Confused on my first aid course

[jane5]

Hi, I have been on a first aid course today and I am confused by some of the information I have been given and I hope somebody can clarify.

One thing is epi pens..... If a child in my setting has an allergic relation, so maybe swelling on the face and lips, and this child has never been prescribed an epi pen, but somebody else around either a passerby, another child in the setting has an epi pen prescribed to them can we as childminders use it on the child with the allergic reaction (not even a life or death situation) if we think it might help that child?

And if our own children have an accident and are taken to hospital whilst we are working and have minded children there, do we have to inform Ofsted? So if my dd falls and my dh takes to a&e for an X-ray, do I have to phone Ofsted and inform them.

Thanks in advance for any info

[FussyElmo]

Hi, I have been on a first aid course today and I am confused by some of the information I have been given and I hope somebody can clarify.

One thing is epi pens..... If a child in my setting has an allergic relation, so maybe swelling on the face and lips, and this child has never been prescribed an epi pen, but somebody else around either a passerby, another child in the setting has an epi pen prescribed to them can we as childminders use it on the child with the allergic reaction (not even a life or death situation) if we think it might help that child?

And if our own children have an accident and are taken to hospital whilst we are working and have minded children there, do we have to inform Ofsted? So if my dd falls and my dh takes to a&e for an X-ray, do I have to phone Ofsted and inform them.

Thanks in advance for any info

I wouldn't be rushing to use an epi pen unless it was a life or death situation. A mild allergic reaction can be combated with other measures.

You don't have to inform ofsted of any accidents to your own children

[moggy]

Epi-pen is only for life-threateding anaphalaxis (my son has one). No way can you give a child someone else's epi-pen, it could kill them- it is carefully prescribed and there are different ones for different ages/sizes.

[loocyloo]

Epi-pen is only for life-threateding anaphalaxis (my son has one). No way can you give a child someone else's epi-pen, it could kill them- it is carefully prescribed and there are different ones for different ages/sizes.

this worried me the other day ... schoolie & I were watching Tracey Beaker ( but one of the new ones, where she is older and working at dumping ground! actually - it was the episode she was leaving I think! ANYWAY ... ) a girl had an allergic reaction to some food and collapsed on the floor, think she'd stopped breathing, and an adult rushed to office, got epi pen and used it - child recovered. then big talk about how this child had never had a reaction to anything before. and I'm sitting saying to schoolie - that's wrong - you should never use anyone elses epi pen.

I used to have a minded child with an epi pen, and I was told to only use mindees for mindee and NEVER to use it on anyone else, WHATEVER. when I worked in nursery we had 2 children with epi pens, and again, we had to be sure, that if we used one, it was the correct one for that child. if you could use any epi pen on anyone, then surely we would have them in our first aid kits?

if you are out and someone suffers life threatening reaction to something, then you treat the best as you can and call 999 ASAP!

[tulip0803]

Devil's advocate .... I did my first aid about 6 weeks ago - Situation he put to us a child you know has been diagnosed and normally has an epi pen but does not have it today has an anaphylactic reaction. You dial 999 and are told they will send an ambulance but it will be 15-20 minutes (we live in a rural area). The child is unable to breathe. You have a child in your care that has an epi-pen. Do you watch the child die because they cannot breathe and have left there epi pen somewhere and the ambulance will not get there in time or do you give your child's epi pen, knowing that it isn't their pen?

Also child has a major asthma attack on the beach and does not have inhaler and you do not have another what do you do?

[Maza]

The problem is, if you used another child's epipen, how would you explain tit to the parents? "Sorry, I used your child's medicine on someone else, and so for the last hour your child hasn't had an epipen around to protect him, good job he hasn't had a reaction to something..."

[tulip0803]

The problem is, if you used another child's epipen, how would you explain tit to the parents? "Sorry, I used your child's medicine on someone else, and so for the last hour your child hasn't had an epipen around to protect him, good job he hasn't had a reaction to something..."

But how would the parent feel if their child was the one that forgot it?

How would you be able to stand and watch a child die?

You can call the parent's of the other child and arrange to collect prescription from doctors/ chemist immediately when child with anaphylactic shock has been taken to hospital. The child that is suffering an anaphylactic shock may not have the chance to wait for the ambulance to arrive.

Rock and a hard place decision


If you are near a chemist and can get the child there they will administer an epipen from stock (also asthma inhaler) without a prescription for an emergency situation - however my nearest chemist is 7 miles away from my village, same with doctors. Nearest hospital 14 miles(country roads). nearest ambulance may be in another county. we had a little girl die in our main town last year as it took 26 minutes for an ambulance to arrive at the scene of a house fire that the police and fire brigade were attending a fire engine took her in the end but was too late. If that is the main town you can imagine what it is like for the rural areas :( On that occasion they had moved all the ambulances into the city 35 miles away :(

[Maza]

Oh that's so sad Tulip.

Indeed it is a rock and a hard place situation.

[jane5]

Thank you so much for your replies ladies.

As a childminder I thought that we were not able to give any child a prescription only medication if it was not prescribed for that child with or without parents permission, for example a baby I care for has baby gaviscon prescribed 1sachet per feed, the parents give the baby 2 sachets as they think it works better but I said I can only give the amount prescribed on the box until the doctor changes the dose


I understand if a child was dying in front of me I would do what ever I could to save the child BUT we are not doctors, we are not trained to diagnose illness' we can only guess what is wrong by looking at the symptoms and the trainer wasn't actually talking about a child dying in front of you he was saying that if a child was showing an allergic reaction, lips swelling and laboured breathing he would administer any body else's epi pen to them whilst waiting for the ambulance. I would give over the counter antihistamines but not an epi pen!!


I will phone my DO tomorrow and ask for clarification but I wondered what you experienced ladies thought.

Thanks again

[tulip0803]

Oh that's so sad Tulip.

Indeed it is a rock and a hard place situation.

You can see why we are being given the advice we got on our course! At the moment our area cannot guarantee a fast emergency response. 7 miles away is a fire station with first responder vehicle which will be sent if available ie not already out on a call or the fire engine isn't already out. We have had ambulances queuing at A&E unable to off load patients to make them selves available again. Not a good situation :(

I have a friend who suffers anaphylaxis shock with loads of things and she has two pens with her at all times and goes for a ride in the air ambulance a few times a year.

[tulip0803]

Thank you so much for your replies ladies.

As a childminder I thought that we were not able to give any child a prescription only medication if it was not prescribed for that child with or without parents permission, for example a baby I care for has baby gaviscon prescribed 1sachet per feed, the parents give the baby 2 sachets as they think it works better but I said I can only give the amount prescribed on the box until the doctor changes the dose. Yes we can only give medication to a child if prescribed to them in the correct dose in ordinary circumstances.

Iv looked into epi pens as my dd age 7 has had severe food allergies from birth, as her symptoms include lips swelling and chest pain and affect her breathing I asked about an epi pen and because antihistamines (bought over the counter) control any reaction the consultant didn't want to prescribe an epi pen as it speeds up the heart rate and can cause problems with the heart if it's not needed. If a consultant thinks there is no need for an epipen then how can a first aider dispute? He is trained in emergency first aid not a qualified paediatric allergy specialist. Our trainer said to give piriton even if not prescribed for that child if they have not been diagnosed with an allergy or have not been prescribed an epi-pen for a minor allergic reaction. And then seek medical help ASAP

I said this to the first aid trainer and he said the consultant was wrong... And that epi pens can do no harm.... I looked on the internet which said that an adults dose of adrenalin given to a child is to much and can cause harm ..I agree too much medication is wrong for a minor allergic reaction but for major anaphalaxis with swollen airways and breathing ceasing , an emergency situation it could be the only option to keep a child alive

I understand if a child was dying in front of me I would do what ever I could to save the child BUT we are not doctors, we are not trained to diagnose illness' we can only guess what is wrong by looking at the symptoms and the trainer wasn't actually talking about a child dying in front of you he was saying that if a child ( it could be my child with her allergies) was showing an allergic reaction, lips swelling and laboured breathing he would administer any body else's epi pen to them whilst waiting for the ambulance. I would give over the counter antihistamines but not an epi pen!! If the child has collapsed and ceases breathing - there is a difference between a minor reaction and an anaphylaxis reaction and you will be able to tell as everything is swelling fast, you would not be able to get piriton in. Anaphylaxis is an extra-ordinary situation and turns everything upside down..

He was also saying lots of other things that I have always been told not to do as a first aider and didn't seem to know about childminders, more about nurseries such as I can't drive a child to hospital unless another adult is in the car.... I work alone and my backup childminders do actually go out sometimes and I couldn't wait until they came back before I got a child treatment for a non life threatening injury if I couldn't get hold of the parents, 2 people might be best but I would actually strap a child in a car seat and drive to the hospital if it was in pain but didn't require an ambulance as I would with my own children. Most paediatric first aiders do not understand childminding and everything is based on school/nursery settings which do not equate to us. The trainers have a blinkered outlook and by the book attitude. When we were being assessed we said that we would not be able to ask for help as others we would have to do the calling and everything ourselves. He took this into account and we were assessed on what we would do rather than what the book says should be done. In an emergency you will do what you have to do, you won't sit around with a child waiting if you can take them straight to hospital

I will phone my DO tomorrow and ask for clarification but I wondered what you experienced ladies thought.

Thanks again

Some people do not understand childminding.

I looked after an older child who had an epi-pen and not all her reactions required the epi-pen if her lips started to tingle we gave piriton and she would recover. We never had to use the Epi-pen

[jane5]

Devil's advocate .... I did my first aid about 6 weeks ago - Situation he put to us a child you know has been diagnosed and normally has an epi pen but does not have it today has an anaphylactic reaction. You dial 999 and are told they will send an ambulance but it will be 15-20 minutes (we live in a rural area). The child is unable to breathe. You have a child in your care that has an epi-pen. Do you watch the child die because they cannot breathe and have left there epi pen somewhere and the ambulance will not get there in time or do you give your child's epi pen, knowing that it isn't their pen?

Also child has a major asthma attack on the beach and does not have inhaler and you do not have another what do you do?

In the situation that I knew the child had an epi pen prescribed but had forgotten it I would probably use somebody else's but the trainer was saying to use it on a child that hadn't been prescribed an epi pen and in the case of my dd where the consultant had advised against it, he said the consultant was wrong and we should use it just incase she got into a life threatening situation before the ambulance arrived.

[jane5]

Some people do not understand childminding.

I looked after an older child who had an epi-pen and not all her reactions required the epi-pen if her lips started to tingle we gave piriton and she would recover. We never had to use the Epi-pen

This is my point, to use an epi pen for an allergic reaction is not necessary, if they were collapsed on the floor unable to breath then that is different

[JCrakers]

Its one of those fine line decisions isn't it. I do have an epi-pen here in the cupboard but wouldn't think of using it on anyone but the child its prescribed to.

But if a child was to collapse after eating something and I could see the progressive collapse after eating and i'd rang 999, the person on the phone would be able to guide me surely. If I mentioned I had an epi-pen in the cupboard then they could advise on the phone? Then it would be recorded that they said I could give it to them.

Its one of those snap decisions you would have to make although a snap decision could be the wrong one so its not a positon I ever want to find myself in. :(


For just swelling of lips etc I would administer Piriton if prescribed, if none was prescribed I would ring parents to ask as long as child wasn't in immediate danger. An epipen should only be used if the child can't breathe and then will collapse.

[Tealady]

If a child goes into anaphylactic shock then you'll be calling 999

We were told on my first aid course that they may advise you to use another person's epipen. We were also told that ambulances carry them so will leave you with a replacement if you have used somebody elses in that situation.