Dear Parent,

Just because you are an MD - which somehow you managed to point out to me despite not being able to return your child's emergency care plan until two months later - does not mean I will sign off on the heavily edited care plan you returned to me.

Perhaps your expertise does not include allergy management, because the new recommendation is that if someone has two or more systems involved in an allergy reaction - in the example you gave, an itchy throat and vomiting - an Epipen should be administered. I am not into the "wait and see" method when it comes to potential anaphylaxis. I also can't say I like the idea of administering PO Benadryl for your vomiting student in case of ingestion. The fact that you seem to know his pattern of reaction so well is a concern too, but not something I can base future reactions on. Just because you have been so fortunate as to have his symptoms stop at an itchy throat and vomiting doesn't mean they won't progress further, quickly, the next time.

We are discussing a severe food allergy, and this is the first I've ever come across a parent suggesting less of a response than the standard, recommended treatment plan. Weird...and my gut says no, I just haven't figured out how I will phrase my response to Mr. Pretentious Parent, MD.


  1. Does he sign the orders for his child's Epi pen too? If the allergist wrote the order to administer for symptoms of an allergic reaction I would consider that all I need. That and of course my school physicians standing order to give an Epi pen. I think we will start seeing Benadryl orders phased out in the next few years anyway. I love your blog! I always say I wish people could see what I actually do in a day as a school nurse 😝

  2. Lol... funny but it's a serious issue wow.