A CONSULTANT WHO specialises in respiratory conditions in children has called for a change in practice in schools over the use of EpiPens. These devices deliver a shot of adrenaline and are used as emergency treatment when a patient has gone into anaphylactic shock.
Dr Chinedu Nwokoro of Barts Health NHS Trust was speaking at the inquest into the death of Nasar Ahmed – the Bow School pupil who told staff he felt unwell after he had been put in detention following a fight between some other boys. There were delays in staff fetching his emergency medical equipment – which included an inhaler and an EpiPen. Even when staff did manage to bring the right equipment to the right place, they held back from using it.
Dr Nwokoro said that the advice should be that if a pupil is struggling to breathe, staff should administer the EpiPen – even if the pupil has lost consciousness. He expressed concern over the lack of information in Nasar’s school care plan over when to use the EpiPen, stating that it should have given advice in a prominent place stating “If in doubt, use the EpiPen”.
The doctor went on to say that in his opinion every school should have a medical box containing an EpiPen and a salbutamol inhaler easily available so that they could be accessed and used within a couple of minutes in an emergency. He pointed out that this was now a legal requirement in the USA and thought that if the USA could do this, so should the UK. He also recommended that schools should have a defibrillator on the premises.
The Coroner, Mary Hassell, has yet to find whether these delays and failures, and other procedural mistakes, were part of the cause of Nasar’s death. Earlier in the inquest she had heard school nurse Goddard Edwards admit that he had used the wrong form to record Nasar’s care plan, which had resulted in the severity of Nasar’s conditions being downgraded – a mistake which Mr Edwards had called “an oversight”.
She did say that she would be writing to the Chief Medical Officer with her concerns and would make a number of recommendations to help prevent future deaths.
There are two main issues in terms of the school’s response to having a boy such as Nasar in their care – a child who suffered from asthma but who also had very serious allergies which could trigger a potentially fatal response. The first is whether the procedures in place were good enough to protect Nasar, and the second is whether the procedures were followed anyway – and if not, why not.
Unless and until these questions are answered, parents in Tower Hamlets will continue to have serious concerns about the safety of their children while they are at school.
•Reports on earlier stages of the inquest:
•Initial reports on the incident: