Posted By Steve Langston Should employees at a leisure centre be trained in administering adrenaline in case someone suffers from nut allergies etc (anaphylactic shock)? During summer holidays the centre run activities for school children. Some parents make us aware that their child suffers from nut allergy and has an EPIPEN adrenaline auto injection in case of emergency. We already have employees trained to administer oxygen, DEFIB etc. Surely the administraion of this medication should be ok with correct training, parental consent etc. Any opinions greatly appreciated.

Posted By Merv Newman I agree with the first posting if you are aware of a possible problem, get the training to deal with it (with suitable practical testing (my wife, as a nurse, learned how to give injections by practising on oranges) and periodic refresher training. The moral reasoning is clear. Legal consequences may be trickier. I would hope that the employer would commit to support fully any employee who might get involved with the law as a result of such an intervention.

Posted By John Murgatroyd http://www.hse.gov.uk/firstaid/index.htm

Posted By Peter Batty Training to the local Playgroup staff was deleivered by the Comunity nurse. It took around an hour and covered all the issues including what to do in case of doubt. The attendance by a known severe nut allergy child also made it necessary to complete a major review of the risk assessments, and subsequently the activites that could be completed. Typically "Creative Modelling" needs to be strictly controlled, empty boxes may have been in contact with "nuts". No cakes, biscuits, chocolate etc can be brought to the sessions. You would be amazed at how many products contain nut products!!!

Posted By Steve Langston Just to say that following the original posting a community nurse delivered training to the staff. The training lasted 40 minutes and involved a discussion on the signs and symptoms, watching a video made by the anaphylactic campaign and practical use of the pens. We have also developed a protocol that is discussed and signed by the parents/carers. If anyone would like to see the protocol we use please e-mail me direct. It is interesting to know that 1 in 80 people suffer from allergies in the UK. some do not show major symptoms but 1 in 160 peopel in the UK suffer from Anaphylactic shock! As a consequence we are now rolling out this training to all leisure centres, theatres etc within the district. A useful reference website is: www.anaphylaxis.org.uk Thanks to all who responded Steve

Posted By Richard Mathews Kevin You are right to be cautious on this issue and whilst I would use the epipen, I would not expect it to be used by anyone who didn’t feel comfortable about their competence. As you say, an ambulance could be called, and it may get there in time, but in severe cases of anaphylactic shock or if the casualty is in a remote place they would be in serious danger of not surviving the wait. Richard

Posted By Steve Langston Agreed....in part The epi-pen is to be used by fully qualified first aiders who have already been trained as to the differences between heat exhaustion and anaphylaxis anyway! To me there is little difference to first aiders assisting with/using an epi-pen (in the correct circumstances) as there is with training them to use a defibrillator or training them to remove a spinal injured person from the bottom of the swimming pool. After consultation with the local NHS trust, school and community nurses it reasonable to expect an anaphylactic suseptibale person is on our public premises at any time. It is also reasonable to expect that someone may have an allergic reaction whilst in our care at one of our leisure classes. As for the speed of the ambulance we are lucky that response times are low, however we are advised that even the minimal wait will place the individual at significant risk. Therefore we must put into place reasonable steps, (I do not consider having a trained nurse at each of these premises reasonable). As a final thought, most parents are not first aiders, when they have a child who is diagnosed as a sufferer they recieve exactly the same training as our staff are recieving. Therefore we have fully qulaified first aiders, who have undergone an extra session on anaphylaxis recognition and treatment, a protocol that gets all the essential information from the parent/carer and authorisation from them to administer/assist with the injection. One other option is to exclude known sufferers from accessing council services, I am sure the Daily Mail (or other reputable national press) would love to have that story. Or as we have no liability to administer first aid to members of the public (under current First Aid Regs) maybe we should just say sorry you have to wait for the emergency services but here is a cushion to rest your head on, maybe we should stop administering first aid to any member fo the public for any situation after all some people are allergic to plasters....

Posted By Ken Taylor One of our schools has 12 epipen carriers. It is now usual for trained teachers to be asked to voluntarily use epipens upon the prior agreement of the parent/guardian for pupils known to require this and unable to self-administer. These things save lives that could be rapidly lost long before ambulances arrive and I can see no reason why similar procedures cannot be used for sports centres and the like. In addition to the training video, there is a trainer version of the epipen for practice purposes. The procedure is little more than removing a protective cover and stabbing the right end of the pen into the outside of the casualties thigh (through the clothing in most circumstances).