For parents of children with life-threatening allergies, risk-assessment becomes a part of their daily lives. For Sarah MacKinnon, that includes walking her eight-year-old daughter, Eila, to her classroom door and seeing if the class will be led by her regular teacher, or a substitute.

"You assume everyone who's going to be with children is trained on [anaphylactic reactions] but it's just not the case," MacKinnon tells CTV News.

One of the coordinators for the Metro Vancouver Anaphylaxis Group, MacKinnon has had several experiences where a teacher on call (TOC) either hasn't had his or her annual refresher on how to recognize the symptoms of anaphylaxis and use an EpiPen -- or has never been trained at all. The latter happened Wednesday, the second day of school, when she approached the substitute teacher who’d monitored the class after lunch.

"She didn't know Eila had an allergy and had never been trained on EpiPen.”

When CTV News tried to get answers about anaphylaxis training for full-time teachers and TOCs, the Vancouver School Board said no one was available for an on-camera interview. The education ministry said the minister was also unavailable for an interview. Both made email statements instead.

When asked about concerns raised by the Metro Vancouver Anaphylaxis Group around ongoing training and refreshers on EpiPens and anaphylaxis symptom recognition for substitute teachers, the VSB wrote, “Every new teacher or teacher on call, when first hired by our district, completes the online.”

The statement insists the VSB is in compliance with a ministerial order to have a plan and annual training to respond to children who may have contact with life-threatening allergens.

“Staff at schools, including teachers and any support staff who work with children, receive a 10-20 minute training session on anaphylaxis every year,” it reads, then continues: “This may or may not include teachers on call, depending on where they are working the day of the training.”

Though it wouldn’t clarify its response, it appears the VSB doesn’t keep records of which teachers or substitutes complete that annual refresher.

While EpiPens are simple to administer, the symptoms to watch for aren’t as intuitive. Warnings signs an anaphylactic reaction is beginning range from coughing to itchy eyes, which could appear like hay fever or other issues to an untrained caretaker.

“Districts must establish a training strategy to be implemented by each school. This includes annual training for all teachers,” wrote Education Minister Rob Fleming in his statement to CTV News.

“Ministry staff have contacted the district in question and they reported that they are in adherence with Ministry policies. I will be directing Ministry of Education staff to remind school districts of their responsibilities pertaining to anaphylaxis protection.”

But while Anaphylaxis Protection Order demands a detailed list of students and their life-threatening allergies, a database tracking which teachers have had initial and ongoing training is not required.

Parents like MacKinnon worry that means some teachers could go years without the refresher, making it easier to forget the warnings signs or what to do in case of an emergency despite a posted notice in each classroom describing “Staff Emergency Procedures for all Medical Emergencies.”

"It's just really frustrating when this is such a serious medical condition that is life threatening,” says MacKinnon of her two-year fight to have mandated, monitored and documented training for all full- and part-time teachers.

“It would be really horrible for someone to fall through the cracks just because of a few [training] steps not lining up.”