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Anaphylaxis procedures for Kindergarten


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#1 Perpetual Sound

Posted 21 March 2017 - 11:38 AM

Hi there,

I was just wondering if anyone knows of where to get resources for dealing with anaphylaxis in a kindergarten?

I am on the committee and at the last meeting we decided to move a student's EpiPen from out of the office to a space that is central to the playground and the classroom, is accessible to everyone including parents/visitors, and with the rest of the emergency equipment (evacuation pack, first aid kit, fire stuff).

Since that meeting we have had push back by one teacher and her aid to say that they want to keep the EpiPen in the office in the child's folder. The argument is that if the child needs the pen they would move the child into the office away from the other children. The office is at the opposite end of the facility to the playground where they also eat lunch. She seems to think that she has between 20 mins and 2hrs to administer the pen.

What is considered best practice? I feel that if the committee is going to stick to their decision, we should have some evidence to present that our change is best practice for risk management and emergency procedure.

#2 MadnessCraves

Posted 21 March 2017 - 11:49 AM

I'd be speaking to the parent about this, they probably would be quite upset to find out the epi pen planned to be moved without their consultation?

They will also likely have the best resources as well.

I'm surprised the pen isn't kept with the child at all times either. in DD's last school, the epi pen was kept in the same room as the child, and the bag that carried it always went outside with the the duty teacher at recess and lunchtimes. It also featured a photo of the child on the bag.

Good luck, I hope you find something that works best for everyone!

#3 AggyW72

Posted 21 March 2017 - 11:50 AM

She is wrong. The child could be dead within 20 minutes - 2 hours.
I wish there was some consistent policy. DS's ;ast school kept each child's Epipen in their classroom - which was then locked at recess and lunch!
I would consider what your committee has done to be best practice. It is an emergency device and should be treated as such.

#4 a letter to Elise.

Posted 21 March 2017 - 11:56 AM

They are wrong. You absolutely do NOT have 20min - 2 hours to administer the epipen. It needs to be administered as soon as there are signs of anaphylaxis. This could be within minutes of exposure, and it can progress very, very quickly.

Best practice is to have the epipen with the child with the allergy. Next best thing would be close to them within the school. In a large school, the office is often too far away.

#5 Kallie88

Posted 21 March 2017 - 12:32 PM

The child should have a management plan, that would be my first point of call. And yes, that teacher is wrong, epi pen must be delivered as soon as possible, even if its just suspected anaphylaxis. A central storage point makes more sense, but yes i would make that change in consultation with, or inform the parents before enacting it.

#6 lisacat

Posted 21 March 2017 - 12:37 PM

The decision that the committee has made is best practice.
I would have at least one person attend training in first aid in an education and care setting HLTAID004.
This has first aid, asthma and anaphylaxis in one course.
If the kindergarten is under NQF you can use this as a guide.

#7 Bwok~Bwok

Posted 21 March 2017 - 12:41 PM

Jesus - We had 15 mins to get my DN the Ambulance/Hospital, even after giving the injection.

Once they start reacting, you don't have much time when they are anaphylatic.

So everything has to be on point.

#8 Riotproof

Posted 21 March 2017 - 12:50 PM

Echoing others above. It needs to be readily accessible. Ds's preschool had a medicine cabinet for all the meds, but they had a centralised first aid kid containing an wouldn't amongst other things.

I would consult ascia https://www.allergy.org.au and please check you've got the latest action plan for anaphylaxis for that child. It specifically states you do not move the patient. They do not walk. They sit or lie. It sounds like a refresher course for staff would be a good idea.

#9 MarigoldMadge

Posted 21 March 2017 - 12:51 PM

Have a flick around other centres policies, and also talk to other centres.

I was on the management committee for my DD's kinder, while she was ANA to peanut and egg. We were a community kinder within a local council, and would meet regularly with a group of the other kinder committees in the same council, precisely to nut out these kind of issues and policy decisions.

Here is a link to one my local kinders allergy policy,

https://rowenstreetk...y-2015-V3.0.pdf

They had a large number of complex allergy kids when this was written a few years ago, and also had Allergies Australia provide them with assistance and advice.

You need to be mindful of access, temperature, easily available to the right people etc

At our kinder, each child was assigned a large plastic box with their medication inside, their photo and name at the front of box, grouped in classes, stored at adult head height in a bookcase adjacent to the eating area and a door to the outside.

Our office door was often closed, due to meetings, staff eating lunch etc, and the office was often cluttered or in a state of flux.

ETA - and yes, you shouldn't be moving the child to the medicine, the medicine goes to them, hence it needs to readily accessible internally and from the external play grounds.

Edited by MarigoldMadge, 21 March 2017 - 12:56 PM.


#10 Tired & Nasty

Posted 21 March 2017 - 12:53 PM

That teacher needs some serious retraining.
The child could be dead in well under 20 minutes.

The epipen is to cease or at least slow down the allergic reaction of airways closing, etc

You have to administer at first signs, not take child to another room, and stuff around for minutes looking for pen, then read instructions. There is no time for that.

If the epic pen is not close to the child or locked away you have lost valuable minutes that could save their life.

Best practice is to have it with the child, so where ever the child is the pen is in the same room.

A central location is ok, much better than being stored away where it will take time to get.

#11 fancie shmancie

Posted 21 March 2017 - 01:02 PM

I wouldn't be happy that the epipen is now in an area that is accessible to parents/visitors or anyone who happens to be walking past.  Nor should it be held in the office.

The pen should be in the child's room and when the child is outside, the supervising staff should have the pen with them.

At the primary school I work at, the pens are in the classroom with the child.

At recess and lunch, each teacher on playground duty collects a bum-bag to wear with the school's epipen in it as the classrooms are not accessible and the children  may be in a play area furthest away from their classrooms.

Bum-bags are returned to office at the end of recess and lunch.

#12 Perpetual Sound

Posted 21 March 2017 - 01:10 PM

Thank you for your responses. They all pretty much confirm what I was already thinking and yes I was shocked that the teacher said 20 mins to an hour. I know for myself I start reacting immediately to my food allergy.

Just to clarify, we are a stand alone Kindergarten (QLD) with one large room and a fenced in play area. The office is at the front of the room and the playground is at the back. The committee voted to move the EpiPen from the office at the front, to adult head height at the back of the room next to the door to the playground (ie the halfway point of the two spaces). Although attached to a school we are not actually part of the school.

I am seriously concerned that she hasn't had proper anaphylaxis training and after speaking to the committee pres, I'm going to contact First Response and get them to send me through some information on the courses and their recommendations for treatment.

The parent of the child was spoken to about moving the EpiPen and she agreed - its just the teacher who is arguing against. I will speak to the parent again to see if she can attend the next meeting.

Thank you very much for that link MarigoldMadge - that is really helpful and I will show the committee and teachers.

#13 MarigoldMadge

Posted 21 March 2017 - 01:18 PM

no worries OP, lot's of schools and kinders have their policies published on their websites - find one in QLD if that helps.

Also, just as an aside from committee days, this kind of stuff is where the committee has to throw their weight around and overrule teachers and other staff.

Also, issues like this shouldn't be subject to a vote - this would be something our core committee would just decide on, and it would not go to a vote. If the core committee believes it's best practice, legally, procedurally, reputationally, under advice from external bodies, then it's a given.

#14 Perpetual Sound

Posted 21 March 2017 - 01:28 PM

As a general rule we do over rule the teachers where needed - we had an open discussion and it was decided that this would be best practice. At the time of the discussion the teacher voiced her opinion that it shouldn't be changed because 'that's how its always been done' but the committee decided as a group that the response wasn't good enough.

I think what is coming into play is that this teacher is taking any changes personally and its becoming about her and not the kids. If this affected her employment or her personally in any way I would understand, but this is completely about the kid's safety and doesn't affect her as a teacher.

I've just spoken to First Response and they are sending me the information for Asthma and Anaphylaxis First Aid training. I guess at the very least this issue has highlighted that the staff need their training updated and we can now move to get that happening.

My own child has asthma so this will also make me feel better about the care he receives.

#15 Bearynice

Posted 21 March 2017 - 01:31 PM

I would think that the child would have a management plan in place. It would have been written up under the guidance of a medical professional.
I think majority of schools and kinders use the bumbag with a photo idea.
I think the kinder teacher is trying to throw her weight around.
She should follow the management plan.

#16 kgtnkate

Posted 21 March 2017 - 01:32 PM

I teach and direct a sessional kindergarten in Victoria (it's not like a school situation with lots of through traffic.

We have 2 rooms both open onto the playground , large but more like huge backyard not school playground size.

Our epipens, including the generic spare epipen hang on hooks at the classroom door in insulated bags.

We don't take them outside as a preschool child shouldn't be carrying their own pen and with multiple staff it makes sense to keep them in the one location.

I think where your teacher is confused is that an episode of anaphylaxis may show up as long as 2 hours from contact but it might also be immediate.

Not good practice to move the child bring the medication to the child to minimise time wasted.

Check the anaphylaxis policy - it will clearly state expectations and it is a mandatory policy under NQF guidelines so no room to individualise it.

#17 kgtnkate

Posted 21 March 2017 - 01:33 PM

Anaphylaxis training should happen every 3 years and updated manually.

Ummm - annually.  WE review ours every 6 months and practice with the dummy pen but when we do our annual CPR update they throw in an anaphylaxis refresher.

Edited by kgtnkate, 21 March 2017 - 03:01 PM.


#18 Mollycoddle

Posted 21 March 2017 - 01:57 PM

Quote

I'm surprised the pen isn't kept with the child at all times either. in DD's last school, the epi pen was kept in the same room as the child, and the bag that carried it always went outside with the the duty teacher at recess and lunchtimes. It also featured a photo of the child on the bag.


This.

#19 Perpetual Sound

Posted 21 March 2017 - 02:15 PM

^^ as stated above, we do not have a school set up.

We are a standalone kindy which consists of one very large room with a big fenced in playground off that room - so as PP said - more like house and a big backyard.

While I understand school children and duty teachers carrying around the EpiPen, this is does not apply to Kindergartens and Daycare facilities. The teachers are not required to carry EpiPens on them but they do have to be readily accessible from both the classroom and the outdoor play area.

EFS

Edited by Perpetual Sound, 21 March 2017 - 02:21 PM.


#20 TND

Posted 21 March 2017 - 02:50 PM

I work in a kinder and also have a child with anaphylaxis.

The epipen needs to be in a central location accessible to all adults. It needs to be able to be grabbed quickly. It also must be taken whenever there is a fire drill or emergency so should be kept will all the other medications.

There should be the child's action plan on the wall close by to the medication so that all staff know it off by heart.

I would also be very concerned about the teachers lack of training.  Not sure about in Qld but here your training must be up to date to even teach.

#21 Perpetual Sound

Posted 21 March 2017 - 03:34 PM

TND do you have a link to your kinder's policy like the one PP posted above?

The more evidence we have the better I think. Everything that you have said in your post is exactly what the committee has put in place.

I too am seriously worried about the teacher's lack of training. Its actually really scary to think she's gone so long with the incorrect information. According to the president, the teacher completed her first aid training along with the school (she also teaches a few days of year 1) so I dont know how in depth that training was - it cant have been the Asthma and Anaphylaxis specific training.

#22 IkeaAddict

Posted 21 March 2017 - 03:41 PM

Something accessible in a central place in the playground and something in the classroom. Not that hard

#23 Mmmcheese

Posted 21 March 2017 - 03:46 PM

I'll pm you

#24 seayork2002

Posted 21 March 2017 - 03:50 PM

I can only comment on what our school does and of the classrooms I see regularly they are grouped in 2 and there appears to be an epipen in one classroom for the two classrooms

I am presuming there are others in the library, computer labs etc. but I am not sure

NSW primary

Edited by seayork2002, 21 March 2017 - 03:53 PM.


#25 Bethlehem Babe

Posted 21 March 2017 - 04:20 PM

Sorry, toddler and open page on phone.

Edited by Bethlehem Babe, 21 March 2017 - 04:21 PM.





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