Epi-pen policy at DCPS - steps to take?

[Anonymous]

I saw one prior thread on this, it seems policies may differ school to school. The school we're likely to end up at next year, as it's our in-bounds (and has other redeeming qualities too), has epi-pens locked (in a jumble) with other kids meds in a box, which is locked again in a cabinet in the nurses office. The epi-pens do not travel with children, period - not even on field trips (because kids don't eat). Was told the department of health prohibited epi-pens being kept anywhere else. I was mostly "ok I'm sure we can work with you on this to find some other set up" until the field trip piece, which just communicates to me that they don't take this seriously or haven't really thought this through at all.

I would like to know how others have worked with their school to get a different set up (ideally pen wherever the kid is, as per the doc) - what did you get/need from the doctor (allergist, ped?), were you able to get a set of pens kept in the classroom (I'm fine coughing up for another set to also keep in the nurses office, though for something that should be wherever the kid is, that seems unnecessary), or with the kid wherever they were, or at the very very least taken when the kids went off site.

Not asking for a debate about anti or pro peanut, whether three year olds should be solely tasked with responsibility for their own life, and so on and so forth. Just asking, if you've got a kid with an epi-pen, particularly a kid too young to manage one themselves, what steps did you take to get your DCPS to follow your doctor's recommendation in terms of placement and accessibility of the epi-pen? Has anyone gone the 504/individual health plan route (which seems like it shouldn't be necessary, but then this is the first time I've run into a school/nurse who thinks taking the epi-pen on a field trip isn't needed, so I may need to adjust my view of what's necessary)?

Thanks!

[Anonymous]

Another big problem is that the schools don't seem to have full time nurses anymore either.

[Anonymous]

OP here - this school does at least have a full time nurse (this year, I suppose that could change? though they didn't indicate it would). Though she can't possibly be immediately available and in her office all the time, by nature of her job, basic human needs, breaks and so on. When she's off site for extended periods someone else has the key, but it's not really a great set up even if she is in her office, all the time.

[Anonymous]

This is definitely an issue, but much of it is dictated by legislation and regulation. There was legislation introduced in the DC Council just this week to allow (and require) undesignated epi-pens to be kept at all schools and school events. That might provide an opportunity for changes to the current system. Info on that legislation can be found at http://legiscan.com/DC/bill/B21-0005/2015

[Anonymous]

DC has had a law since 2007 allowing students to self carry and self administer epinephrine. The school is wrong.

The epi-pen needs to be on your child's person (e.g. in a fanny pack), not in the teacher's possession.

[Anonymous]

Have you privately talked with the teacher and aid? I think these particular issues may be better served by calmly talking with someone that is with the child most of the time. Also, have your kid carry an epi with him/her in his/her bag.

[Anonymous]

An dpi-pen get taken on every field trip my kid goes on. There is always a trained adult present who is carrying an epi-pen.

If the nurse told you this, go to the principal and ask for the school's policy in writing. Most of the fields trips our DCPS kids take go past lunch. If the school has a policy that doesn't include provisions for epi-pens on field trips that is a big problem. And the nurse should not be the only person in the building who is trained on how to use an epi-pen.

[Anonymous]

14:11 I forgot to mention, if the principal told you this policy about field trip, you need to take it to the next level. This is totally unacceptable and negligent.

[Anonymous]

Anonymous wrote:Have you privately talked with the teacher and aid? I think these particular issues may be better served by calmly talking with someone that is with the child most of the time. Also, have your kid carry an epi with him/her in his/her bag.

If the kid is 4, he/she is not likely to be able to self administer. If the teacher is not trained, they are not likely to know when to administer it and even less likely to actually do it. I wouldn't bring this matter up to the teacher unless it's to confirm they are trained on when/how to administer.

[Anonymous]

Yes, she'll be in preK, so not at the self-administer and I assume not even at the self-carry level. Also can't meet with teacher - won't know who it is, and this isn't the sort of thing I can leave up to chance, hoping I get a teacher who works with us. The nurse is the one who outlined the policy - I asked the principal and he directed me to the nurse, so I'm not sure that there's a different policy, but I can definitely ask. I'd like to do so in an assertive, this needs to be taken seriously, but not aggressive I'm going to alienate you (yet) sort of way. But I guess I'd like to understand the process and possibility of getting the school to work with us. If they won't, I don't think attending there is an option (which will be a real problem from an early stages/sped placement perspective...). Yes, nothing will likely happen, but the bad outcome if it does is not worth even minimal risk.

[Anonymous]

When my kid was in kindergarten and early elementary in PA, I got one public and 2 private schools to agree to always have a trained teacher or any other adult responsible for him to carry an epi-pen and benadryl in a fanny pack or keep an epi-pen and benadryl in an unlocked cabinet in the same room as my son. They also agree that the same adults would be trained on how to give epi-pen as well. I had my son's allergist write on our food allergy action plan from foodallergy.org that the epi-pen was to always be in the same location as my son with a trained person able to give the epi-pen. These schools also agree to nut free classrooms.

Here is the food allergy action plan which is essential:

http://www.foodallergy.org/document.doc?id=234

Some highlights of the CDC recommendations for allergies in schools:

http://www.foodallergy.org/document.doc?id=315

More guidelines from the CDC:

http://www.foodallergy.org/document.doc?id=285

Some other things to do:

1. Offer to give educational materials from foodallergy.org to school. Offer to help train personnel.

2. Insist that epi-pen not be locked up in an office somewhere since this goes against medical advice.

3. For early grades, insist no peanut or tree nuts in classroom.

4. Have school enforce a no sharing of food policy.

5. Ask for nut free table for lunch or better yet a table for those eating nut products so child is not singled out.

6. Ask to be notified of any birthday celebrations to take place in school so you can bring safe cupcake to school for your kid. Better yet ask for food free celebrations.

7.Consider auvi-q instead of epi-pen since it is much easier to use and is less scary. There are savings cards available on website below as well as educational material.

https://www.auvi-q.com/

8. Insist child be able to carry epi-pen from 5th grade onward if your child is ready but still insist on trained personnel who will be working with your kid.

9. Ask that all personnel who work with children in school to be trained in CPR and First Aid.

10. Ask to meet with all personnel who will be working with your child.
Always check ingredients of every single thing you give to your child. Read foodallergy.org to learn how to prevent cross-contamination and how to identify anaphylaxis. Do not eat "made in same facility" or "may contain" products. Do not eat Asian food and rarely eat out. Be sure to ask about ingredients. Do not eat other people's homemade food since most people are not trained in how to prevent cross contamination.

11. Consider going to John Hopkins to see their pediatric allergists since they are exploring peanut desensitization.

12. Search for Private Practice OIT on facebook for promising info on peanut desensitization.

I hope that helps. Insist on your rights and a 504 plan as well.

[Anonymous]

One other thing I forgot. An argument against not taking epi-pen on field trips is that anaphylaxis can happen up to 2 hours or so after food ingestion. Also, can they guarantee another child will not offer your child food on filed trips? I doubt it.

[Anonymous]

Foodallergy.org (FARE) has tons of educational info for you and schools. It looks like they even have webinars and videos on youtube:

https://www.youtube.com/watch?v=p2uTNc-Abmg

[Anonymous]

Anonymous wrote:When my kid was in kindergarten and early elementary in PA, I got one public and 2 private schools to agree to always have a trained teacher or any other adult responsible for him to carry an epi-pen and benadryl in a fanny pack or keep an epi-pen and benadryl in an unlocked cabinet in the same room as my son. They also agree that the same adults would be trained on how to give epi-pen as well. I had my son's allergist write on our food allergy action plan from foodallergy.org that the epi-pen was to always be in the same location as my son with a trained person able to give the epi-pen. These schools also agree to nut free classrooms.

Here is the food allergy action plan which is essential:

http://www.foodallergy.org/document.doc?id=234

Some highlights of the CDC recommendations for allergies in schools:

http://www.foodallergy.org/document.doc?id=315

More guidelines from the CDC:

http://www.foodallergy.org/document.doc?id=285

Some other things to do:

1. Offer to give educational materials from foodallergy.org to school. Offer to help train personnel.

2. Insist that epi-pen not be locked up in an office somewhere since this goes against medical advice.

3. For early grades, insist no peanut or tree nuts in classroom.

4. Have school enforce a no sharing of food policy.

5. Ask for nut free table for lunch or better yet a table for those eating nut products so child is not singled out.

6. Ask to be notified of any birthday celebrations to take place in school so you can bring safe cupcake to school for your kid. Better yet ask for food free celebrations.

7.Consider auvi-q instead of epi-pen since it is much easier to use and is less scary. There are savings cards available on website below as well as educational material.

https://www.auvi-q.com/

8. Insist child be able to carry epi-pen from 5th grade onward if your child is ready but still insist on trained personnel who will be working with your kid.

9. Ask that all personnel who work with children in school to be trained in CPR and First Aid.

10. Ask to meet with all personnel who will be working with your child.
Always check ingredients of every single thing you give to your child. Read foodallergy.org to learn how to prevent cross-contamination and how to identify anaphylaxis. Do not eat "made in same facility" or "may contain" products. Do not eat Asian food and rarely eat out. Be sure to ask about ingredients. Do not eat other people's homemade food since most people are not trained in how to prevent cross contamination.

11. Consider going to John Hopkins to see their pediatric allergists since they are exploring peanut desensitization.

12. Search for Private Practice OIT on facebook for promising info on peanut desensitization.

I hope that helps. Insist on your rights and a 504 plan as well.

PA has always been ahead of the curve on special needs.

[Anonymous]

Anonymous wrote:
PA has always been ahead of the curve on special needs.

Actually they were not. I had to meet with the principals and get them to agree with to this after much discussion. It was a learning curve for them. I would do whatever it takes to keep your kid safe including taking it all the way to Kaya, DC council, OSSE, and the mayor if need be.