Teachers barred from helping epileptic kids

Should California teachers be allowed to administer Diastat, a life-saving medication, to epileptic children? These days few schools have a nurse on campus. Reason.TV’s take is titled  Union Jobs vs. Children’s Lives: Which side are you on?

As the father of a child whose allergies require her to carry an Epi-Pen at all times, Mark Hemingway sympathizes with the parents of epileptic children who need immediate access to Diastat. He writes in the San Francisco Examiner:

Like my daughter’s EpiPen, Diastat comes in a specially packaged syringe designed to be easily administered with little or no medical training. That’s because it usually has to be administered before an ambulance can arrive. The medication was administered by nonmedical personnel in California schools for more than 10 years, before the California Nurses Association abruptly changed its policy last year.

However, the Epilepsy Foundation, California Medical Association and the Association of California Neurologists supported the bill. The only real opposition came from teachers unions, which made sure the bill never emerged from committee.

I suppose the union’s theory is that disability law will force schools to hire a full-time nurse to administer Diastat if an epileptic child enrolls. Otherwise, epileptic children wouldn’t be able to attend school without risking their lives.

I carried an EpiPen on trips for awhile after a bizarre tongue-swelling incident — never explained — that sent me to the emergency room barely able to breathe. Jabbing yourself with a preloaded syringe is easy — if you’re not having an epileptic seizure.

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Comments

  1. Why doesn’t Huff introduce a bill to get a nurse in every school? Epilepsy is not the only serious medical condition our kids face. Our middle school of 600 kids has no nurse. Ever. Our insanely overburdened secretary administers medical help to a steady stream of kids every day. The true “anti-kids” people here, as usual, are stingy Republicans who think they can get Mercedes services on a Kia budget.

  2. Let me change that last line to “first world services on a third world budget”.

    And add: the more Republicans axe the social safety net, the more the burden falls on schools to serve as the social services agency of last resort. Child protection agencies, public health programs, unemployment benefits, mental health supports are all anemically funded and constantly imperiled by heartless and feckless Republicans. We in the public schools see the aftermath: emotionally and physically messed up kids; parents who have nowhere to go for help; erstwhile middle class parents taking a nosedive into poverty; parents working ungodly hours at slave wages (because of that’s all our “free market” creates these days) who are thus unable to do proper parenting; kids who cannot see the board because their parents cannot afford glasses; kids inching towards diabetes who drink Coke for a recess snack because Coca Cola has infinitely more money to advertise than public health propagandists… Republicans, do we want to be more like Denmark or Guatemala? We’re rapidly heading toward the latter.

  3. dangermom says:

    But the point is not that parents of epileptic children don’t want nurses in the schools. There aren’t nurses in the schools now, and that does need to be fixed. But meanwhile, there are kids in need of medication, and you can’t just cut them off until there’s a nurse at the school. California is not going to be able to afford school nurses anytime soon; the budget problems are getting worse, not better. If the bill gets passed, the result will not be that we get nurses in the schools, no matter which party is in control.

  4. A partial solution is to offer a voucher worth the cost of a public school education to diabetic and allergic students so that they can attend a non-union school, or at least one willing to accommodate their needs. It may not work in every case, but it won’t cost the taxpayers a cent.

  5. …You say epileptic, I say diabetic… The “Diastat” threw me.

  6. This is a nobrainer, and I really don’t see what it has to do with unions. Maybe they’re the only ones here who can see the potential for lawsuits.

    I would not want to be administering medication of that nature to a student. This is a world, mind you, in which we can’t give them aspirin.

  7. Dangermom, you speak as if our budget woes are incurable, but they’re not. Here’s how all the other advanced nations in their world fund decent public services: tax the upper income brackets at 50% or higher (rather than say, further exploiting the poor with scratch-off lottery tickets). Our rich pay 34% max. Why bash the unions (one of the last vestiges of middle class America) while letting the rich and their trustafarian kids off the hook? If Queen Meg gets elected, the little people will suffer even more. The rich will invest their lightly-taxed fortunes in their trustafarian kids and Bangalore start-ups, while America decays.

  8. dangermom says:

    I didn’t say the money problems are incurable. But they are certainly not going to be solved in the next year or two. (And I don’t particularly want to argue budget politics.)

  9. Mark Roulo says:

    Here’s how all the other advanced nations in their world fund decent public services: tax the upper income brackets at 50% or higher (rather than say, further exploiting the poor with scratch-off lottery tickets)

    That is more a federal option, though, right? I’m pretty sure that if California raised the *state* income tax to 50%, enough rich would leave that things would be worse.

    What do you suggest California do to raise an additional $20B in taxes per year?

    -Mark Roulo

  10. Raise the state income tax.

  11. Where in California are the Republicans in charge?

    The late Cathy Seipp had a piece about her daughter’s inhaler and the principal.

    http://reason.com/archives/2002/04/01/asthma-attack/singlepage

  12. Mark Roulo says:

    Raise the state income tax.

    To what level? And starting at what AGI?

    -Mark Roulo

  13. Union schools, bloated and still bloating administrations, and union-protected lousy teachers are some of the main reasons I plan to home-school my kids. There are other ways to “socialize” them with other kids–which is necessary, but not nearly as much so as some would have us believe.

  14. I’ve had tons of epileptic students — several who had seizures very regularly in my class and one who eventually had surgery — and never heard of Diastat. We have a nurse in our building, so perhaps she has it, but this can’t be that common if I haven’t seen it come up in umpteen years.

    I can’t even give a kid a Tylenol (and I keep a well stocked desk supply of Excedrin), so I don’t see how I could administer something like that legally, even if I wanted to. The most I can do is hand a kid a bandaid.

    Why are they even bothering with the union? They need to sue for a school nurse. They don’t cost THAT much. It’s one position per building, for heaven’s sake. What the hell?

  15. Miller Smith says:

    Dear god! Please look at the directions for administering (http://www.diastat.com/pdf/Ped%20admin.pdf) and-with a serious face-say that you don’t understand the serious reservations that a regular everyday classroom teacher would have being required to perform this procedure!

    Can you imagine the legal liability a teacher would be exposed to? Can you imagine the serious disruptions and gossip that would occur from the other children and parents if it were known that a teacher did this to a child in need?

    Stop putting every damn new thing that comes down the pike on the teacher’s back.

    Now I do know that the union wanted broad protections for liability included in the bill but were rejected-which then ended in the union’s opposition to the bill. Maybe we should talk with the people who wanted to leave the teachers liable abut why they wanted to have teachers who come to the aid of a student subject to hell.

  16. On the budget:

    It STILL goes back to unions when you talk the budget crisis. The public employee unions are bleeding state and local governments dry by demanding impossibly generous pensions for retirees. Pensions and debt service are the two biggest barriers to actually making sure the tax money collected by Sacramento goes to the promised purposes. The state needs to make sure it’s spending the massive amount of money it ALREADY gets effectively before asking for (demanding) one more cent from any tax payer.

    The two best things that could happen for the California budget would be for the state-level public employee unions to disband and the ability for voters to pass bond measures to be curtailed. Instead, all most people can think of is more taxes instead of solving problems.

    On liability:

    If liability was the sticking point, then I agree with killing the bill. There has to be some sort of protection in there for school personnel because there’s actually a dual liability exposure. If the medicine is administered incorrectly there is obvious liability. If the medication is administered late or not at all, there is also a liability exposure with regards to the duty of school personnel acting in loco parentis. The second one is shakier on legal grounds, but even if a suit fails, the damage to whoever is the target could be significant.

  17. Interesting how this is twisted into a union bashing issue.

    Here’s a better idea, California should quit underfunding its schools and provide each school with a nurse.

  18. So how much would constitute fully-funding education? 50% of the state budget? 60% of the state budget? The entire state budget?

    “Underfunding” is such a vague term don’t you think?

  19. From the Hemingway editorial: “Like my daughter’s EpiPen, Diastat comes in a specially packaged syringe designed to be easily administered with little or no medical training.”

    Thanks to Miller Smith for providing the link to instructions for administering pediatric Diastat. A quick summary: it involves first differentiating between a “cluster” and “ordinary” seizure (?), then A. pulling down the child’s pants, B. spreading open his rectum, C. inserting the syringe into his rectum, D. depressing the syringe plunger slowly while counting to three, E. keeping the syringe in the rectum for another three count, F. removing the syringe and pressing the rectum closed so the medicine doesn’t leak out.

    I am not sure under what circumstances this process could accurately be described as “easily administered.” Well, except for one: if you’re trying to score a cheap political point and the whole story gets in the way.

  20. Cranberry says:

    Even if a school [i]had[/i] a nurse, the nurse wouldn’t be able to reach an epileptic in time to administer the dose. That’s why schools in our state are at great pains to give all school personnel training in administering epi-pens.

    Are the teachers’ unions in California seriously proposing that epileptics should choose to risk their lives, or brain damage, every day, for an education? There are Good Samaritan laws in many states which protect Good Samaritans from lawsuits.

  21. Are the teachers’ unions in California seriously proposing that epileptics should choose to risk their lives, or brain damage, every day, for an education?

    You think the tae kwon do instructors, the swim coaches, the librarians of the world are ready to insert meds up a kid’s rectum?

    Whatever the kids are risking, they’re risking it every time they leave their parents.

    Just another in a long line of absurdities demanded from public schools.

  22. I’m not a medical professional. I’m not going to stick anything in any child. I’ll keep peanuts out of my classroom (for the allergic kids) but I’m not going to “insert” medication into a student. That’s not the role of a teacher. Some might try to make that my role, some might say “what about the children”–I’ll teach them math, thank you. If you want them to have medication, either have a nurse on campus or, if the condition is strong enough, perhaps an alternate placement is in order.

  23. Cranberry –
    Epipens are not for epileptic seizures…they contain adrenaline (otherwise known as epinephrine) to counteract a possibly fatal allergic reaction to bee stings, peanuts, etc. Children who need an epipen are trained to self-administer, but that doesn’t always work if the child does not recognize the initial onset of symptoms and the allergic reaction incapacitates them. As for administration, all you need to do with an epipen is take it out of its case, pull off a blue safety tab, and jam it into the person’s thigh and hold it there. Given a situation where a child is in anaphalactic shock and has an epipen available, I would not think twice about administering it.

    Gotta loves the names of the disorders and these drugs – Epipen is not for epilepsy, and diastat is not for diabetes.

    As for the diastat, I have no interest in administering it. Seizures are not inherently fatal unless choking occurs. Best thing to do is make sure the person is laying down on their side and the head is on a soft surface.

    As for liability… Good Samaritan laws are on the books for just about every state, but the details in each vary. In NY, as long as the responder does not commit gross negligence, they are protected from criminal and civil penalties.

    Quite frankly, anyone who can but fails to act in a possibly fatal medical emergency for a child because they fear being sued is a coward. Life is precious. As for those who honestly have no clue how to help, then stand back.

    My suggestion? Even with nurses on site, schools should provide mandatory Red Cross first aid training to all teachers.

  24. So what happens when the regular teacher is out sick? can the school train each sub that might be assigned to her/his classroom on how to administer Diastat? I agree with Supersub — this issue is being overdramatized by the reference to “life-saving.” All of the epileptics I know are at risk when they have seizures mainly if they happen to be on a high spot when the seizure strikes and they fall from it.

  25. Quite frankly, anyone who can but fails to act in a possibly fatal medical emergency for a child because they fear being sued is a coward

    Oh, come on. This is just bizarre misinterpretation.

    The issue is a) can the kids have the meds with them in class, making them an exception to the rules and b) should the teachers be REQUIRED to be ready to administer the medication–which most assuredly does lead to lawsuits.

    If you can’t figure out the difference between that and Good Sam laws, then you’re just being a tad silly.

  26. My nephew has seizures and Diastat is only to be administered in life-threatening situations. We’ve never had to use it. By the time you realize the seizure isn’t going to break and the kid can’t breath, you have already wasted one to two minutes of precious time.

    If I was the teacher with a kid in a life-threatening situation under these guidelines, I’d have the class out of the room and the kid’s pants down even before the nurse got there.

  27. Molio identifies another factor–what do you do with your other students while addressing the need of the epileptic kid?

    Have any of you ever taught or worked with a student who has epilepsy? I have. She never had a seizure around me, but I knew the teacher who was working with her when she had one in class. She didn’t have time to administer the Diastat, between caring for the student and trying to clear the room to maintain a certain degree of modesty for the affected student.

    I have sped colleagues who have needed to call in help to manage other students while dealing with the kid who’s seizing…and if it’s a bad one, that can be a long time until help arrives. For most kids, observing a seizure can be traumatic and scary in the elementary years, and potentially embarrassing to the person with epilepsy in higher grades–an issue which teachers need to consider when managing these situations.

    Seizures can be serious and they can kill. One killed that student of mine. At home. However, a seizure that’s serious enough to administer something like Diastat also requires 9-1-1 as well–and that’s how I was trained. I haven’t been trained to administer Diastat, and I was frankly told during my sped training that if you are not explicitly taught by a medical professional how to administer any medical device or technique, don’t do it. It’s not an issue stemming from unions, but an issue stemming from liability concerns. It is a very big issue in sped classrooms, especially self-contained academic classrooms with very low level students who have significant physical disabilities. The line between doing it right and not doing it right can be very thin in some places. Plus we aren’t licensed to dispense medication.

    I might also add that my district medical training includes the use of Epi-Pens (which I do know how to use because I carry one myself) and AEDs. And while first aid training is provided by the district, they always seem to manage to schedule a mandatory training which sucks off a lot of us from taking advantage of it on a regular basis (and our training is, in my opinion, better than the Red Cross–I’ll take training from a paramedic any day, and we’ve good ones on call).

  28. Cranberry says:

    This issue led to a lawsuit in Ohio. The judge found for the defendant (the school system.) He found that the school could require special education aides to administer Diastat. A pediatric neurologist testified that seizures lasting longer than 5 minutes could cause brain damage or death. The neurologist stated that parents could teach school personnel to administer the drug.

    https://www.epilepsyfoundation.org/epilepsylegal/upload/ohiostdiastat.pdf

    “The Court is not persuaded by the position that the knowledge of a student’s propensity for seizures negates the emergency nature of the situation. An emergency arises when a bee stings an allergic child even though it was previously known that the child was allergic to bees. […] The heat of litigation should not cause us to lose sight of the fact that administering this drug could save this child’s life.”

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