and you thought it was bad when BLS was pushing meds...

[ccmedoc]

If they inject an epi-pen into a child that doesn't need it..he may get tachy and anxious...If they need it, it saves their lives, or calms the reaction until ALS arrives. win-win.

Either way they get to the hospital. Maybe not the case if the epi-pen is not there.

[Just Plain Ruff]

But teachers don't have a background in medicine. This wasn't all about how I think it's a little crazy to have Epi-Pen's in schools, although some of it was. But the fact that a BLS unit doesn't even carry such a medication, and a BLS unit, I would hope would have just a little more knowledge in such a subject. I also find it no reason to be on a BLS unit either, as medication administration is mainly an ALS skill. My real point is that, we're letting teachers give ALS treatment. At least if a paramedic unit screws up with the epi, they are more capable to counteract what they have done.

And the two hour class was an estimate, I have no idea what type of training they need to go through.

actually I would trust a teacher with the epi-pen for my son if he needed it under one condition, EMS is activated. If no EMS then they better be calling me when they give it.

So I guess that you have a problem with bystanders using an ALS item. Then if you have a problem with laypeople using an AED or giving medication to the child which the parents have given permission for the teacher or nurse giving. Remember in many schools there are no nurses and the teachers are required to give the medications. I guess that letting teachers giving the child their add meds or their prescription medications is wrong then too. That's an ALS skill right?

It's not a valid argument but the valid argument you just made was that no medications should be given by teachers or emt's because thats in the purvue of an ALS skill. So we need to stop allowing emt's to help patients take their nitro, glucose paste and whatever other medication that your local protocols allow emt's to help give because it is a ALS Skill.

[dahlio]

actually I would trust a teacher with the epi-pen for my son if he needed it under one condition, EMS is activated. If no EMS then they better be calling me when they give it.

So I guess that you have a problem with bystanders using an ALS item. Then if you have a problem with laypeople using an AED or giving medication to the child which the parents have given permission for the teacher or nurse giving. Remember in many schools there are no nurses and the teachers are required to give the medications. I guess that letting teachers giving the child their add meds or their prescription medications is wrong then too. That's an ALS skill right?

It's not a valid argument.

A person is not making an assessment when using an AED, a machine is. There is no machine to recognize anaphylaxis. I've never been to a school without an RN on staff, so I really wouldn't know why there would be a reason for the Epi in an AED.

Regular Medications are a different story, since it is a daily regiment, and there is nothing to assess. Which is why that is not an ALS skill.

Then again, who am I to speak as well, with an advanced first aid certification. I might have spoken to early and not thought of such reasons which you supplied. I apologize on being over anxious and not thinking about it, but this is my inital reaction.

[Eydawn]

The argument about teachers giving prescription meds (ADD, ADHD, allergy etc.) to the children being an ALS skill is a crock.

Sorry, all it takes in the state of Colorado is a QMAP (Qualified Medication Administration Provider) cert to administer those meds to the kids as prescribed by the doc. In the case of my summer job, we didn't even have to get QMAP certs. Under BSA protocol, we're allowed to supervise the kids when they take their meds, and to help those who aren't old enough to accurately count out their own.

It's not hard to follow a label or a Med Administration Chart/Record, especially once you've had the training. I would surmise that the teachers have to document when they administer the meds, and it wouldn't be a leap of imagination to assume their med admin charts look kind of like mine, where you can at least double check the chart to the original bottle's label and make sure you're giving the right thing.

I'm willing to bet you QMAP providers and teachers trained as such make *fewer* medication administration errors than some parents do, since they are legally required to not "tweak" any dosages, which many parents do of their own accord. Bad idea, but commonplace nonetheless...

Now, back to the original topic.

I also don't understand the huge fuss about the epi pens being in the AED kit... most AED stations *I've* seen have been wired in to auto-dial EMS, in schools, theaters, malls, airports... on the off chance that there might not be a system like that in place, I'm sure there's protocols for EMS to be summoned by the teacher or other school officials.

I know that at a summer camp in Tennessee, they are *required* to have Epi and EpiJR on hand in case a kid has never been stung before and has an allergic reaction. The staff members and camp director (my ex's mom, in this case) were required to undergo training in the pen's proper use and indications for use, and kiddos coming onto camp grounds had yet another piece of paperwork releasing staff to provide necessary medical care, including the Epi pen.

Let me ask you this... how many parents have medical training? Ok. How many parents with children with severe allergies have "official" medical training? How many of those parents carry and use their childrens' Epi-pens on them when they experience severe symptoms? Now... how is this any different from a teacher who spends several hours a day, every day of the week mind you, with children and being able to use an Epi pen on one of them?

If you don't want teachers to be responsible for your children and any events-- medical or otherwise-- that happen during the day, then either sign paperwork to that effect or homeschool your children. Worked for my parents.

I have to agree with everyone else on this one (and no, I'm not a sheep) because the potential benefits GREATLY outweight the potential risks. An EpiJR has risks, no doubt... but the kid is much more likely to die from the anaphylaxis than some reaction to a component of the Epi-pen. The risks from inappropriate use or adverse reaction are minimal (legal, ethical, medical and otherwise) as compared to the risks from NOT having these available.

You might argue that "the kids who need Epi-pens will already have them- either in the medication box or on their person". Yes, for many kids, this will be true. But how many parents forget to bring that particular one in to the teacher? How many kids will usually keep it in their backpack, but clean out the backpack and forget to put it back in? How many kids will *lose* their inhaler or epi pen during their school career? Since most kids go to school for 12 years, there's a good chance of any of the above happening.

And let's not forget the kiddos who randomly sensitize to stuff. Happens *all* the time, and we all know it. Would you rather have a teacher with an Epi-pen available to reverse a random anaphylactic reaction in a kid with no history, or would you rather wait for EMS to get to the kid first since there's no "prescription" for that kid and the teacher "has no background"?

Epi-pens were made to be moron proof for a *reason*. That's why we don't see nearly as many of the Ana-kits with syringes and vials anymore. Epi-pens are much easier to regulate and use. I've gotta vote for the average teacher having access to one over waiting for EMS. If you've got a school nurse who can handle this stuff, bully for you. They're now usually LPN's if they exist at all.

Just my (about 5 cents) on the matter.

Wendy

CO EMT-B

[Kaisu]

The only issues I have with this type of deployment of epi-pens are 1 - are they stored properly ?and 2 - are expired meds disposed of and replaced ?

Its pretty useless to have them if they don't work.

[Chief1C]

Yeah, that's terrible! Gawd forbid, people trying to save lives with out EMS..

What's next, bystanders doing CPR?

We need to put a stop to this! Stop lives from being saved, pre-EMS!

[spoil:18f2e20f84]Disclaimer: Sarcasm[/spoil:18f2e20f84]

[aussiephil]

I will throw in my 2 cents worth, from an aussie perspective.

I have 3 children currently attending school. At the school there are a number of children with allergies to varying foods. We are a small community & the ambulance station is approx 5 miles from the school. All teachers have attended courses in anaphalaxis & the use of epi pens, however, it is up to the family to provide them to the school & each is labled for the particular child. Do I feel threatened because a teacher will administer a drug that is normally reserved for EMS? No. Am I thankful that they are proactive in learning about this? Hell yes.

The simple fact is that today, unlike years gone by, more & more children are diagnosed with allergies, I am sure we all have opinions as to why (too many preservatives in foor, hormones & antibiotics in chickens etc.). Put simply, what is needed in an anaphalactic reaction is swift, decisive treatments. Nothing More. Nothing Less. Make no mistake about it, Anaphalaxis is life treatening & provided the drugs are in date, lets train everybody in the use of Epi-pens.

Phil

[HellsBells]

dahlio I think you're mistaken about the number of schools that have RN's on site, when I was coming up (elementary to high school) we never had Nurses on site at any time. So, I agree that its fine for teachers to admin this drug as long as all the caveats mentioned in previous posts are followed.

However, for the very reasons everyone here supported Epi in the classroom, there should also be preload epi pens on every BLS ambulance in the nation. We can agree on that, right? Can't we...?

[VentMedic]

However, for the very reasons everyone here supported Epi in the classroom, there should also be preload epi pens on every BLS ambulance in the nation. We can agree on that, right? Can't we...?

The teachers and coaches usually have access to witnessed or known history and medical information of their students.

[aussiephil]

The teachers and coaches usually have access to witnessed or known history and medical information of their students.

I can only speak for us in Aussieland vent, but we all do carry adrenaline in every car here.........