Epi-Pen Waiver for school

[ameliasward]

My daughter has allergies to spinach (diagnosed by a rash around her mouth, but negative in both the skin and blood test done by the allergist), and mold/dust mites/cat dander (all positive by skin test, but negative by blood test). The allergist suggested we avoid nuts until she is 5, then introduce in his office. There was no treatment given, no epi-pen, etc. My daughter is now three and is in a preschool program. They have given me a waiver for permission for the school to administer an epi pen in case of an allergic reaction. The form says that the epi pen would be administered first, then 911 would be called, then parent would be called.

Is anyone else dealing with mild allergies and feeling torn about signing a waiver like this? I feel a little uncomfortable with an unprescribed epi pen being given before I am even contacted. I guess my fear is that it would be used in circumstances where it is not completely necessary. Any opinions on this? Or additions to the waiver to be sure that it used only when necessary (ie when do YOU use an epi pen for your children?)

[spedteacher30]

I've never heard of the school asking for permission to administer an unprescribed medication. Whose epi-pen would they be using? Some other child's?

I'd ask for more information for sure.

[Scribe]

I'd be a bit concerned as well. Though the epi-pen is a wonderful invention and it has saved my butt, it's not a small thing to use one, especially for a child. Not something you want to do lightly.

[nalo]

Originally Posted by spedteacher30

I've never heard of the school asking for permission to administer an unprescribed medication. Whose epi-pen would they be using? Some other child's?

I'd ask for more information for sure.

Absolutely! It's not like epi-pens are just handed out like candy. Where are they getting them? Are they keeping them current? Are they seriously insured for administering life saving medication that has not been prescribed? (I guess that last comment is kind of tricky because obviously you would expect them to do CPR if, God forbid, the need arose but somehow this seems different.) Perhaps you could provide Benadryl and instruct them to give that and call 911 immediately if an ana reaction is suspected????

[fek&fuzz]

Have you talked to her doctor about it?

I'm guessing if my kid stopped breathing I would want them to administer an epi pen before calling me. How much time would be wasted trying to get a hold of you, then you deciding whether to have it administered, etc.

I guess if I were concerned, I'd talk to her dr. now about it, ask the school what they do to keep the meds current, and have all those things resolved so in the event of a life threatening emergency my child could receive the treatment.

[4Blessings]

Work with your doctor on an emergency action plan.
This is just one example, from FAAN http://www.foodallergy.org/actionplan.pdf

[Fiestabeth]

I agree about the emergency action plan.

If the person or persons who would be administering the Epipen are med trained (know the signs/symptoms and how to use the Epipen), personally I would sign the waiver. I can't imagine they would give it unnecessarily, and in the unlikely event that your dd did have an ana reaction, you want them to get that Epi in ASAP, without trying to call you first.

I think it's great that they want to be prepared. (Says the mom who just had to pull her dd out of a school over food allergy accommodations. )

[kjbrown92]

I guess I would think that was extreme. My kids get rash around their mouth for various foods (DD for cinnamon, DS for soy and MSG). They got negative reactions on blood tests for allergies, but positive for food intolerances. They also have environmental allergies. I've never even thought of an epi-pen for them (maybe I should?). Are you just worried because she might come across spinach somewhere along the way? Or are nuts the major concern?

[Scribe]

Originally Posted by kjbrown92

I guess I would think that was extreme. My kids get rash around their mouth for various foods (DD for cinnamon, DS for soy and MSG). They got negative reactions on blood tests for allergies, but positive for food intolerances. They also have environmental allergies. I've never even thought of an epi-pen for them (maybe I should?). Are you just worried because she might come across spinach somewhere along the way? Or are nuts the major concern?

I don't know for sure, but I think the concern may be that for kids who have displayed mild allergic behavior, a more serious allergy is more common. The first thing that comes to my mind (and the reason I carry an Epi Pen) is a bee sting.

[ameliasward]

I spoke to the doctor and she was willing to write an epi pen prescription, but I told her I didn't see the need for one since the allergist hadn't prescribed one and avoiding nuts was only a precaution. The doctor is writing a note saying that it is unneccesary that I will attach to the waiver. Thanks for your responses. I'm going to get in to another allergist and look at the emergency plan that was linked. I would like to do some food challenges so that we can stop worrying about nuts!

[kjbrown92]

If the doctor wanted you to challenge the nuts in the office, then I would do that, if I were you. And you'd have to test all nuts, right?

There should still be a plan, even for the spinach one, whether it's an epi-pen or not. My DS has food intolerances, and I gave the teacher the complete list, and the plan was, avoid all the foods on the list, and if there is ANY question, to call me. And for parties, he has a bag of safe food there for "treats". His teacher goes out of her way to make sure he feels included in everything (same teacher as last year, and very good about the whole thing). For my DD (also has food intolerances), I send snack in with her, but for "group snack" I look to see what it is, and can okay any additional snacks (not many though). But again, mine are for intolerances, not IgE allergies.

[gilamama]

my dd1 is in kindy with allergy or intollerances (dont know) to wheat, dairy, corn, chocolate, soy, sugars. She does fine with all nuts. So does my gfcf 2 y.o. I was however terrified of bee stings. My dd1's mosquito bites blow up like balloons and take 2 weeks to go away. They were so bad this summer I even applied benedrill cream, and i am a person who doesnt even own tylenol. Well... she stepped on a bee today in school. They put a tomato on it (never heard of that remedy) and she was fine to ride her bike home. I would say to challenge the nuts in your dr's office so you can either put your mid to rest or get your own epipen and be prepared and also appretiate the school's caution but understand that they dont know as much about kids' food allergies as you do (i.e. the diff btwn a rash and an ana reaction).

[kjbrown92]

My DD#2 has the same reaction to mosquito bites. They're HUGE, and hot and red. I put the benadryl gel on them but it doesn't do much. They pretty much just have to wear themselves out (usually a week). I have heard of mustard (the vinegar in it), vinegar, and ice (which keeps the venom from travelling) for stings. I've never heard of a tomato either!

[columbusmomma]

Hmmmm.....
I am a school nurse and all the children at my schools who have epipens have pens that have been prescribed by a physician. A Dr. prescribes and writes the orders to have one so hmm.....??

[gilamama]

My husband had a student last year (18 y.o. student) with a peanut allergy and his mosquito bites were enormous. i was thinking of starting a thread her to see if that is a common thing for allergic people.

Back to topic now.

[kjbrown92]

My DD has huge mosquito bites, and is not allergic to bees or peanuts (but has lots of food intolerances and environmental allergies as well). She's had raging infections 3 times that went from 0-10 in less than 24 hours (toe, thumb, and sinus). For example the toe one started with "ouchy toe" around 8am ended in the ER with IV antibiotics/fluids and them lancing her toe at 3am. It does seem like she has a hyperactive immune system, in my opinion anyway (and I'm obviously not a doctor). Do they have epi-pens in the nurse's office Just In Case someone has an allergic reaction possiby to something they've never been exposed to before?

[Scribe]

I have broad spectrum allergies, and my misquito bites do that. It is my understanding that there is a link, and bee stings would be a concern.

[xekomaya]

Originally Posted by kjbrown92

. Do they have epi-pens in the nurse's office Just In Case someone has an allergic reaction possiby to something they've never been exposed to before?

Very possibly. Epi-pens ARE given out like candy, and I can't say that I feel negatively about that. Folks are usually hesitant to give someone an injection, so if my child had a reaction that a competent adult though enough of to give the epi, I'd be glad.

IMHO, the consequences of the unnecessary epi (assuming its an epi-junior? I hope that would be what they'd have in a school) are FAR less than the alternative.

So yes, I'd sign that waiver, and frankly I'd be sure to have someone write a script for an epi to leave at school. Its much better to have it sit there and expire than not have if God forbid your child needed it.

[ameliasward]

I asked and they do not actually carry epi-pens in the nurse's office. You do need to get a prescription for your child, at least in this instance. I guess the waiver assumed I would also be providing an epi pen with the doctor's blessing.