A nearly fatal flaw on ferries

If you think you have allergies or sensitivities then you should read this article and take precautions on BC Ferries and airplanes. Click here, pdf file, or the newpaper copy to learn more. Here is the newspaper version. I have archived it entirely because I am an allergy advocate and I hope this never happens again to another individual.

Policy relies on a doctor being aboard, so when a local girl had a life-threatening allergic reaction, there was no help

MARCH 1, 2011

A 14-year-old Comox Valley girl proved a potentially fatal flaw exists in B.C. Ferries emergency medical procedure – two years later the company continues to operate with an Achilles’ heel.

The transportation giant has always operated its medical procedure on one assumption – a licensed B.C. doctor is on board.

With over 2,000 people on each sailing ferry staff don’t usually have a problem finding a physician, in fact often they see “one or two or three doctors come forward,” said ferry spokeswoman Deborah Marshall.

But on March 4, 2009, when a 14-year-old girl went into anaphylactic shock in the middle of the Georgia Strait, there were no doctors on board. The one thing she needed most to survive, no one had the authority to administer.

Michelle Chowns remembers that day with clarity, because when the ferry docked two years ago, paramedics said her daughter was minutes away from dying.

It was a close call she doesn’t want to see repeated, but despite her best efforts to advocate for better training or new policy, B.C. Ferries continues to stand behind its medical procedure.

“It gets so frustrating I feel like banging my head against a wall,” Chowns said.

“I don’t think anyone is taking this seriously or has really grasped the severity of the situation … they brush it off without really looking at it, recognizing the gaps and trying to fix them so this never happens to another child.”

Her daughter, a Vanier High student, was coming home from the Penticton Music Festival when she ate a cashew and went into anaphylaxis, a life-threatening reaction that can be fatal if not treated with epinephrine.

It was the last thing Chowns expected to hear because doctors had never flagged her daughter, Cheyanne, as at risk for an allergic reaction. She was tested every six months. The teen had even eaten nuts before and never had the run of symptoms that were spreading rapidly throughout her body – from swelling and nausea to running eyes and nose.

When her daughters’ guardian called to tell her what was happening, Chowns immediately gave permission for her daughter to have epinephrine. The symptoms were all too familiar having dealt with the reactions in her anaphylactic son.

“It was scary … I knew what was happening and that it was important for Cheyanne to get epinephrine, but I wasn’t sure if anyone else understood the urgency. Time wasn’t on their side,” Chowns said.

Incident reports from B.C. Ferries say Cheyanne had trouble breathing and was brought to the first aid room. Her tongue, lips and throat were swollen and a rash had spread from her chest and neck down to her arms.

Her limbs had also gone numb.

The chief steward paged passengers to see if any doctors were on board, but on that day, no one answered the call.

Staff has an emergency kit with the epinephrine Cheyanne needed, but without a doctor, the only thing they could do was give her oxygen and an antihistamine until paramedics took over in Nanaimo. The report said the antihistamine did little to stop the swelling.

Each of B.C. Ferries’ vessels carries an emergency kit with injectable drugs for several medical problems, including anaphylaxis, but the only people allowed to use the contents are licensed B.C. physicians. Policy prohibits occupational first aid attendants from administering medicine over liability concerns, even in life-threatening situations.

First aid attendants aren’t doctors and don’t have access to passengers’ medical histories, Marshall said.

“We could be causing more harm than good” and the company is unwilling to place to responsibility for another person’s life in the hands of their employees, she said.

Marshall wouldn’t discuss the anaphylactic incident citing privacy concerns, but called the event unfortunate and stressed that the girl turned out OK.

The system has worked until now, and even knowing its not a failsafe procedure, Marshall said B.C. Ferries is reluctant to change policy.

Chowns calls the response lackluster, believing B.C. Ferries dropped the ball.

What would have happened if her daughter had died on board that ship? Would they have changed policy then?

Two years after her daughter nearly died, Chowns is still haunted. She wonders why the ferry didn’t turn around and head back to Horseshoe bay or use ship-to-shore radio to get medical advice – and she especially doesn’t understand why B.C. Ferries continues to operate knowing if there was a medical emergency and no doctors, the result could be fatal.

The Comox Valley Allergy Awareness Committee is aware of the close call and suggests B.C. Ferries follow in suit of WestJet airlines, which ensures there is backup in an emergency.

Like B.C. Ferries, the airline has an emergency medical kit to prepare for everything from heart attacks to severe allergic reactions, but it also recently added epinephrine auto-injectors for adults and children. The auto-injectors are intended to make it easier and faster to administer medication, said Robert Palmer, spokesperson for WestJet.

The airline doesn’t have many issues with allergic reactions. It can usually count on guests who suffer from life-threatening allergies to carry their own epinephrine and be the first to administer it during a reaction. The airline provides the failsafe. If a passenger is too incapacitated to inject the medication or needs a second injection until the plane can land, WestJet employees have the equipment and medical guidance to help.

There are usually doctors or nurses on board to help in an emergency, but employees are still obligated to call a medical hotline, which will instruct them on what to do. Airline policy allows staff to administer medication under the guidance of MedAire, a global emergency response centre that provides real-time medical assistance to people in remote locations – at sea or in the air.

“Whether it’s a heart attack, allergic reaction or a guest vomiting profusely and experiencing chills and fevers, we don’t take any chances,” Palmer said.

“This is about the safety of our guests, why would we (take chances)?”



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