentioned I was concerned that I was told it wasn’t hives. I said if a child with a known allergy presented with hives as their first reaction before anaphylaxis and a first aider didn’t recognise it that’s extremely worrying. I was told that they’re “not medically trained” but they’ll pass the message on. When they told me this I said surely, for allergy reasons, they must know how hives present? And I just kept getting that they’re “not medically trained”.

Does anybody think I need to take this any further or should I just leave it at this with whoever I spoke with? My DD is luckily ok and her itching has gone down but the hives are still slightly up, we have no idea what’s caused it.

I'd have thought the same @unicornpower . In fact, my daughter came home today and her face looked bumpy. I put it down to heat and make up.

There is a limit to the training of first aiders. They are really they to give you a better chance re cpr or by stemming bleeding, getting someone into the recovery position etc. They are not there to act like a GP and diagnose.

I ve seen plenty of spots and rashes on my children and myself too, and I was a nursery nurse, but I've honestly never seen a case of hives. A first aider wouldn't necessarily have much knowledge of them either.

I would have identified hives from this photo but not from the one shared by OP. I wouldn’t have confidently said it wasn’t though. That seems like an overstep.

As a parent of a child with severe allergies I get your concerns @mommalaulau.

I find that it is an unfortunate side effect of the rise of self diagnosis of allergies. Schools seem to have a really slack approach to anything other than peanuts. Dd has an anaphylaxis reaction to citrus fruits and pineapple. School had a child die from an undiagnosed peanut allergy and I have repeated pointed out they need to treat dd's allergy with the same degree of severity. It took me losing my shit and sending a ranty email that repeated the phrase "it could KILL my daughter" before they actually took it seriously despite having had her medical records and her HCP.

Hives are a really basic first sign of an allergen. They have no business being a first aider if they cannot recognise them.

The school should have an allergies policy, you need to read it and use it to highlight where they failed to implement and protect your dd. Feel free to pm me if you want additional assistance.

Appropriate reaction from school. If a child has an epi pen in our place of work they also have an emergency action plan which states exactly what to look out for and steps to follow.

Do you know when to administer an EpiPen ? Or is that someone else’s job?

The first aider can't diagnose anything. It was a rash/bumps. Hives? Could be but she's not a medical professional. They can't administer medicine I don't think. Unless it's already prescribed.

I don't really know what else they could've done. It sounds like you expected it to be very minor, in which case it would have been a waste of time to drag you down there?

But when it was quite serious and they told you to go to pharmacy and maybe get antihistamines, you're saying that's also not the right thing for them to have done?

Why write a letter to SLT? The first aider didn't recognise it as hives (it doesn't look like hives from the photo) so they phoned the parent to come and check. What else could they have done? They didn't ignore. They didn't dismiss. They said 'mom, she's got a rash, we don't know what it is, it doesn't look like hives, we think you need to take a look, she might just need antihistamines.' You want the OP to complain that someone was concerned enough to ring mom?

I’m a GP.
That rash isn’t classically anything. Could be any number of things. The first aider suggested getting it checked and trying an antihistamine.
Perfect advice.

If she has POTS she may have EDS and mast cell activation disorder which are all comorbid? Mast Cell Activation Disorder will cause hives / allergy type symptoms.

@Hereslookinatyoukidyes ma’am. But if there was no record of the child needing an EpiPen on a care plan then that would not be my first port of call. I’d ask the office to ring parent and go from there.

Makes sense!

As a mum of a child with a severe allergy who was a child with a severe insect allergy myself, I would love to know what exactly you think the school did incorrectly here for this child whose only allergy history is a rash when given Penicillin a decade ago.

The student presented with an isolated itchy rash and no other symptoms. The school recognized that this was potentially an allergic reaction (thus suggesting she might need antihistamines), called the parents to ask them to pick up and take their child for medical attention, and monitored until that happened. No other symptoms appeared. What part of an allergy plan do you think wasn't followed here?

I'm medically trained and that looks much more like an Excema flare to me...Hives would not have been my first thought at all, and I've seen many examples of Hives.

A diagnosis one is sure of, depends not only on appearance/presentation, but the taking of a robust history alongside. No 1st aider would be expected to do that.

I think the school acted entirely appropriately in the circumstances.

I'd be annoyed tbh. I agree with you OP. Funny isn't it that when it's someone else's child is doesn't matter. And identifying hives is surely common bloody sense

If they commit to 'it is hives' and they are wrong about that, they are damned. If they say 'it is not hives' and it is hives, again, damned.

They don't have to commit to any diagnosis or un-diagnosis.

OP: Is it hives?
First Aid Person: It's a raised rash, it doesn't look like classic hives to me but I'd recommend seeing a pharmacist for advice.

I think OP's concern is that they are actively saying it isn't hives and maybe dismissing her concern as an untrained person (though a look may have been misinterpreted) when they're not actually trained either and the pharmacist said it was hives. And whether they might do the same in a more serious case. Hopefully in a more alarming case of hives they would recognise it, not through medical training but as any of us would who've seen it before/seen pictures.

It's fair to say a first aider doesn't have medical training. Most schools don't have a school nurse on site these days.

Doesnt look like hives to me, so im not sure why you decided to be snippy with the school about it

How have they failed to protect her daughter and not implemented a policy?

Well for a start they specifically said it wasn't hives...if we are arguing they had no medical training to say yes it was then by the same logic they also have no training to say no it wasn't either.

The picture from the op is how my dd can present with hives, it is also how I can.

But they should not have said a definitive yes or no. But if the child is prone to allergy reactions, and given the op's first question was is it hives it would suggest she is, then they should have been aware of the presentation.

Why would you think it 'doesn't matter because its someone else's child'?

They phoned mom. They didn't dismiss it. They asked her to come and check because it didn't look like hives. Meaning they didn't know what it was, therefore they were concerned enough to notify mom.

If they'd ignored it all day and said nothing, then I'd be angry.

But angry because they phoned home and asked mom to check it out? Really?

I'm a first aider and she's right we are not medically trained.

We give first aid, which is what she did.

What difference would it actually make between “no it’s not hives” or “I don’t know” - what’s the different outcomes there?

Oh my days! Some of the responses on here 🤦‍♀️

Damned if you do. Damned if you don't.

I could give you many examples of the reactions we get from parents. Some are grateful. Some are understanding. Some are cross that you phoned them. Some won't return the call. Some are 'out shopping' and don't turn up for hours after you ring. Some are angry you didn't do more. Some are cross that their child has to be sent home. Some try and send their child back before they're ready. Some don't like being disturbed at work.

Some are just kind, normal, fair human beings who can see that you phoned them out of concern for their little one and recognised something wasn't quite right and they appreciate you.

I love my job. I really do. But Jesus christ, some days you just cannot win 🙄

Hives are just a type of rash. Knowing or not knowing the term doesn't mean anything. One of my children gets them from face paint. You would know very quickly if an initial rash became anaphylactic and you can't administer an epipen before that point anyway. Not sure what you expected of her.