Dr. Michael Byrne:

Go raibh maith agat, a Chathaoirligh. Ar an gcéad dul síos, ba mhaith liom mo mhíle buíochas a ghabhaíl leatsa as ucht an obair atá déanta agat ar an ábhar tabhachtach seo.

I am Dr. Michael Byrne. I am head of the student health department in University College Cork. I am also co-co-ordinator of UCC Health Matters, an initiative that is seeking to make UCC a HSE-recognised health promoting university. I was the founding medical director of UCC’s first responder automatic external defibrillator, AED programme, that has overseen the provision of more than 40 automatic external defibrillators in multiple locations on and off campus in UCC. I am a trained health care AED provider and have previously been an AED basic life support, BLS, instructor for both health care and lay personnel. I am co-lead, along with Professor Hourihane, of UCC’s anaphylaxis initiative.

I am more than happy to defer to Professor Hourihane in terms of the research, science and the application of knowledge in the area of anaphylaxis, especially in the paediatric setting. He is acknowledged as a world expert in the field of anaphylaxis, and Ireland, and in particular Cork and the Munster region, are indeed fortunate to have the services of an expert such as he.

My passion, interest and concern in this area arises from my role as the medical practitioner on-site, responsible for protecting the health, welfare, well-being and safety of more than 18,000 students that are on campus daily. As head of the student health department, I lead a team of health care professionals, endeavouring to anticipate and provide care for the full range of the usual presenting problems that occur in the primary care setting, for a population comparable to any large rural town.

In addition, as a student health physician I am challenged with anticipating and providing for the unique health threats and risk-taking behaviours that are prominent in a third level setting and among students. To date, we have had a number of notable successes, including in the area of alcohol related harm, with the successful implementation of the university alcohol action plan, which has been recognised nationally and internationally as an example of best practice. A particular success in the area of life-threatening emergencies was the establishment of the first responder automatic external defibrillation, AED, programme on campus, with the recruitment and training of lay university personnel to act as first responders, along with the deployment of more than 40 AEDs. Within one month of having AEDs on campus in UCC we had the great fortune to manage to save the life of a parent of an attendee at a conferring ceremony by means of successful defibrillation.

All of which is cited by way of illustrating that we believe in UCC that we have an established a track record of identifying real life-threatening risks and of implementing innovative and effective solutions to mitigate those risks. It was in that context that I was delighted to be approached by Professor Hourihane to seek to establish a comparable first responder anaphylaxis autoinjector programme, which as he has indicated, we managed to design and implement in 2011. It is with some dismay therefore that we continue to be unable to activate this innovative and life-saving pilot project for the want of appropriate legislative approval.

We contend that, given the in-house expertise, the established proven track record, and the unique high-risk practices that this anaphylaxis-prone age group display, there is no better setting in which to demonstrate proof of concept and to establish such a first responder anaphylaxis autoinjector pilot programme. Thankfully, life-threatening anaphylaxis is rare. We very rarely see cases of near-death anaphylaxis in the student health premises. We have done so, however. In my eight years as head of service in UCC, we have saved at least one life in danger of anaphylaxis in our emergency treatment room through the prompt administration of adrenaline. We have had one episode of anaphylaxis on our premises in eight years. Therein lies the problem, however, because there will be many more anaphylaxis episodes which will occur outwith our premises. Anaphylaxis will occur when someone is not there but in the library, on the running track or in one of our multiple eating places on campus. It will occur at night and at weekends. It will occur when we are closed and not available.

Students are risk takers; it is in their DNA. They see themselves as invincible and even those who know themselves to be at risk often will ignore the risk. We anticipate that those who know they have anaphylaxis may not even carry their autoinjector on many occasions. Few, if any, will step forward and admit to having an issue with food allergy or anaphylaxis, not wanting to stand out in any way. In four years, despite regularly promoting and encouraging self-declaration at registration and orientation, not a single student came forward to tell me of an existing food allergy so that I could establish and compile a risk register. This is a high-risk vulnerable population. We believe we have the expertise in-house and the willingness to embrace the challenge. We have an innovative, safe and effective means of reducing the risk, and we ask for the committee's support to make that happen.