Talking Allergies

I came across some information that has me quite confused - and concerned. (Many thanks to Deb from the peanut board for finding this link. )

Teachers belong to the Elementary Teachers' Federation of Toronto and their collective agreement can be found at http://www.ett.on.ca/2004-2008-Elementa ... pt2-05.doc

Under Working Conditions it states the following:



D.2.1. Concerns me greatly. Does Sabrina's Law outrank a collective agreement? This agreement is for the school years 2004-2005, 2005-2006, 2006-2007 and 2007-2008.

D.2.3. States *except as defined in the Board protocol on the administration of medication*. Have all Ontario Board protocol's been updated? as of January 1, 2006?

I was quite surprised when I first read this because at my son's school every staff member is trained to administer an epi-pen. I can't see the principal forcing them to administer medication if that were against the agreement.

AM, I'll try to verify this later this week, but ....

1) *except as defined in the Board protocol on the administration of medication* - yes, my understanding is that the new law means board protocols are updated;

2) I think the administering "on a regular basis" would not be required with anaphylaxis/Sabrina's Law. Administering an EpiPen to a child would be an emergency situation, so that's different from requiring a teacher to give a regular treatment.

I have been really thinking about this issue. In BC, children and youth nurses (hired by community) are responsible to train school staff, but it is really loosey - goosey, as I am sure it is everywhere. Usually, in my experience, it means a 30 minutes with all the staff while they eat their lunch. AC's newest newsletter has an article about how only 12% of Ontario teachers had a pass rate on how to give an epipen, even though 76% surveyed had received training. I am sure these results are typical.

If a child has a medical condition such as diabetes, a nurse working for the province is responsible for setting up a care plan and training staff, usually special education aides. The staff have to sign off that they have been trained and feel comfortable with the training and are responsible for administering whatever the care plan entails. School secretaries are usually the ones in a school who have received first aide training and are responsible for minor illnesses, accidents. These staff are often trained by these nurses too.

I think this is the route we should be seeking for our children too. There needs to be an adult on hand who has comprehensive training on how to deal with life-threatening allergies. This is how we would get effective advocates in the schools, as those adults would see it as their responsiblily to keep that child safe. I believe that all staff should be trained, but that someone needs to be directly responsible for that child. Typically, for a child with a condition such as diabetes ( I am using diabetes as an example as in some ways the conditions are similar, as both can lead normal lives as long as safety protocols are in place), 3 or more support staff would be trained specifically to work with that child, in case of staff absences. The teacher would work closely with the support staff and be aware of all that was needed for the child, but their primary responsibility is teaching.

There are aides who are available to help with children with all sorts of special needs who are not bound by the same type of contracts with unions, and these people should be utilized in the school system to support our kids. (Especially on the playground and lunch rooms, where teachers are not present.

Gwen, it's the first point that has me most concerned. *No Teacher shall be required to carry out any of the following medical procedures: administer medication by injection,*

I know of a child in Toronto - and the only person at that child's school allowed to administer the epi-pen is the principal. Anyone that spends a lot of time in an elementary school knows that there are days that the prinicipal is not in the school. When the parent questioned, she was told it was because of the teacher's collective agreement.

Yet, at my son's school - same school board, and same collective agreement - everyone, even the caretaking staff, are trained and are allowed to administer epi-pens.

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I've read over Sabrina's Law several tmes. It does not specify who can administer. But, it does state that someone has to be available (which is not the case if only one person can and that person is off-site at a meeting).

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I'd also like to add my own personal opinion here. I think the statement about not administering medication by injection is intended to protect the teacher's health. Not being fully trained, the risk of accidentally injecting yourself with someone else's needle is pretty risky - especially these days. However, I don't think there's as much risk with an epi-pen as with (for example) an insulin shot. Plus, with other injectible meds you need to get rid of air bubbles, etc., and there's much more risk of injuring the patient. So, I do understand the concern the teacher's (and their union) have.

I think that the epipen is not really considered in the "injection" category as it is an auto-injector. First aid people are not "allowed" to inject anything into anyone, but can give the Epipen without concerns for liability. My opinion of course.

I have heard that teachers will not be be administering the second dose of twinject if needed. I am also wondering if ambulance personal will administer the second dose if needed.

Back in September I spoke with my son's principal about my son's allergy, and I mentioned to her about the twinject. Basically, I just wanted to give her a *head's up* about a new injector that will eventually make it's way in to her school. (Last year there were at least 5 students carrying epi-pens.) I gave her the twinject web-site, but did briefly explain how it works.

She said she would look into it, but from my explaination she felt they would use the first shot - but not the second. I'm actually quite OK with this. If I switch to the twinject I will still send two. One for my son to carry and one to be kept in the office. In three years I have forgotten to send his pen twice. I figure it's still worth keeping a back-up at the school for those days.

Also, the ambulance should be called immediately - and in my city all ambulances carry epinephrine and all paramedics are qualified to give it. They would probably not use the epi-pen - they would use their own supply.

Mylene, I agree with you about the epipen no really being in the *injection* category. But, how do you convince a school of that? My personal experiences with going to the Superintendent of Education (not allergy related) was a very negative experience. I'm hoping Sabrina's Law will straighten this out. I'm scared to move.

My son is four and is severely allergic to peanuts. I recently had to refill my son's epi pen prescription because it had expired and my allergist/asthma physician assured me that my son (5 years old next month) will only require one dose of the epi-pen and then the ambulance is supposed to be called and that if he needed a second dose the ambulance attendants or paramedics have the necessary skill, training and supplies to give him a second dose if he needed it.

Yesterday I mentioned to one of the school supervisors (monitors at lunch and outside playground about who in the school is supposed to administer the epi pen if the school nurse is not there and she took it to her meeting with the supervisors and they are in the midst of getting all the supervisors, principal, and secretary of our elementary school to train them and retrain them in administering the epi-pen.

I also am in the midst of meeting with the principal of our school to see what they have adopted as standards, guidelines and policies for children with anaphylaxic reactions to dairy, soy, peanuts, etc. I will update you all after I meet with her.

I am trying to get in place some sort of set standard of policies and guidelines in the elementary school for when my son starts kindergarten in September of this year, but I will actively work with and support our lobbyists, when I can, to get Sabrina's Law implemented in BC. In the meantime, I need some solid plans in place in time for this September.

I am a teacher in Ontario and a parent of an allergic child. So far I have received little information about Sabrina's law through my teacher's association or board. THis is not surprising as change takes time in large organizations. I have been in regular contact with my board as to how the current anaphylaxis policy will change with the passing of the new legislation. I would strongly encourage other Ontario parents to do so as well.

My board thinks that for the most part they are already compliant with the law. I disagree with this and am pushing for an improved policy. The law mandates avoidance and emergency plans for allergic children however the difficulty will be overseeing what the specifics of these plans will be. School board officials and principals unfamiliar with anaphylaxis might not know what measures will be needed for avoidance plans particularly for allergies to things like milk, sesame or other less common allergies (most schools are familar with peanut allergies).

This is a very important time in school boards in Ontario right now. Policies are being reviewed. There are guidelines coming from the Canadian allergists to help. Parents should contact their boards to see what or if anything is happening. Now is the time for your input when the policies are being revised.

I don't believe that the administration of epinephrine falls into that category as it is life saving measures. In New Brunswick, I only had to sign a waiver to allow the teachers to administer it, if required. When I lived in Manitoba, I had to sign a waiver there also

ps Happy New year!