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Epipens In Every Nursery?


Helen
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Has anyone else read the article in Nursery World about insect bites and stings? I was pretty shocked to read the advice that every setting "should have an Epipen to hand in case of emergencies". Surely we shouldn't ever use them indiscriminately on any child? Aren't they provided by a child's parents if they have a high risk of a reaction?

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Guest Wolfie

I haven't seen the article Helen but yes, it does sound a bit alarming - surely nursery staff have to be given specialist training as well before being able to administer this?

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That was how I understood it. I thought you had to have a certificate from the trainer, who would often be the practice nurse, and that you needed the certificate for insurance purposes. But I'm not certain about it.

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Epipen is a Prescribed medication..so I cannot see it being kept 'just in case'. As with all prescriptions you cannot or should not give it to anyone but the named person.

 

All cases are different and there can be side effects to the drug, being adrenalin.

 

as you rightly say specialist training is needed for giving the drug and in most cases is specific to the person involved so can be done individually for every child involved, retraining for every case. The local school has staff trained fro every child, just because they have been trained once does not cover them for another child.

 

Inge

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I have just updated my first aid training and using an epipen was included. The trainer said as it was included on the certificate we were covered on our insurance. He never said we had to have one just in case but said it would be issued with the child.

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Given that epi pens are prescribed for individual children or adults (and incidentally have to be checked to make sure they haven't passed their 'sell by' date), I wonder where the author thinks we're all going to get one from? Does she have shares in the makers of epi-pens I wonder??

 

Maz

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Not sure but i'm pretty certain that this is mentioned in the day care standards somewhere stating that it is imperitive that staff have relevant training to administer specialist medications, it also states that medication should not be administered without parents consent.

 

I dont feel the parents at my setting would happily give consent for any medication in which we felt the child required!

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As the 'proud' bearer of an Epipen (NOT!!!!!)

 

I can say - it is prescribed, so should only be used for prescribed person. Yes, training should be given/received, but an 'in case' epipen is a farce!!!!!!!

 

Sue :o

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My 4 year old has an Epipen and each time she has gone to a new setting our local community nurse has gone in and delivered the training. It is prescribed and one thing to watch is how quickly it goes out of date - they need renewing and disposing of on a regular basis - just can't find a pharmacy or doctors who is happy to take it, even when it hasn't been used!!

Other thing to mention is when you get the training don't be afraid to ask lots of questions - my daughter had a mild anaphylactic reaction to salmon the other day - lips swelled, went blue but could still breathe - I panicked and didn't know at what point to give it - yet I consider myself as a bit of an expert!!! It's frightening - advice is always give it if you're not sure rather than leaving it too late.

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Hi Janine,

 

My local pharmacy are fine about taking out of date epipens, so it's a shame you can't get anyone to do it. Your doctors surgery should do it, they probably have sharps collected regularly! I watch the date on epipens when they are dispensed, as I pay for my prescriptions and want at least a year on them! (Advised by immunology nurse re this). I have been told to take two Cetirizine Dihydrochloride (standard antihistamine, but cheaper than branded ones) on first signs of a reaction, then use epipen if no improvement within 10 minutes or unless it worsens. It must be very scary for you being responsible for your little one, at least I know how I'm feeling!

 

Sue

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I was horrified when I read the article yesterday and my list of 'to do' things included contacting nursery world. The article gives a link to a website for further information on epipens and when you access the site you get this message:

 

LIFELINE

This website is specifically intended to provide additional patient information and support to those who are currently prescribed EpiPen Auto-Injectors. If you have not been prescribed one of these devices by your Doctor please leave this website immediately

 

That says it all really! In the past I have had a child in my setting who was known to suffer anaphalactic (spelling!!) shock and had an epipen prescribed. This was stored securely in the setting, changed regularly to ensure it was in date and all staff received training on administering it from the practice nurse from the child's GP surgery.

 

I have phoned nursery world and am awaiting a response this afternoon from the 'relevant person' will let you know the outcome.

 

I definitely won't be keeping one 'just in case' and I don't see how any setting could do so as it is a prescribed medication for individuals - I don't even know if all epipens are the same or whether the actual prescription varies from person to person!

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Amazing how things can get out of hand when communication is wrong. I wonder how many other things there are like this, use of egg boxes in nursery perhaps comes to mind. Good job everyone here is on the case - I wonder how many others have just gone ahead and wasted their time trying to get one.

Nikki

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You can't call it a howler today Sue. Not with the HP book out tomorrow - or did anyone find the NW magazine folding itself up into a mouth and screeching at them? :o

 

Um - and besides which, I'm now a little nervous about the first time we publish an article with a blooper in it...

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Other thing to mention is when you get the training don't be afraid to ask lots of questions - my daughter had a mild anaphylactic reaction to salmon the other day - lips swelled, went blue but could still breathe - I panicked and didn't know at what point to give it - yet I consider myself as a bit of an expert!!! It's frightening - advice is always give it if you're not sure rather than leaving it too late.

I remember on our first aid training the chappie said that if in doubt, give the epi-pen and then call the ambulance. Giving the pen would not adversely affect the child in any way, just that the night staff would probably not thank you for it because the children who have had epi-pens are generally high as kites running around the ward all night...

 

Maz

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My feeling is that a magazine that sets itself up to inform a body of professionals shouldn't have made a howler like this in the first place!!!!!

 

Sue

It certainly would have been an easy thing to check, I'd have thought. Mind you, I suppose with tight deadlines for a magazine published weekly it is always possible that things slip through the net. The trouble is with something as important as this, there can't afford to be any confusion, can there/

 

Poor Nursery World - I'll bet they'll be inundated with letters from 'angry of Tonbridge Wells'....

 

Maz

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On the issue of insect bites/stings I actually considered having Piriton available to help counteract any allergy reaction, we happened to have an Ofsted at the time we had bought this 'care' issue up at a staff meeting, they were not in favour of this, reason being parental consent, so we decided against it. I am sue their reaction would be the same for epipens.

 

The reason the discussion came about was because a staff member had an allergic reaction when we were outside and it made us think about what if this happened to a child.

 

 

Peggy

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Amazing how things can get out of hand when communication is wrong. I wonder how many other things there are like this, use of egg boxes in nursery perhaps comes to mind. Good job everyone here is on the case - I wonder how many others have just gone ahead and wasted their time trying to get one.

Nikki

Hopefully I'm going on a training next term which is all about 'urban myths' so I'm going to arm myself with lots of questions like 'can we use egg boxes/toilet rolls' etc. Might ask the epi pen question just to be provocative...

 

Maz

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Really sorry to put a downer on this, but epipens are not toys or things to be bandied about.

Quite so - and are obviously at the centre of much anxiety and misunderstanding both among practitioners and those advising practitioners who have to handle - or might be asked to handle - such life or death situations on behalf of children's families.

 

What I meant was that Nursery World might unintentionally have created their own 'urban myth' in saying all nurseries should have an epi-pen 'just in case' - and further increased the depth of misunderstanding about the subject. These things spread like wildfire and once started, are often difficult to stop. Like the students who tell me they are not allowed to cuddle children in their care 'because of child protection'.

 

Hopefully a suitable retraction/apology on Thursday will put the record straight.

 

Maz

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