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.

But the point is that in the meantime they should have at least kept an eye on breathing, potential swelling in the throat or airways and have made sure an EpiPen was to hand.

No-one is going to take the responsibility of saying they are medically trained outside of a medical degree because they are opening themselves up to litigation.

Your ire explains exactly why.

As a school first aider (my currently held qualifications are paediatric first aid and emergency first aid at work) I am not allowed to diagnose medical conditions. I know full well what chickenpox looks like, or what hives look like BUT I have to “advise” the parent to take the child to a pharmacist in the first instance. I am NOT medically trained and cannot give medical advice.

I think they did what they should have done here, and I would’ve done the same. They probably thought it was actually hives but didn’t want to make a diagnosis as they are not allowed, what if it had been something my more serious and they had not advised you to get a second opinion? I’m sure if someone was presenting with a severe allergy they would call an ambulance, I can’t really see any issue with the school here!

OP, you're worried that a child will have their first serious allergic reaction with the early signs being hives and you are concerned that school won't recognise this symptom? I understand where you are coming from but I think the worry is misplaced. If a child was having a life threatening allergic reaction then the staff should be trained recognise this from a list of other symptoms - its not just a few hives on an otherwise well child. Lots of people get itchy rashes and hives and it is not life threatening. School can't give out medication without prior arrangement so calling the parent to collect the child is the correct thing to do.

I am allergic to penecillin and my reaction looks nothing like that.

Labeling the rash as hives or not was not part of their first aid response. They didn't make any decisions based on whether it was hives, and they didn't ask the parent to. Properly "diagnosing" this itchy rash as hives specifically would not have impacted the course of action in any way - there was no indication for emergency treatment here and the school did not yet have permission to give other treatments so calling the parent and asking them to come pick up was the correct response. The parent was reluctant to come pick up and wanted to know if the rash looked like hives - the first aider said it didn't but still requested the parent come and take their daughter to be seen and treated appropriately. At no point in this story was the school dismissive of any symptoms.

It's vital that first aiders treat any unexplained itchy rash or diffuse itching without explanation as a potential allergic reaction and not be focused on looking only for hives specifically.

If the school had responded to OP's question about hives with a refusal to say she'd almost certainly be complaining about that.

My son has allergies and gets hives, they don't look like that picture, his look more blister like. I did paediatric first aid training several times when I was working with children, to be fair it was about 8 years ago so I may have forgot or it could have changes but I don't remember hives being covered.

Schools don't usually have spare epipens on hand.

Schools (and all other childcare settings) must take no risks when it comes to children’s wellbeing and also have to cover themselves. Any concerns they have to refer back to parents and recommend seeking advice from a trained medical professional. It’s to protect children and to protect themselves.

Imagine the school nurse presumed it was a simple case of hives, gave her antihistamines and sent her back to class………. then an hour later she falls into a coma in the middle of class because it’s a severe allergic reaction…. Or meningitis? A school nurse isn’t trained highly enough to make those decisions. They always will refer to someone else highly medically trained. And I’m glad that is the case. I do not want someone untrained in a school making a mistake when it comes to my children’s wellbeing, I would always prefer they use caution, call me and advise to seek trained medical advise. It’s just not worth the risk for us or them.

YABVU. It's a school, not a doctor's surgery. Have you ever been on a first aid course? It doesn't teach you to diagnose different rashes and skin conditions. I had chronic hives on and off for years and those look nothing like hives. I get that you were worried for your daughter, but all parents worry for their children. Schools really could do without parents just automatically blaming them for everything every time they are worried about their child.

Why do you think they didn't do exactly that?

Yes they do, legislation was introduced in 2017 to allow it and guidance encourages them to do so.

PoTS is not well understood by medics, never mind schoolmfirst aiders.

This “kid” doesn’t have a care plan or medication in school! Allergy to penicillin doesn’t result in a care plan or meds in school. If one of my pupils with a care plan for allergy started a rash without being aware of exposure then yes, I would initially administer their own prescribed and labelled oral antihistamine and watch for anaphylaxis while calling the parents, but I will NOT administer someone else’s medication to a child without a care plan unless they presented in a life threatening condition.

First aiders are told not to diagnose especially to the person they’re aiding. They can explain information and symptoms to medical professionals.

any form of diagnosis is legally dicey for a first aider. They are told to direct you to a medical professional at all times.

Unless she was experiencing serious anaphylaxis they wouldn’t give and epi - pen. They had her under observation and called her parent. If she didn’t have anaphylaxis while under observation why would they have an epi-pen?

better to get her to a medical professional.

This

FFS, every day I thank good Providence that I am no longer a teacher. I was trained as a TEACHER, for heaven's sake! Not a doctor/social worker/psychiatrist/conflict resolution expert/Mother Confessor...I taught five subjects, four languages, children aged 3-18, 47 years. I dealt with serious asthma attacks, anaphylaxis, epileptic fits, choking, fainting, anorexia, teen pregnancy. I spent hours beyond memory counselling children with emotional and home problems, suicidal, desperate,just listening and being there as a front-liner, and then with their permission, passing them on to the professionals. I fielded phone calls and in-school visits from parents wanting help with parenting because "you have such a lovely relationship with your boys". I gave children without money for mufti day a few quid to buy a nice top or jeans, made meals for sick parents, tutored kids desperate to pass exams. Then you get people like this woman who just wants to make a point for who knows what reason. Teachers are just that; they are not superhuman, omniscient and with all the time in the world to engage in petty squabbles with parents who have been advised, quite correctly, of appropriate steps to take.

I am glad your DD is okay.

The school staff aren’t medically trained but they called you and gave you the right advice. I don’t know what else they could have done- hives can present differently- they can be larger and more raised.

Her job is not to diagnose as she could be wrong! and parents would be very quick to criticise then too.

I feel for the first aider tbh.

This

I did first aid training in a school. They didn't train us on different types of rashes and certainly not what hives look like. (I’ve done first aid courses for a primary and a secondary so delivered by different providers)

School first aiders are usually teachers who, in our school, give up two evenings 4pm -8pm (unpaid) every three years to do a basic first aid course. I am a first aider but am by no means an expert

The only thing I can think that is wrong with how the first aider acted is...I asked if it was hives, they said no. ... I don't think they should have said a definitive 'no', because they couldn't be sure. If it was me, I would have said, 'they don't look like hives to me, but I think the rash should be checked out' or similar.

I agree. This post is next level. People are absolutely nuts.