CLEVELAND - The Ohio Association of School Nurses has been fighting for children, teachers, administrators and visitors to any Ohio school to have the ability to receive epinephrine injections in the instance of a severe allergic reaction.
The association finally was able to get its plan to address food allergies introduced by legislators
Dr. Eileen Smits is not only a clinical neuropsychologist, she's also an incredible baker of goodies for her four children, three of whom have severe food allergies. It's a daily life of being extremely careful food-wise for her children. It's diligence and a level of trust that can't be duplicated by many others in most restaurants or a school classroom.
Smits' is quick to point out her children's school has been phenomenal in being proactive for students with food allergies.
A new law that puts more epinephrine injectors in schools for anyone with a severe allergic reaction, by anyone properly trained, just makes sense. Training for anyone with severe allergies is a must, said Smits.
Smits recounts an instance that one, or more pen injections, just wasn't enough to help her son. As a rule, an ambulance should be called even before an Epi-Pen is used, if possible. Both should go hand-in-hand in an anaphylactic event.
"My little guy was two and he had eaten some yogurt. I had known that there was an ingestion, but he had never had dairy before so you don't really know how they are going to react. You can look at lab values and the allergists can look at the likelihood that anaphylaxis will occur, but it always depends on how much they ate, the severity of the allergies, and a number of factors. We had never had an accident before that," Smits said.
"So, I was on alert to watch him and he was fine. And then 20 minutes later he came to me and wanted me to hold him. Given that he had just finished lunch and usually he would have been ping-ponging off the walls kind of let me know something wasn't right. And he starting coughing and I knew that it was a time to not be a mom and to be a clinician. So, I sat him in the high chair because I wanted to be able to observe him, and there was no rash whatsoever, he did not break out at all. He looked a little pale but otherwise he was just kind of coughing and then he vomited...everywhere," Smits said.
A recent family appointment sharing thoughts with an allergist soon paid off.
"Tell me what anaphylaxis looks like, I don't know what it looks like. He had talked about how if a child kind of has a rash and he's itching, use Benadryl. But, if there is vomiting or any change in their breathing that's a sign that you need to use the Epi-Pen. So, I did. I used the Epi-Pen and there was this sense that, all right, I did it, we're done. And the next question was should I call the ambulance, because the rule is if the Epi-Pen is administered you call the ambulance. But I was looking at a child that was mad at me from giving him the Epi-Pen, was crying because he was in pain from the shot, and was lustily crying, and had no rash, I'm thinking, well, I gave him the Epi-Pen, are we safe now? The thought came to me, you're a mom, you need to advocate for him even if it's a false alarm, even if it's not necessary. We need to be safe rather than sorry and so I called the ambulance," said Smits.
That call turned out to more than a safe mother's hunch.
"It was probably five minutes, I mean it was quick. But, in that time he went from crying lustily to drifting into unconsciousness and he turned blue. And I remember holding him in the garage, pacing, waiting for the ambulance to come and when they drove up I ran to them with him and he was lifeless at that point. They administered another epinephrine injection and they gave him a breathing treatment and I think it took them over twenty minutes before he was stable enough from them to transport to the nearest hospital," added Smits.
"We nearly lost him that day and it was to dairy."
Ohio school district administrators are hoping they can use the new law's language to join dozens of other states already using Epi-Pens or other brands of injectors to save children and adults when seconds and minutes count, as well.