7 yr old girl died at school in VA on 1/2/12

[TabiCat]

Oh I thought they were like TX and couldn't stock. I guess I misread something. 

[maeve]

But maeve, doesn't this say that a nurse CAN stock generic Epipen if prescribed by a medical doctor? (You said before VA schools could only take Rx for specific person).

More from the VA code:

D. Pursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize registered nurses and licensed practical nurses to possess (i) epinephrine for administration in treatment of emergency medical conditions and (ii) heparin and sterile normal saline to use for the maintenance of intravenous access lines.
Pursuant to the regulations of the Board of Health, certain emergency medical services technicians may possess and administer epinephrine in emergency cases of anaphylactic shock.

PS tabi, pm me ... I can't figure out pm on this site.

Rainbow,
It says RNs and LPNs.  Many school systems do not have an RN or LPN in the school.  My school district has health clinic assistants at the elementary school level but doesn't put RNs in schools until middle school but I think it's really at the HS level that all schools have RNs.  So for an ES in my SD, there are no RNs.  When my DD was in kindergarten her school had an RN because the RN's child attended the school, but they were redistricted to another school the next year.  Now, I wasn't very impressed with that RN and have found the current health clinic assistant (who's been there since DD was in 1st grade) to be wonderful.  Despite the fact that there are 1,100 students in the school, many with health issues, this HCA will email me when DD has used her inhaler more than once per day or when the inhaler is getting close to needing a refill; she'll also make copies of the log she keeps through the year of DD's inhaler use so that I can provide that to our allergist.  She's been a partner in DD's care and was the one who finally put the hammer down on DD's teacher not having the class wash hands after lunch last year.

[hk]

Also very troubling is the part of the mother's interview where she says that one version of events is that someone "made" her child eat peanut. Ugh.

In kindergarten, another girl forced my son to eat a peanut butter filled keebler sandwich cracker. He came close to dying. No one epi'ed him, they sent him to the bathroom vomiting alone, and then parked him in the office for nearly an hour. They called me and told me he had stomach flu. They insisted he hadn't eaten anything unusual. I found the cracker in his lunch pack later with a small bite taken out of it. Ten kids, two teachers.

Not an apology to be found. They expelled him later without warning as "too great a liability". Private school. But tax exempt and I coulda woulda shoulda blown their cover as a tax exempt facility violating on the basis of a recognized disability.

This really scares me as my DD is dealing with some serious FA bullying at school right now.  This kid absolutely does not care about punishments and just keeps coming back at her like the terminator.  I'm terrified that something like this could happen next.  I thought maybe second grade was too young for something like that, but if it happened to your son in kindergarten... 

[TabiCat]

Yeah I read it reported (by someone claiming to be another parent) that she was Dared to eat a peanut or piece of a peanut at recess.

We have to be careful to not assign adult motive and understanding to kids. We think kinder or second is too young for this to happen because we think it is too young to intentionally harm and that maybe true. However, at that age they don't understand it that way. They don't get the permanency the REAL danger the would be JUST as likely to chase one of our kids with peanuts as a boy chasing the girls with a bug and not see the difference. IMO they are MORE at risk of these kinds of dears, taunting, and bullying  in k-3rd than when older precisely because the kids don't fully understand. Unfortunately their lack of understanding makes things MORE dangerous not LESS.   

[hk]

Yeah I read it reported (by someone claiming to be another parent) that she was Dared to eat a peanut or piece of a peanut at recess.

We have to be careful to not assign adult motive and understanding to kids. We think kinder or second is too young for this to happen because we think it is too young to intentionally harm and that maybe true. However, at that age they don't understand it that way. They don't get the permanency the REAL danger the would be JUST as likely to chase one of our kids with peanuts as a boy chasing the girls with a bug and not see the difference. IMO they are MORE at risk of these kinds of dears, taunting, and bullying  in k-3rd than when older precisely because the kids don't fully understand. Unfortunately their lack of understanding makes things MORE dangerous not LESS.   

Good point Tabi. 

Our situation is that the principal addressed a situation yesterday and literally 10 minutes later the kid did it again.  That is just inconceivable to me, but I'm not 7.

[aouda]

Does anyone know if it is possible to figure out how many epis were administered in schools (national, state, or even district) level in a year? 

I really wish that every epi administration would make the news -- for so many reasons.

[maeve]

Aouda,
The county next door to mine keeps such stats but my county does not.  I imagine, that without some sort of federal requirement to track that data, that it will be hard to gather that information.  Even tracking how many cases of anaphylaxsis lead to a trip to the hospital or how many anaphylactic reactions lead to death is not accurate because there's no consistent reporting standard and the CDC does not require that hospitals report that data (in the way that admission of a person with TB is).

[rainbow]

Where / which interview did the mother say her child was dared to eat a peanut?  I can't find this.  That is really bad!

[rainbow]

Ok I just found this:  Police Say Peanut Was Cause of Young Girls Death


http://www.nbc12.com/story/16465115/police-say-peanut-was-cause-of-young-girls-death


CHESTERFIELD, VA (WWBT) –Police conclude the death of 7-year-old Amarria Johnson's was caused by eating a peanut.

Johnson, who is allergic to peanuts, died last week after police say she ate a peanut handed to her by another child on the playground of Hopkins Elementary School.

Police say that classmate was not aware of her allergy.

Upon realizing what occurred, police say Johnson approached a teacher and was taken to the school clinic.

Police say a clinic aide was attempting to help Johnson when she stopped breathing.

School personnel and emergency responders performed CPR and used an AED, but were unable to revive her.

Police say no crime or criminal negligence was committed by the child who shared the peanut, school personnel or Johnson's mother.

[CMdeux]

The only state that I know keeps such stats-- state-wide, that is-- is MA.

I found the information extremely enlightening the one time that I looked at the numbers.

[aouda]

Thank you for your replies.  So in your district (Maeve) or in MA (CMD), do you remember approx how many school epi shots were given over x months?  What I am wondering is if these shots are ever administered.  If the answer is never, I don't know whether to be elated or terrified. 

[Carefulmom]

So the emergency responders used an AED but no epi?  Can this possibly be true?  That is horrible!

[ajasfolks2]

Crossposting.

I haven't been able to post about this yet.

Right now all I can say is

this could EASILY have been in Fairfax County ,

THANK YOU VERY MUCH!!!



Here's why:


Area schools guard against students' allergic reactions
Thursday - 1/5/2012, 4:47pm  ET
Darci Marchese, wtop.com


From the article:

Fairfax County Public Schools spokesperson Mary Shaw says the system, which serves nearly 178,000 students, is in the middle of producing district-wide guidelines on how to deal with and treat students with allergies.

Shaw says officials want parents, teachers and school leaders to be on the same page, and students in general are treated on a case-by-case basis. Some are allowed to keep epinephrine -- which can be used to treat reactions caused by things like insect bites and foods -- with them while other students will have to get the treatment from the school nurse.

Shaw says students who need them will have "individualized health plans."

http://www.wtop.com/?nid=120&sid=2693335





People,  SAME sh** NEW DAY.

Nearly 4 years since our hideous experiences with Fairfax County began.


Same sh**.



Let me also say that Shaw has SERIOUSLY misspoken:

There are NOT school NURSES in FFX schools.  Same set up as in Chesterfield -- PHN's who over see multiple schools and just "trained" laypersons in the schools on the front lines.


The epipens are LOCKED UP in the "health room" -- no longer called a clinic as there are NO MEANINGFUL HEALTH SERVICES PROVIDED.

After reading some of Chesterfield County School's NEW (as of spring 2011) food allergy policy, there is a MAJOR, MAJOR distinction between it and Fairfax County:

Chesterfield allows and trains for SYMPTOM RECOGNITION by the layperson/"aide" such that there is supposed to be allergic reaction recognition and treatment according to written physician plan.

UNLESS Fairfax County's "new" food allergy policy has the major CHANGE of allowing SYMPTOM RECOGNITION so far as when to administer epipen, there still exists an incredibly flawed and dangerous policy.

From the epipen form for FFX County:

Emergency injections are usually administered in FCPS or SACC by nonhealth professionals. These persons are trained by the school public health nurse to administer the injection. For this reason, only premeasured doses of epinephrine may be given. It should be noted that these staff members are not trained observers. They cannot observe for the development of symptoms before administering the injection.

http://www.fcps.edu/it/forms/se64.pdf


In Fairfax, either the child OR a staff member must report that an exposure has occurred in order for the epipen to be administered, according to policy and in direct contradiction to any/all current best practices.  OF course, this allows for the staff member taking such report to make a decision as to veracity of the report and then refusing to give epipen . . .


and then to try to talk the child OUT of the child's position that there has been an exposure AND that there is a reaction underway . . .

and then to call the parents of said child to COME ASSESS THE SITUATION at the school.



All the while the reaction may progress.



And nothing is done to potentially save the child's life.


Nothing.

[CMdeux]

In MA, the number was startlingly high-- dozens and dozends annually, in fact-- but that's actually more worrisome when you stop to consider how poorly anaphylaxis is recognized and appropriately treated even by medical professionals.  There is ZERO reason to think that school personnel are better at administering epinephrine than ER physicians, after all.

The problem is that the killer symptoms don't really scream "this child is dying of an allergic reaction-- NOW" until it's very nearly too late.   Cardiovascular collapse is particularly challenging as it is a point of essentially no return outside of a hospital setting-- and it can happen with terrifying speed and virtually no outward signs that suggest anaphylaxis is taking place.   

The fact that there are not more fatalities isn't necessarily a reason for schools (or anyone else) to be congratulating themselves; anaphylaxis is MOSTLY self-resolving, after all.  That doesn't mean that the appropriate treatment is "wait and see," since that is effectively "wait and see how lucky we're going to be, here."    Clearly not a good management policy.

[ajasfolks2]

I think the number from Fairfax County, Virginia for 2009 was 59 epipen administrations?

I'll see if I can get link here.



ETA
Well, well well.

The link I had to the report is now defunct.  That's pretty recent.