DRIVING THE INDUSTRY SINCE 1991
“WE TRAIN THE DRIVERS PER EACH STUDENT'S HEALTH CAR PLAN, WHICH INCLUDES THE DOCTOR'S PRESCRIPTION AND THE PARENT'S SIGNATURE,”
— Linda Gingerich, School Nurse, Weld County SD RE-3J
in a spring-loaded injector pen known by the brand name EpiPen. Sue Shutrump, the Trumbull County Educational Services’ supervisor of occupational and physical therapy services, said all drivers are being trained to use the EpiPen for allergic reactions and Diastat suppositories for seizures. “Te administration of the ‘rescue med’ is for students who have their allergic condition documented in their IEP or 504 reports along with a doctor’s prescription, and a parent’s signature indicating permission to admin- ister,” she said. Shutrump, who chairs the NAPT Special Needs Com-
mittee, noted that alternatives to this type of adminis- tration of the EpiPen are to either call an ambulance or schedule a nurse to ride aboard the bus with the allergic child. She said the parent input is mandatory at a school meeting. Te parent must describe what their child’s symptoms could appear to be if going into anaphylactic shock. Te parent is also responsible for monitoring the expiration dates on their child’s EpiPens.
REQUIRED TRAINING AMONG URBAN AND RURAL SCHOOL DISTRICTS
Required training for EpiPen administration may not be an issue in many urban areas of the country. For exam- ple, Rockford Public Schools in Illinois requires students with allergies to carry their own epinephrine pens with them on school buses. Rockford Schools Transportation Director Gregg Wilson stated his staff would “gladly” place a 911 call if there is an emergency, but they require students who may be prone to allergic reactions to carry their own EpiPens. “Our reasoning is that if there is a bus breakdown and a
child is moved to another bus, the medicine moves with that student,” he said. “In our urban area, about 50 miles west of Chicago, our routed buses are no more than 10 minutes away from medical assistance.” Some rural areas approach the issue quite differently. In
northeastern Colorado, school buses for the Weld County School District RE-3J cover 487 square miles each school day. Transportation Coordinator Cyndi Lovell explained that every driver receives Red Cross-certified training, which includes training on EpiPen administration. She noted there has not been a case that has necessitat-
ed any driver to administer the shot in the 20 years she has been in her position. But because the district is far from emergency medical assistance, she continues training her drivers since student passengers who have allergies can choose to carry their EpiPens with them on the bus. Linda Gingerich, school nurse for the school district, trains
on administering the drug to specific bus drivers and substi- tute drivers who have passengers who need it. “We train the drivers per each student’s health care plan,
which includes the doctor’s prescription and the parent’s signature,” she explained. At Lewis Palmer School District in Monument, Colo., students also carry their own EpiPen injectors. Every bus driver has a first-aid certification from either the Red Cross or the American Heart Association, said Transportation Supervisor Tammy Phipps. Te training in that district includes proper administration of the EpiPen by non-med- ical personnel for use as a rescue med until the student can receive medical assistance.
UPDATE ON ADMINISTERING DIASTAT Concerning the use of the controlled substance Diastat,
Shutrump said the parent must describe the symptoms of the child’s possible seizure. If the seizure occurs on the school bus, the child could receive the Diastat by trained personnel, and the bus would be re-routed to go by the hospital to get urgent care for the student. Shutrump ex- plained that each case is different, yet all cases are handled in the manner of teamwork. In any case, the parents sign off on the usage of both the Diastat for seizures and epinephrine for allergic reactions to bee stings, peanuts or other allergies. According to Shutrump, judgment regarding the
administration of these medications must be reasonably prudent, and in most cases be used as a rescue med in isolated, remote areas when time is of the essence in saving a child’s life. “Te bottom line is that bees are attracted to yellow
buses, and with even a history of only one bee sting, a child may experience lip swelling or severe swelling of the tongue and throat,” she said. “Te EpiPen is not to be used without a doctor’s prescription, and the student should carry it with them at all times.” According to Dr. Marilyn J. Bull, a pediatrician of neuro-
developmental disabilities at Riley Hospital for Children at IU Health in Indianapolis, the American Association of Pe- diatrics is currently working on a policy statement regarding the issue of administering these drugs. “We must make sure as clinicians that we are handling this in the right way,” she said. Bull explained the Diastat issue, saying there is extensive
review of the administration process, which is well under- way but will take until spring 2015 for official recommenda- tions to be released with regard to the seizure medicine. Epinephrine injections and Diastat administration for stu-
dents are increasingly important in-flux issues for all school districts. As yet, there is no uniform response or protocol. School districts’ efforts to adjust to the new federal law
bear continued watching, together with any attendant legal cases addressing this expanding subject area.
www.stnonline.com 15
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84