Board of education discusses emergency medical treatments

James HowellStaff

September 13, 2012

Developing a protocol to address students that suffer from a severe allergic reaction during school hours was the main topic of discussion during the monthly meeting of the Ashe County Board of Education.

Board members were presented information about this type of medical emergency and discussed how school personnel might respond, but took no official action.

“Across the nation, we’re having issues with kids having trouble with anaphylactic reactions,” said Amy Quesinberry, northwest region school nurse consultant, who presented information in favor of the policy.

At issue was whether school personnel could administer epinephrine (known as an “EpiPen”) to students suffering from anaphylactic shock as the result of an allergy to certain foods or a bee sting. In severe cases, anaphylaxis can cause the victim’s airways to tighten up with potentially fatal consequences.

If the policy discussed during the meeting was adopted by the board, it would allow “unlicensed” personnel to administer medications to students in an emergency situation.

Board member Dr. Lee Beckworth voiced concerns about having unlicensed school personnel administer federally-controlled medications like epinephrine without a prescription.

Beckwork acknowledged that the intent of the policy offered by the N.C. Department of Instruction was grounded in good intentions; he, however, questioned the legality of providing this type of medical treatment by unlicensed school personnel.

Board member and Vice Chairman C.B. Jones offered unqualified support of the proposed policy.

“I have seen the severe reactions of this (anaphylaxis). I support this myself. It would be a shame to lose a child or a staff member for that matter,” said Jones.

As the discussion between the board members continued, it was generally agreed upon that obtaining prior parental consent for the administration of emergency medications at school was needed.

“If we’re going to do this, we need prior permission from parents,” said Beckwork. He also said some parents may not want a faculty member without a medical license to deliver emergency epinephrine treatments.

Board of Education member Terry Williams agreed to the idea of parental consent, but that emergency situations often do not lend themselves to careful considerations.

“I think it’s a good idea to have parental permission, but if someone is in anaphylactic shock, no one is going to search through the files to see if a parent signed a consent form. Someone has to make a decision,” said Williams.

While this discussion was taking place, Ashe County Schools’ Superintendent Dr. Travis Reeves stepped in and injected a personal story. During his teaching days, one of his students suddenly started choking. Even though Reeves had never been trained to perform the Heimlich maneuver, he jumped in to action and administered the technique.

The student survived after coughing up a mint that he had accidently swallowed. Reeves said, “There are a lot of quick decisions that need to be made by the staff, and the best interests of the student need to be taken into account.”

According to Reeves, a consent form can be added to the health form given out at the beginning of each school year.

Quisenberry said that in 2002, a student in California died from a severe anaphylactic reaction. Since then, anaphylaxis has caused deaths in Virginia, Ohio and Chicago.

Quisenberry said these deaths have led to a stock piling of epinephrine in schools across the nation, including schools in northwest North Carolina. She said, “Even though parents may not know it, having epinephrine on hand is crucial.”

According to Quesinberry, 16 to 18 percent of those diagnosed with these types of allergies will have an anaphylactic shock in their lives. What’s worse is 25 percent of those with anaphylaxis are undiagnosed. This happens when a child hasn’t been exposed to the allergen, like a child who is allergic to bees but has never been stung.

“If there is something you can do to provide a safeguard for local children… this is a local decision, but we (western North Carolina) seem to be moving towards that,” Quesinberry said.

Reeves said he would consult with an attorney the following week to find answers to the questions brought forward during the meeting.

Before the discussion of medical protocol took place, the board meeting covered several other topics.

For example, the meeting opened with flair when retired music teachers Judy Dancy and Connie Hardison rapped to endorse National Arts Education Week. By the end of the performance, the audience applauded them both.

Anita Ferguson, a teaching assistant for exceptional children at Ashe County High School, was recognized as September’s employee of the month.

Reeves said, “She was doing exactly what we told her to do, and that was to lead and instruct.”

The board unanimously approved a trip to Disney World for the high school band. Band Director Carrie Mitchell will lead her band in a parade through the Magic Kingdom. During that time, a panel of expert judges will evaluate the band’s performance and give them feedback.

In appreciation, Mitchell said the following: “The Ashe community has been nothing but helpful in our efforts to grow the program. Our trip to Disney World will help do just that! The students will have a fantastic musical experience and get feedback from the best of the best, while also experiencing the fun of Disney.”

Also, Superintendent Reeves has been elected vice chairman of Region 7 Superintendents’ Council.