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CA public service unions recently changed the rules on the care which their members are allow to give for wards of the state...
...they now can not use finger nail clippers on toe nails and finger nails...
Yes, you and I are paying for ALL wards of the state to go to Nail Salons.
Oh, also, they now cannot (will not) administer intranasal medications as well. Which severely retards quality of care.
Sad thing is, most care givers I know are frustrated... but it's their union, and they can't voice complaints or go against the union. They have too much to loose, and so much to gain.
Remember this next time some union hack tries the old "its for the children" line on you.
What's shameful is you turning a legitimate concern about the hazards of administering a potentially dangerous drug (diastat) into an anti-union screed.
Did you watch the entire video you posted? Did you even understand the medical issues raised here? I doubt it.
I watched the video and I could see where both sides are coming from. While I would have no problem giving diastat to a child myself in the manner recommended i.e. rectally (since I am a physician and am trained to do so), I could see why nurses and lay people would be leery about doing it. First of all, you'd have to be able to recognize a seizure when you see one. Not all seizures look alike. Can you tell a pseudoseizure from a real one? How about narcolepsy from absence seizure? If you gave diastat to a child who has narcolepsy (not seizure), you'd likely end up killing him.
What's shameful is you turning a legitimate concern about the hazards of administering a potentially dangerous drug (diastat) into an anti-union screed.
Did you watch the entire video you posted? Did you even understand the medical issues raised here? I doubt it.
I watched the video and I could see where both sides are coming from. While I would have no problem giving diastat to a child myself in the manner recommended i.e. rectally (since I am a physician and am trained to do so), I could see why nurses and lay people would be leery about doing it. First of all, you'd have to be able to recognize a seizure when you see one. Not all seizures look alike. Can you tell a pseudoseizure from a real one? How about narcolepsy from absence seizure? If you gave diastat to a child who has narcolepsy (not seizure), you'd likely end up killing him.
Now, now, High and mighty...
1. Diastat should be prescribed to children with a history of appropriate prolonged seizure activity, or close clustered seizures. I don't believe "petit mals" or pseudoseizures would fall into this category.
2. As the video states, Diastat would only be allowed to be given by individuals who voluntarily undergo training (likely this would include evaluating appropriate physical findings for seizure).
3. By your line of argument, should Epipen's and Defibrillators only be allowed to be handled by the person who prescribed them? Try that when your in Afib/Vfib or the later stages of anaphylaxis.... Actually, I guess the newest AED's think for themselves... But not the evil, scary epinephrine
4. Narcolepsy? Narcolepsy can sometimes be mistaken for epilepsy, but what are the odds of a specific child prescribed Diastat, having both Narcoclepsy and Epilepsy?
5. Psychogenic nonepileptic seizures (pseudoseizure)? ...a little diazepam might be a good thing, before you have the psychiatric intervention talk.
Cost benefits ratio, ...Doctor. The point is somewhat mute though, the Union will win regardless of how many children are hurt by prolonged seizures/status epilepticus, until buccal midazolam is generally accepted.
Oh, just for s### and giggles:
Drug Saf. 2004;27(6):383-92. Safety of Diastat, a rectal gel formulation of diazepam for acute seizure treatment.
Pellock JM.
Virginia Commonwealth University, Medical College of Virginia, Richmond, Virginia 23298, USA. jpellock@hsc.vcu.edu Abstract
Diazepam rectal gel (Diastat) is the only medication approved by the US FDA for the management of selected, refractory patients with epilepsy, on stable regimens of antiepilepsy drugs, who require intermittent use of diazepam to control bouts of increased seizure activity. An analysis of the safety of diazepam rectal gel reveals that this formulation has certain advantages over intravenous diazepam administration: most notably a very low incidence of respiratory depression, low potential for abuse and the opportunity for out-of-hospital use by non-professional caregivers. Sedation is the most common adverse effect of rectal diazepam treatment, occurring in approximately one-quarter of patients, although drug-induced somnolence is difficult to distinguish from normal post-ictal sedation. Overdosage of diazepam rectal gel is rarely associated with serious clinical consequences, and overdoses of up to 330% of the maximum recommended dosage have been reported without any respiratory or cardiac depression. Under-administration may be a serious safety issue because of morbidity that may result if seizures are not terminated. Chronic administration may cause tachyphylaxis and should be avoided.
QUOTE=AwayAndBackToSac;15473520]Now, now, High and mighty...
LOL....here comes the general of the name calling brigade.....
Quote:
1. Diastat should be prescribed to children with a history of appropriate prolonged seizure activity, or close clustered seizures. I don't believe "petit mals" or pseudoseizures would fall into this category.
Oh please...go away. You don't know what you are talking about. Obviously you have never seen pseudoseizures. They can last a really long time. And BTW, you are exposing yourself as someone with no real medical background....just a googler of medical information. Petit mal and pseudoseizures are not the same thing, honey. Go, google some more, and come back here once you've learned something about seizures.
Quote:
2. As the video states, Diastat would only be allowed to be given by individuals who voluntarily undergo training (likely this would include evaluating appropriate physical findings for seizure).
Ahhh I see....but then again that would support the nurses' and teachers' unions' contention that more resources be directed to them in terms of more manpower, training, or both in order for them to adequately take on the new tasks assigned to them - a contention that you and the OP have labeled as an attempt by the unions to suck in more resources for themselves. So, make up your mind here.
Quote:
3. By your line of argument, should Epipen's and Defibrillators only be allowed to be handled by the person who prescribed them? Try that when your in Afib/Vfib or the later stages of anaphylaxis.... Actually, I guess the newest AED's think for themselves... But not the evil, scary epinephrine
Which line of argument that I didn't make are you reacting to? How in heaven's name did you ever extrapolate that in that small brain of yours? Or are you just fond of making strawman arguments here? Show me where I said in my post that diastat should only be administered by the person that prescribed it. The point of my post was to tell you that the unions' objection to the use of diastat by inadequately trained personnel was based on valid medical concerns.....Therefore, the training of personnel may obviate the risk of misdiagnosis and of diastat administration. Which means more money should be spent on them. Which, of course, you object to, coz that would mean higher taxes and bigger government.
Also, just for your education, a fib and v fib can't be faked. You can actually diagnose them pretty self-evidently with the defibrillator. And anaphylaxis is also straightforward. Which is why defibrillators and epipen can be used by first responders and even lay people. This is unlike the case in seizures where the diagnosis is not immediately clear or verifiable. There are no portable EEGs in schools. There are also many types of seizures, and they all don't present as generalized convulsions, which is what you probably saw on TV.
Try giving diastat to someone with narcolepsy (and transient paralysis), and we'll see if you can find a good enough lawyer to defend you for knocking out the respiratory drive in someone who is already paralyzed.
Quote:
4. Narcolepsy? Narcolepsy can sometimes be mistaken for epilepsy, but what are the odds of a specific child prescribed Diastat, having both Narcoclepsy and Epilepsy?
You don't get it, do you? The point is, narcolepsy can be mistaken for epilepsy, not that narcolepsy and epilepsy can (or cannot) co-exist in one patient. If an inadequately trained teacher were to misdiagnose narcolepsy for epilepsy and give the child diastat, be prepared to call the morgue to receive the dead child's body.
Quote:
5. Psychogenic nonepileptic seizures (pseudoseizure)? ...a little diazepam might be a good thing, before you have the psychiatric intervention talk.
Unless of course you give an overdose which kills the patient.
Quote:
Cost benefits ratio, ...Doctor. The point is somewhat mute though, the Union will win regardless of how many children are hurt by prolonged seizures/status epilepticus, until buccal midazolam is generally accepted.
The correct word is moot, not "mute". Though in your case, going mute might not be a bad idea. Come back here after you've done your googling and armed yourself with more knowledge about seizures.
Quote:
Oh, just for s### and giggles:
Drug Saf. 2004;27(6):383-92. Safety of Diastat, a rectal gel formulation of diazepam for acute seizure treatment.
Pellock JM.
Virginia Commonwealth University, Medical College of Virginia, Richmond, Virginia 23298, USA. jpellock@hsc.vcu.edu Abstract
Diazepam rectal gel (Diastat) is the only medication approved by the US FDA for the management of selected, refractory patients with epilepsy, on stable regimens of antiepilepsy drugs, who require intermittent use of diazepam to control bouts of increased seizure activity. An analysis of the safety of diazepam rectal gel reveals that this formulation has certain advantages over intravenous diazepam administration: most notably a very low incidence of respiratory depression, low potential for abuse and the opportunity for out-of-hospital use by non-professional caregivers. Sedation is the most common adverse effect of rectal diazepam treatment, occurring in approximately one-quarter of patients, although drug-induced somnolence is difficult to distinguish from normal post-ictal sedation. Overdosage of diazepam rectal gel is rarely associated with serious clinical consequences, and overdoses of up to 330% of the maximum recommended dosage have been reported without any respiratory or cardiac depression. Under-administration may be a serious safety issue because of morbidity that may result if seizures are not terminated. Chronic administration may cause tachyphylaxis and should be avoided.
[/quote]
And just for giggles too, let me point out that you've pasted a factual but nonetheless irrelevant piece of googled information. Irrelevant, because the blurb you pasted does not address the concern about misdiagnosis of seizures in children, especially those with syncope, narcolepsy, pseudoseizures, cardiac arryhythmia etc wherein the administration of diastat by an inadequately trained person can be fatal to the child.
Anyway, the intention of the OP and you on this thread was clearly to bash the unions and put them in a bad light as being "anti-child", when in fact the basis of their position had some scientific validity. If you want to be taken seriously, you need to take your right wing ideological blinders off and go back to actual science.
LOL....here comes the general of the name calling brigade.....
Oh please...go away. You don't know what you are talking about. Obviously you have never seen pseudoseizures. They can last a really long time. And BTW, you are exposing yourself as someone with no real medical background....just a googler of medical information. Petit mal and pseudoseizures are not the same thing, honey. Go, google some more, and come back here once you've learned something about seizures.
Ahhh I see....but then again that would support the nurses' and teachers' unions' contention that more resources be directed to them in terms of more manpower, training, or both in order for them to adequately take on the new tasks assigned to them - a contention that you and the OP have labeled as an attempt by the unions to suck in more resources for themselves. So, make up your mind here.
Which line of argument that I didn't make are you reacting to? How in heaven's name did you ever extrapolate that in that small brain of yours? Or are you just fond of making strawman arguments here? Show me where I said in my post that diastat should only be administered by the person that prescribed it. The point of my post was to tell you that the unions' objection to the use of diastat by inadequately trained personnel was based on valid medical concerns.....Therefore, the training of personnel may obviate the risk of misdiagnosis and of diastat administration. Which means more money should be spent on them. Which, of course, you object to, coz that would mean higher taxes and bigger government.
Also, just for your education, a fib and v fib can't be faked. You can actually diagnose them pretty self-evidently with the defibrillator. And anaphylaxis is also straightforward. Which is why defibrillators and epipen can be used by first responders and even lay people. This is unlike the case in seizures where the diagnosis is not immediately clear or verifiable. There are no portable EEGs in schools. There are also many types of seizures, and they all don't present as generalized convulsions, which is what you probably saw on TV.
Try giving diastat to someone with narcolepsy (and transient paralysis), and we'll see if you can find a good enough lawyer to defend you for knocking out the respiratory drive in someone who is already paralyzed.
You don't get it, do you? The point is, narcolepsy can be mistaken for epilepsy, not that narcolepsy and epilepsy can (or cannot) co-exist in one patient. If an inadequately trained teacher were to misdiagnose narcolepsy for epilepsy and give the child diastat, be prepared to call the morgue to receive the dead child's body.
Unless of course you give an overdose which kills the patient.
The correct word is moot, not "mute". Though in your case, going mute might not be a bad idea. Come back here after you've done your googling and armed yourself with more knowledge about seizures.
And just for giggles too, let me point out that you've pasted a factual but nonetheless irrelevant piece of googled information. Irrelevant, because the blurb you pasted does not address the concern about misdiagnosis of seizures in children, especially those with syncope, narcolepsy, pseudoseizures, cardiac arryhythmia etc wherein the administration of diastat by an inadequately trained person can be fatal to the child.
Anyway, the intention of the OP and you on this thread was clearly to bash the unions and put them in a bad light as being "anti-child", when in fact the basis of their position had some scientific validity. If you want to be taken seriously, you need to take your right wing ideological blinders off and go back to actual science.
[/quote]
A lot of words, a lot put downs, a lot of self-importance...
My intention is the appropriate treatment of patients. It is not the intention of the Unions. PR Diazepam is first line therapy for prolonged or closely-clustered seizures, when IV access in unavailable. That is the circumstances this girl presents with. She is not prescribed PR Diazepam otherwise. The number of children who are prescribed PR Diazepam is incredibly small. The number of children diagnosed with prolonged or closely-clustered seizures, prescribed PR Diazepam.... and may have Narcolepsy extremely unlikely. Thus, I will grant you Diastat should not be used willy-nilly, but it should be on hand and used for this girl and others like her.
This drug, as ALL prescribed medication, should only be used on the patient indicated, but in emergent situations...
It is not the teachers/nurses job to diagosis Epilepsy or Narcolepsy, or use this drug on ANY other child, but then there are emergent situations, where lives can be saved and morbidity reduced.
...Just as an inhaler is prescribed and used on a particular child for acute asthma symptoms, in emergency situations is may be needed by an undiagnosed asthmatic.
...Just as an Epipen is prescribed and used on a particular child for anaphylaxis, it may be emergently needed for a new food allergy leading into anaphylaxis.
(actually, I looked it up. Right now Epi can be given to anyone in emergency situation, and Glucogon to those who are on insulin).
...Just as Diastat... can be given by the school nurse who already controls the above two.
Just to be clear, the article states:
"DeLorenzo feared the worst when he receive a call from his daughter’s school, informing him that she had suffered a seizure. Gianna survived that day, but DeLorenzo was outraged that school administrators had not given his daughter Diastat, a drug that stops seizures before they do permanent harm and is FDA-approved for use by laypeople. Today many schoolchildren must wait until an ambulance brings them to a hospital before they receive Diastat. That’s much too long, says DeLorenzo who supports, SB 1051, a California bill that would allow trained non-medical volunteers to administer Diastat at schools. Epilepsy advocates like the Epilepsy Foundation and physicians groups like the California Medical Association have lined up to support the bill. Unions representing teachers, nurses, and other public employees have lined up in opposition, claiming the bill would put children in danger. Their solution: hire more school nurses. “The unions are not on the side of the kids,” says DeLorenzo who believes unions are more interested in expanding their ranks than protecting epileptic children. “It’s exactly the opposite,” says Gayle McClean, southern section president of the California School Nurses Organization and a member of the California Teachers Association. ”We care deeply for children and we want them to receive the most appropriate care and that means they need a licensed medical person caring for them.” Sacramento lawmakers sided with unions and have refused to bring the bill up for a vote. The bill will officially expire on August 31."
This bill authorizes school districts to provide school
employees with voluntary emergency medical training to
provide emergency medical assistance to pupils with epilepsy
suffering from seizures. Specifically, this bill:
1) Authorizes a school district, in the absence of a
credentialed school nurse or other licensed nurse onsite
at the school, to provide school employees with
voluntary emergency medical training to provide
emergency medical assistance to pupils with epilepsy
suffering from seizures.
2) Requires a school employee with voluntary emergency
medical training to provide this emergency medical
assistance in accordance with yet-to-be-
established standards, and the performance instructions
of the licensed health care provider of the pupil.
3) Prohibits a school employee from being required to
provide emergency medical assistance unless that
employee volunteers and has been trained pursuant to
this bill.
4) Encourages the Epilepsy Foundation of America to develop
performance standards for the training and supervision
of school employees. This bill authorizes the standards
to be developed in cooperation with the State Department
of Education, the California School Nurses Organization,
the California Medical Association, and the American
Academy of Pediatrics.
5) Requires the Department of Public Health, upon
development of the standards, to approve the standards
for distribution and make those standards available upon
request.
6) Requires training to include all of the following:
a) Recognition and treatment of epilepsy.
b) Administration of diastat.
c) Basic emergency follow-up procedures
including, but not limited to,
calling 911 and contacting the pupil's parent and
his or her licensed health care provider if
possible.
7) Deems training by a physician, credentialed school
nurse, registered nurse, or certificated public health
nurse in accordance with the performance standards as
adequate training.
8) Requires a school employee to notify the credentialed
school nurse assigned to the school district if he or
she administers diastat to a pupil. This bill requires
the school employee to notify the superintendent of the
school district if a credentialed school nurse is not
assigned to the school district.
9) Requires all materials necessary to administer the
diastat to be provided by the pupil's parent or
guardian.
10) Defines "diastat" as diazepam rectal gel, marketed as
Diastat AcuDial, approved by the federal Food and Drug
Administration for patients with epilepsy for the
management of seizures.
11) Declares that a school employee who is trained to
administer and who, acting in good faith, administers
diastat is immune from criminal or civil
liability for injuries resulting from his or her acts or
omissions in administering the diastat.
12) States legislative intent, among other things, that
children suffering from seizures due to epilepsy have
the right to appropriate programs and services that are
designed to meet their unique needs. This bill further
states legislative intent that nurses be authorized to
train and supervise school employees to administer "
diastat to children with epilepsy in the public schools."
I do not believe that a new drug demands hiring another nurse.
1. I never said Petit mals and Pseudoseizures were the same thing.
2. Better and more likely to dx Afib by ECG. The new defibrillator will not diagnose crap. You'll get "No shock indicated" or "shock indicated". So you'll really only know if pt had V.fib/V.tack.
3. Anaphylaxis is often not straight forward.
4. I showed you data on the VERY low incidence of respiratory depression due to rectal diazepam. Pubmed usually has information a bit above "googled information" Check uptodate, or whatever you care to.
I care for the patient, only.
I can only lead you to the water.
Last edited by AwayAndBackToSac; 08-14-2010 at 05:08 PM..
What's shameful is you turning a legitimate concern about the hazards of administering a potentially dangerous drug (diastat) into an anti-union screed.
Did you watch the entire video you posted? Did you even understand the medical issues raised here? I doubt it.
I watched the video and I could see where both sides are coming from. While I would have no problem giving diastat to a child myself in the manner recommended i.e. rectally (since I am a physician and am trained to do so), I could see why nurses and lay people would be leery about doing it. First of all, you'd have to be able to recognize a seizure when you see one. Not all seizures look alike. Can you tell a pseudoseizure from a real one? How about narcolepsy from absence seizure? If you gave diastat to a child who has narcolepsy (not seizure), you'd likely end up killing him.
Yeah I did watch the whole thing - and read all the comments on the Reason Site - and it pissed me off enough I posted it here.
Did you watch it, Doctor? Maybe you missed the part how the nurses union had the regs changed to prohibit non nurses administering diastat and the law was meant this change. And How Diastat was adminstered by non medical professionals for a decade before the reg changed.
Of course it is always prefereable to have a medical professional adminster drugs, particularly in an emergency situation. But since life isn't perfect, training up lay people to render aid until medical authourities arrive is a sound policy. Which is why millions of people take CPR and lifesaving classes every year. This is no different - except a public employee union sees putting up roadblocks as a way to force schools to hire more union nurses.
I wanted to clean up my last post, but I got busy... and the time elapsed for editing (never knew that existed).
Regardless, I wanted to add that the Cost/Benefits ratio has to be evaluated in all cases...
All drugs have potential negative side effects. Some physicians have been burned badly (litigation) and treat according to "defensive medicine". Trust me I understand this. But, the chance of new narcolepsy (which ndfmnlf seems most concerned about), would not present with signs/symptoms of profound continued seizure activity. Additionally, the prevalence of narcolepsy is quite low.
The prevalence of Narolepsy is estimated at 200,000 Americans (with only 50,000 total diagnosed in the entire country)
200,000 new cases of epilepsy are diagnosed EACH YEAR (45,000 are children, under the age of 15).
Almost 3 MILLION Americans are diagnosed with active Epilepsy (326,000 of whom are 15 years old and younger).
Upon reflection, there are two issues:
1. Should this girl, who has been diagnosed with prolonged or closely-clustered seizures, be treated in school with a previously prescribed medication? I believe she should.
2. Should TRAINED medical staff and TRAINED support staff/school employees, be allowed to treat with rectal Diazepam in the appropriate clinical situations (signs and symptoms of prolonged or closely-clustered seizures)? Considering the incidence/prevalence of Epilepsy and the potential benefits/potential adverse effects of treatment with this drug, I believe this drug should be available in schools.
ndfmnlf is an Internist who has been practicing for around 13 years, and is entitled to his opinion.
I disagree.
(...and I'm not invoking post-grad, grad school, post-doc, professional school, internship, residency, fellowship... ...vocational school, therapy, counseling, GED, summer school, correspondence degrees... Because in this venue, it does not matter...)
As a olive branch, ndfmnfl, look at provision #11 in my last post...
Last edited by AwayAndBackToSac; 08-14-2010 at 06:41 PM..
A lot of words, a lot put downs, a lot of self-importance...
My intention is the appropriate treatment of patients. It is not the intention of the Unions.
Your mistake is that you look at this issue through right wing ideological glasses. You framed this debate as a struggle between left wing unions and families. You swallowed the video peddled by Reason Foundation, a right wing organization, which cast the issue in terms of unions wanting more power at the expense of children's health. Because of your ideological bias, you failed to consider the valid medical basis for the unions' opposition to this bill.
Quote:
PR Diazepam is first line therapy for prolonged or closely-clustered seizures, when IV access in unavailable. That is the circumstances this girl presents with. She is not prescribed PR Diazepam otherwise. The number of children who are prescribed PR Diazepam is incredibly small.
You're wrong. The first line of defense in a child with known epilepsy is making sure the child is taking maintenance anti-convulsants at therapeutic levels to prevent her from having a seizure in the first place. Diastat given when the child is already having a seizure is an admission that the child, her parents, or the doctor of the child have failed in keeping the child compliant with the maintenance regimen.
Quote:
The number of children diagnosed with prolonged or closely-clustered seizures, prescribed PR Diazepam.... and may have Narcolepsy extremely unlikely.
You're still not getting it. The risk of misdiagnosing narcolepsy for epilepsy is very real, and a teacher who does not see these cases on a regular basis can easily make that mistake. And since - as you admit - narcolepsy and epilepsy are relatively uncommon, it makes it even more difficult for lay people who have never seen these cases before to make split second potentially fatal therapeutic decisions.
Quote:
Thus, I will grant you Diastat should not be used willy-nilly, but it should be on hand and used for this girl and others like her.
This drug, as ALL prescribed medication, should only be used on the patient indicated, but in emergent situations...
What? You want the CA legislature to pass a law specific to this one girl? What kind of harebrained idea is that?
Quote:
It is not the teachers/nurses job to diagosis Epilepsy or Narcolepsy, or use this drug on ANY other child, but then there are emergent situations, where lives can be saved and morbidity reduced.
Well, yeah....and that's why the nurses' and teachers' unions want increased funding for training, manpower, or both....for them to be able to perform this task that you want them to do.
And here I thought you were opposed to higher taxes and big government. Because that's exactly what you're gonna get if you insist that teachers and school nurses should now be required to administer diastat in school.
.
Quote:
..Just as an inhaler is prescribed and used on a particular child for acute asthma symptoms, in emergency situations is may be needed by an undiagnosed asthmatic.
...Just as an Epipen is prescribed and used on a particular child for anaphylaxis, it may be emergently needed for a new food allergy leading into anaphylaxis.
(actually, I looked it up. Right now Epi can be given to anyone in emergency situation, and Glucogon to those who are on insulin).
...Just as Diastat... can be given by the school nurse who already controls the above two.
Again, you want taxpayers to foot the bill so that the nanny state which you so bitterly oppose can extend its reach into children's rectums?
Ahhh.....the irony of it all! The right wing anti-government rabble rousers want to give the government more power to intrude into people's lives (and rectums). LOL....Methinks you didn't think through your position very well. This is what happens when you simply swallow talking points from Beck, Limbaugh, and Palin - people who are not exactly the brightest people on the planet. Well, I suppose if you have an IQ of 50, you must think someone with an IQ of 70 is a genius.
Quote:
And the specific Bill:
" ANALYSIS
This bill authorizes school districts to provide school
employees with voluntary emergency medical training to
provide emergency medical assistance to pupils with epilepsy
suffering from seizures. Specifically, this bill:
1) Authorizes a school district, in the absence of a
credentialed school nurse or other licensed nurse onsite
at the school, to provide school employees with
voluntary emergency medical training to provide
emergency medical assistance to pupils with epilepsy
suffering from seizures.
2) Requires a school employee with voluntary emergency
medical training to provide this emergency medical
assistance in accordance with yet-to-be-
established standards, and the performance instructions
of the licensed health care provider of the pupil.
3) Prohibits a school employee from being required to
provide emergency medical assistance unless that
employee volunteers and has been trained pursuant to
this bill.
4) Encourages the Epilepsy Foundation of America to develop
performance standards for the training and supervision
of school employees. This bill authorizes the standards
to be developed in cooperation with the State Department
of Education, the California School Nurses Organization,
the California Medical Association, and the American
Academy of Pediatrics.
5) Requires the Department of Public Health, upon
development of the standards, to approve the standards
for distribution and make those standards available upon
request.
6) Requires training to include all of the following:
a) Recognition and treatment of epilepsy.
b) Administration of diastat.
c) Basic emergency follow-up procedures
including, but not limited to,
calling 911 and contacting the pupil's parent and
his or her licensed health care provider if
possible.
7) Deems training by a physician, credentialed school
nurse, registered nurse, or certificated public health
nurse in accordance with the performance standards as
adequate training.
8) Requires a school employee to notify the credentialed
school nurse assigned to the school district if he or
she administers diastat to a pupil. This bill requires
the school employee to notify the superintendent of the
school district if a credentialed school nurse is not
assigned to the school district.
9) Requires all materials necessary to administer the
diastat to be provided by the pupil's parent or
guardian.
10) Defines "diastat" as diazepam rectal gel, marketed as
Diastat AcuDial, approved by the federal Food and Drug
Administration for patients with epilepsy for the
management of seizures.
11) Declares that a school employee who is trained to
administer and who, acting in good faith, administers
diastat is immune from criminal or civil
liability for injuries resulting from his or her acts or
omissions in administering the diastat.
12) States legislative intent, among other things, that
children suffering from seizures due to epilepsy have
the right to appropriate programs and services that are
designed to meet their unique needs. This bill further
states legislative intent that nurses be authorized to
train and supervise school employees to administer "
diastat to children with epilepsy in the public schools."
Did you even read what you posted above? Do you understand what that means? This bill you are pushing means more regulations being created and imposed on the citizens of CA.
Makes me wonder about the intellectual capacity of you right wingers. You don't even seem to realize that what you are pushing in this bill is the exact opposite of what you claim to believe in.
Quote:
1. I never said Petit mals and Pseudoseizures were the same thing
.
You lumped them in the same category as conditions that don't last a long time. You're wrong.
Quote:
2. Better and more likely to dx Afib by ECG. The new defibrillator will not diagnose crap. You'll get "No shock indicated" or "shock indicated". So you'll really only know if pt had V.fib/V.tack.
What? So now you want schools to purchase ECG machines and not just defibrillators? And so, this means teachers will now have to be trained on how to obtain 12 lead ECGs? Did you know that this is even more difficult to do than just putting 2 defibrillator paddles on a patient's chest? Not to mention you have to train teachers to interpret ECGs? What happened to your low taxes and small government mantra?
Quote:
3. Anaphylaxis is often not straight forward.
False. Unlike seizures, anaphylaxis can never be mistaken for anything else.
Quote:
4. I showed you data on the VERY low incidence of respiratory depression due to rectal diazepam. Pubmed usually has information a bit above "googled information" Check uptodate, or whatever you care to.
If the child has syncope or narcolepsy and you give him diastat because you think he is having a seizure, you are going to kill him because 1) you will drop his blood pressure, which would be catastrophic in someone with syncope who already has low blood pressure and 2.) you will stop his breathing if he already is paralyzed by the narcolepsy. This link you gave about the supposed "low risk" of diastat only works in theory in someone who doesn't have any of the above conditions i.e. a healthy person. But our real life patients are not healthy.....that's why they are in the situation they are in to begin with!
I suggest you pull your head out of Glen Beck's a$$ and start thinking for yourself.
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