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PostPosted: Thu Oct 18, 2007 3:17 pm 
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Joined: Tue Nov 07, 2006 6:40 am
Posts: 50
Location: Victoria
Has anyone else heard of this?

We just had a call from our school's health nurse to say that they won't be instructing teachers on how to administer this second dose because it's an open needle because from what I understand presents a risk. (My husband took the call)

I have heard that there are some changes to Work Safe BC policies around health care and the safety of needles but I'm not sure of the details. A colleague is checking this out.

I've also asked who is responsible if teachers are not aware of the changes to the School Act and new Anaphylactic Framework if something happens?

I can't imagine anyone standing around while a child is in anaphylactic shock and not administering it but if they are not trained...then what?


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PostPosted: Thu Oct 18, 2007 3:51 pm 
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Joined: Tue Nov 07, 2006 6:40 am
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Location: Victoria
The more I think about this the more I question the logic behind it. If the exposed needle of the second dose is an issue, why then is the exposed needle of an already administered needle not an issue too?


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PostPosted: Thu Oct 18, 2007 6:49 pm 
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Joined: Tue Mar 22, 2005 11:17 pm
Posts: 6492
Location: Ottawa
Quote:
If the exposed needle of the second dose is an issue, why then is the exposed needle of an already administered needle not an issue too?

It would be an issue.

They are most likely concerned about needle stick injuries and contracting an illness such as HIV or Hepatitis. This is a very real concern within the health industry.

In most cases, the ambulance should arrive within a few minutes but you may want leave an Epi-Pen with the school and carry a Twinject on the child. You would have 2 doses if you required it when the child is with you and the school could get the second dose from the office.

I would definately recommend the student carry some form of auto-injector on them.

_________________
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Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Thu Oct 18, 2007 7:50 pm 
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Joined: Tue Nov 07, 2006 6:40 am
Posts: 50
Location: Victoria
We'll definitely make sure she has two doses however that needs to be but from an educator's perspective there are going to be a lot of kids in the classroom with only one dose because parents just can't afford it. We barely afforded the Twinject this year and it's more reasonable than 2 epipens but a lot of parents won't have the finances to do this.

Maybe we should advocate for schools to be purchasing at least one epipen for the office?

I'm still struggling with the potential risk as it seems there is equally as much risk handling the first dose as there is the second dose. Either way you can still get poked.


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PostPosted: Thu Oct 18, 2007 10:12 pm 
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Joined: Mon Apr 11, 2005 9:38 pm
Posts: 933
Location: Oakville, Ontario
Hi Michelle,

I live in Ontario. The school board in our particular area has expressed that they will only administer using an Epipen autoinjector, or the first dose from the Twinject. Because the second dose in the Twinject is a manual injection, they would not administer this dose (teachers will not administer using a manual injection process as they are concerned it would not be done correctly (or something to this effect)) (sorry, I can't quite remember the rationale behind their decision). I went to an information evening last fall, and it was VERY clear that the second dose of the Twinject would not be administered. They recommended that everyone carry an Epipen during the time they are at school, and not the Twinject.

_________________
15 yr old daughter: no health issues
12 yr old son: allergic to peanuts, tree nuts, eggs, fish, sesame, sunflower, mustard, poppy seeds, peas, carrots, some fruits, instructed to avoid all other legumes (except soy & green beans), pollen, cats, horses


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PostPosted: Thu Oct 18, 2007 10:17 pm 
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Joined: Tue Nov 07, 2006 6:40 am
Posts: 50
Location: Victoria
Thanks for your response.

I can't imagine how one could incorrectly administer it.

What did they do with the old anakits that were not just manual injections but had to be measured by the persons weight? They used to freak me out yet Health Nurses trained here with those in the past.


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PostPosted: Thu Oct 18, 2007 10:42 pm 
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Joined: Mon Apr 11, 2005 9:38 pm
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Location: Oakville, Ontario
Were the teachers trained on using the anakits?

I think the Epipen design is pretty foolproof (unfortunately, I know this because I've had to use it twice with my son). I think everyone just wants to make sure that everyone feels comfortable with one design, one method for delivery, and that no mistakes are made in using a device to deliver a life-saving medication.

Don't get me wrong, I really like the Twinject as well, but we have to make sure the school staff feels comfortable. In our private lives, we can choose to carry either device, but the schools must feel more comfortable with the Epipen.

_________________
15 yr old daughter: no health issues
12 yr old son: allergic to peanuts, tree nuts, eggs, fish, sesame, sunflower, mustard, poppy seeds, peas, carrots, some fruits, instructed to avoid all other legumes (except soy & green beans), pollen, cats, horses


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PostPosted: Thu Oct 18, 2007 10:49 pm 
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Joined: Tue Nov 07, 2006 6:40 am
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Location: Victoria
We didn't have the anakit in school because there were epipens by that time but in daycare the health nurse's trained the staff.


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PostPosted: Fri Oct 19, 2007 6:28 am 
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Joined: Tue Mar 22, 2005 11:17 pm
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Location: Ottawa
I think the twinject's first dose is very similar to the Epi-Pen (you just need to remove a cap from both ends). The issue seems to lay in the second dose being a proper needle.
Many schools here in Ottawa were concidering only accepting the Epi-Pen but I think that has subsided and some schools are allowing the Twinject. Check with your local school.
I agree that Twinject is much more affordable as it is two doses for a cost similar to that of one Epi-Pen. For those without a drug plan that is a crucial savings. We already spend a lot on special foods.

_________________
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Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Wed Oct 24, 2007 3:13 am 
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Joined: Sat Oct 01, 2005 8:55 pm
Posts: 412
Location: Vancouver, BC
Teachers are not allowed to administer injections, so the 2nd dose of the Twinjet is the problem. I do not think it is up to them, I believe it is part of their union contract. The nurses union probably states that they can't teach patients algebra (ha, ha, ha!)

I am sad for Twinjet, I am glad they are around. Before they came on the scene, Epipen trainers were $6.50 each. Twinjet gave theirs away for free, and now Epipen does too. So it is good for us that there is competition.


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PostPosted: Wed Oct 24, 2007 6:23 am 
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Joined: Tue Mar 22, 2005 11:17 pm
Posts: 6492
Location: Ottawa
Pamela Lee wrote-
Quote:
Before they came on the scene, Epipen trainers were $6.50 each. Twinjet gave theirs away for free, and now Epipen does too. So it is good for us that there is competition.

I second that! :)
With the soaring loonie, perhaps the price of the auto-injectors will come down some too? Maybe we should all head to the states some weekend and purchase Epi-Pens and TwinJects en masse!

_________________
Moderator
Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Wed Oct 31, 2007 2:10 am 
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Joined: Tue Nov 07, 2006 6:40 am
Posts: 50
Location: Victoria
Quote:
Teachers are not allowed to administer injections, so the 2nd dose of the Twinjet is the problem. I do not think it is up to them, I believe it is part of their union contract.

I haven't found it anywhere in our teaching contract that says teachers can't give an injection. I did speak to someone at the BCTF today who is also looking into this.

Quote:
The nurses union probably states that they can't teach patients algebra (ha, ha, ha!)
:lol:


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PostPosted: Mon Nov 12, 2007 12:31 am 
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Joined: Tue Nov 07, 2006 6:40 am
Posts: 50
Location: Victoria
I keep thinking about this and looking for more information. What isn't quite making sense is that if it's considered neglect if a teacher doesn't administer the epipen or the first dose of the twinject, yet the a child needs a second dose...and the teacher just stands there, wouldn't this be considered neglect as well?

Possibly it's not because they've not been trained but what teacher would want that weight over the shoulders? How do we advocate for this change, how do we make teachers more comfortable and how do we advocate for Twinject to make their second dose more user friendly?

My big thoughts for the evening....


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PostPosted: Mon Nov 12, 2007 7:34 am 
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Joined: Tue Mar 22, 2005 11:17 pm
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Location: Ottawa
Quote:
What isn't quite making sense is that if it's considered neglect if a teacher doesn't administer the epipen or the first dose of the twinject, yet the a child needs a second dose...and the teacher just stands there, wouldn't this be considered neglect as well?

It would be concidered neglect if they did not call 911. Assuming that the auto-injector worked properly, it should give relief for 15-20 minutes (in a smaller body I think it would be closer to the 20 minutes). The ambulance should be there within that time and the EMS would take over.
If your school has an auto-injector for your child and if your child is wearing another one, this would give you 2 injections which the school staff can administer.
Cost is a huge issue though... :(

It seems to me that the BC Ministry of Education was balking at the whole peanut butter ban idea because it would create a financial hardship for many families. Peanut butter being a cheap form of protien.

Could we not use the same argument for allowing the second twinject dose to be administered?

_________________
Moderator
Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Mon Nov 12, 2007 5:53 pm 
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Joined: Tue Nov 07, 2006 6:40 am
Posts: 50
Location: Victoria
Quote:
Could we not use the same argument for allowing the second twinject dose to be administered?


Yes, I think this argument could be used and a few others. I keep thinking about this and concerned about all those families that can't afford two epipens. I think there needs to be some strong advocacy for the Twinject and teaching of it.

My other concern is what if the ambulance doesn't come within 15-20 minutes for some reason. Then is it neglect if the solution is there and not being used?


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