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Let’s inject some sense

One injector, two injectors, three injectors... Copperfield is exasperated by the arse-covering approach to anaphylaxis.

One injector, two injectors, three injectors... Copperfield is exasperated by the arse-covering approach to anaphylaxis.



It's the middle of an unreasonably busy duty doctor session. I'm checking the repeat prescriptions for schoolboy errors as they flash momentarily into my field of vision. If subliminal advertising works then I reckon I can make a convincing case for subliminal prescription scanning.

At the bottom of the pile are those that the pharmacist has sent back for amendments – there are no gentamicin and hydrocortisone ear drops, the delivery man didn't bring any 500mg naproxen tablets and there's a supply chain problem with adrenaline auto-injectors. He tells me not to worry, though… the alternative brand costs a little more but in percentage terms the difference isn't that great. When you're spending around £30, what's a pound either side?

There are some things that we buy but hope we'll never have to use, like puncture repair kits or disaster recovery CDs for our computers. And there are some prescriptions I hope will get to their use-by dates without being filled, like GTN sprays for angina and self-injectors for anaphylaxis.

GTN sprays are cheap enough to be disposable but four Epipens or Anapens will set the NHS back well over £100. Come their expiry date, they're landfill.

The word on the street in Essex is that every patient has to have two injectors, in case the first one misfires or a second dose is needed. That's despite the fact that the UK Resuscitation Council's guidelines advise that patients should be prescribed one device and trained how to use it properly, on the grounds that device failures are, apparently, ‘exceedingly uncommon'. The local nursery nurses, in true arse-covering style, insist all children in their care have two injectors on the premises.

The nurses have another interesting rule. They say they cannot (for which read, will not) administer any medication to a child unless it is prescribed for that individual. They even try it on with Calpol.

The rules also apply to Epipens and Anapens, so nursey's shelves are groaning with unused kit, on the off-chance one of their little terrors might somehow sneak a peanutlicious Jordan's cereal bar past the sniffer dogs.

Around one child in a hundred suffers from a genuine nut allergy, but the average nursery seems to have three or four kids with prescriptions. Statistics are all very well, but they don't necessarily apply to the alarming world of the Daily Mail-reading parent.

Now… an analogy. Suppose, God forbid, that one of the kids caught fire. How many extinguishers would you expect the school to have? I'm guessing two, one to use first and another as back-up in case the first failed or a second was needed.

Now imagine the teachers needed a list of children on whom the extinguisher could be used. Can you see where I'm going here? I'd be happy to sign the list off for them. Tough luck for the new kid though. If his name's not been added, he's toast.

So let's be sensible, supply two injectors per school and save a shed load of money. After all, if a previously undiagnosed child had their first anaphylactic reaction during school hours, would the nurse with the adrenaline in their drawer stand back and do nothing on the grounds that the child's name wasn't on their list?

Oh come on! Not even I'm that cynical.

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