Wrong use of a PEEP, that's not it's intention it would be part of the care plan, but that would depend on what is meant by residents, supported living, people living in a domestic dwelling, care home etc?

http://www.hse.gov.uk/firstaid/faqs.htm

Employers
Tablets and Medication

**emotive comments about moral use of the term 'others' removed**

Really not sure what your question is asking - but as a first aider I would be trained to recognise the symptoms and look for a bracelet, card, epi-pen etc.

How would a 'PEEP' type document help, apart form causing confidentiality issues?

To get to the point - surely all you need to do is ensure trained and competent first aiders, and support them in their decisions. If you have people with known allergies that could cause anaphalaxys then additional training to provide further confidence in the use of epi-pens might be beneficial?

What do your first aiders think?

Good luck

A PEEP does not (should not) identify specific ailments - it identifies evacuation needs and how to meet them.

I really don't see anything wrong with training people to help others in life-threatening emergencies. People are trained to give CPR so why on earth not to use an Epi-pen? But I don't see any connection at all with PEEPs.

quote=Kate]A PEEP does not (should not) identify specific ailments - it identifies evacuation needs and how to meet them.

I really don't see anything wrong with training people to help others in life-threatening emergencies. People are trained to give CPR so why on earth not to use an Epi-pen? But I don't see any connection at all with PEEPs.

You say the first aiders don't want to do it - the first step to fixing this is to find out why they don't want to do it. They may have some worries that can be addressed. For example, they have sometimes heard scare stories (from training providers attempting to sell them insurance) about a purely imaginary risk of being personally sued.

Bingo! the trained first aiders have stated that they were instructed that 'under no circumstances should you administer any medicines'

There are specific courses for the administering of epi-pen medication BUT they default to the first advice (I don't blame them either)

PEEPs (Personal Emergency Evacuation Plans) are irrelevant as regards the use of epi-pens. Good points made earlier in this thread include 'People are trained to give CPR, so why not train them to use an Epi-pen?' Also 'Anaphylaxis is a PROPER emergency...' i.e. a condition requiring very prompt treatment with adrenalin delivered via an epi-pen. Without it, the affected person could be dead before any ambulance arrives.

Quite a number of my former employer's primary schools each had one or two pupils with severe allergies, usually to peanuts, which put them at risk of anaphylaxis in the event of exposure to the allergens involved. Although schools tried to avoid such exposure, it could never be guaranteed. Therefore, the schools held epi-pens and usually had effective arrangements to match. These included ensuring that all employees (teachers & support staff) knew who the pupils were (often via a 'mugshot' of them with their name, class, etc.) and training of at least a good proportion of employees in using the pens. My understanding is that using an epi-pen is fairly simple and mostly comprises being taught where and to apply it, apparently with practice on a piece of pork or other cut of meat which has the same needle resistance as human flesh.

I understood that similar arrangements existed in secondary schools I worked with. In addition, any secondary pupil at risk usually also carried an epi-pen and that several trusted classmates/friends knew where it was carried and how to use it if necessary - which seems to reflect the fact that using an epi-pen is a simple procedure.

In echo of earlier sentiments the phrase "time is of the essence" is very pertinent if anaphylaxis occurs!

Graham B

My first aid train stated the same but also said that if you are on the line to 999 they can talk you through and that way you are giving the medication under medical guidance. That is the issue with first aiders not giving it by themselves - they are not medically trained.

MadiB

Most of us would disagree with a first aid trainer who thinks that a 999 call centre receptionist talking someone through using an epi-pen to administer adrenalin constitutes medical guidance.

This comment is not intended as a criticism of the knowledge, training and skills of such receptionists, but rather the shortcomings of a emergency situation in which someone needs to use an epi-pen promptly and listen/respond to the 999 receptionist at the same time. Also, it wrongly assumes that a mobile phone is readily available and/or that mobile coverage exists! In various rural/remote parts of the UK mobile phone coverage is feeble or non-existent. Coverage can also be patchy in some urban areas where sizeable buildings can cause 'shadows'.

Graham B

I'm glad this has evoked such debate

Given my scenario and circumstances (sic: workplace) circa 5000+ persons I will not advocate the training nor authority to administer, even if trained.

The only scenario I would consider would be were the individual is awake and conversant.

as I say this is very much a case of my specific workplace and after consultation with the management and first aiders

How would you know if the individual wasn't having an epileptic fit, heat stroke, had fainted ad infinitum

as I stated, this is a certain scenario not a closed workplace/ office etc were everyone knows one another

And its still Health and Safety that gets a bad name. We are all terrified of being sued for trying to save someone's life! Back to the training to use defibs or give CPR!
just last week a colleague came into our office and said she had seen someone lying down outside our building. Someone else had said he had been their 20 min's, a discussion ensued about should she ring 101 or 909 or what?
While this was going on another colleague asked me to accompany him and we went outside and spoke to the guy and gave him a little shake. Turns out he was just drunk. But at least now we new he had not had a heart attack or was actually dyeing on the public footpath outside our door!
I don't believe the HSE or LA would give a dam if a first aider or anyone else for that matter used someone's epi pen on them in what could be a life or death situation

As per Terry556s comments - if its an epi-pen carried by an individual for their own use and they went down - you would still say no to administration?? I don't think a H&S manager has the power to 'authorise' whether or not a first aider administers an Epi-pen - is it not the First aider who makes this call (Open question - didn't think its for anyone other than a trained FA to make such a decision)

In one of our sections we have individuals who may need this action in an emergency so we train our staff to administer epi pens. we have had no issues with this or false administration of them.

Thank you for all your comments, interesting discussion

I write this response as an experienced first aid instructor/assessor of a range SQA and OFQUAL accredited first aid courses including anaphylaxis management.

This thread deeply troubles me, it is clear that whole basis of this thread is misinformation and scaremongering probably by the litigation brigade. Nobody in the UK has been prosecuted for providing emergency first aid. The new Social Action, Responsibility and Heroism Bill is there to guard just against this. In fact it is far more likely that a nominated workplace first aider be prosecuted for failing to carry out a basic lifesaving intervention for which they are trained than being prosecuted for making the wrong call.

The UK Resus council say this about the matter "There is no legal problem in any person administering adrenaline that is either prescribed for a specific person or administering adrenaline to an unknown person in such a life saving situation (through specific exemptions in the medicines act)"

Further, to address the point raised of "only administering if the person was conscious" and "How would you know if the individual wasn't having an epileptic fit, heat stroke, had fainted ad infinitum" Well....if you were able to confuse fainting with anaphylaxis then you really shouldn't be a first aider. If you are not sure what i mean do a google images search for anaphylaxis, you'll see what i mean!!

To sum up, "Anaphylaxis is a severe allergic reaction – the extreme end of the allergic spectrum – and is life-threatening. Anaphylaxis is a medical emergency, and requires immediate treatment" If you decide to wait, epi-pen in hand, until an ambulance arrives the casualty will likely be dead by the time they get there.

Here is what anaphylaxis UK say: "Adrenaline is life saving and must be used promptly in anaphylaxis. Delaying the giving of adrenaline can result in deterioration and death. This is why using an adrenaline device is the first line treatment for anaphylaxis. IF IN DOUBT, GIVE ADRENALINE FIRST and then call for help."

https://www.allergyuk.or...-anaphylaxis/anaphylaxis

Hi Steve, my apologies, absoloutley no intention of tarring anyone with any brush.

My response is not aimed at any individual but at a gerneral theme, not just on this thread but a wider first aid context. I guess it is just a little frustrating that so many people would sooner watch somebody asphyxiate in front of them than to perform a low risk, simple lifesaving intervenion that requires very minimal training. And all this for the fear of ending up in court. 

The part that troubles me most about this thread is that we appear to be talking about 5000+ student accomodation envirnment where all of the first aiders have refused to provide a basic level of care. Terryifying really. Were a student to die of anaphylaxis in this accomodation where the casualties auto-injector was available but refused to be used, i suspect there would be a very real case for negligence.

I would contest a couple of points here. 

1) I can see there being legal issues with a company keeping a stock of Epi-Pens, these are prescription only medecines and they should only be administered (by a lay person) when they have been prescribed to a person. Ie somebody at risk of anaphyslaxis would carry a epi-pen and the first aider would administer their epi-pen to them. Were you to witness somebody in anaphylatic shock and you had another pen available then you'd have a judgment call to make. But to have a 'policy' where the company keeps a stock of them is definitely going to be an issue. 

2) We are not talking about a by-stander here. This is deemed a workplace under the the health and safety at work act where the organisation have a duty which extends to those that are not employees. The Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate and appropriate equipment, facilities and personnel, this is a statutory duty. Where a workplace is required to and has nominated workplace first aiders they then have a legal duty to provide emergency care until professional help arrives. 

If first aiders are not willing to accept this legal duty then they should not accept the role of first aider. 

Please qualify what "legal duty" a first aider would be failing to accept.

The employer has a legal duty to assess requirement and make adequate provision.

Invariably First Aiders are volunteers from the workforce - some rewarded, some recognised and many without benefit over and above the training provided.

Epi-Pen administration is not part of the general FAAW training so the individuals are acting responsibly within their competence.

You can have the moral argument to include additional skills (Epi-Pen, defib etc.) within the general training but until such tiime that it is every qualified individual has the right to decline organisational expectation.

Correct, there is no duty to provide first aid care to non employees but can can you see a situation in a (presumably university/college) environment where first aiders would only provide first aid to to staff but not students? Do they just leave the student as found and say, sorry not staff and walk on by?

The HSE says this: "The Regulations do not place a legal duty on employers to make first-aid provision for non-employees such as the public or children in schools. However, HSE strongly recommends that non-employees are included in an assessment of first-aid needs and that provision is made for them."

Legal duty is perhaps the wrong phrasing, to clarify; it would be easy to argue that first aiders that are nominated under the regs, owe a duty of care to those that they are treating. Of course this is a common law duty. The requirements on employers to provide equipment and personnel is a statutory duty. I would still dispute the fact the first aiders in a work place environment can be deemed 'volunteers' and hold no duty of care.

The point i made is not whether they are currently competent but whether they should be competent and should be providing that level of care should it be required. The point to remember is that they have clearly been approached by a person on their site who has potential specific first aid needs. This information now needs to be considered in the first aid needs risk assessment. From the information presented i would consider it a no brainer that this training be provided and staff be available to provide this basic life saving care if required.