Millions of children across the country need emergency epinephrine at school because they could suffer a severe, potentially life-threatening allergic reaction (anaphylaxis) to food or an insect sting. As schools across the country implement policies to stock emergency epinephrine, some are seeing dramatic results.
According to a new study being presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting, stock epinephrine was used on 38 children and adults in Chicago Public Schools (CPS) during the 2012-13 school year for severe anaphylactic emergencies. According to the study, CPS was the first large urban school district in the United States to develop and implement a comprehensive stock epinephrine policy in accordance with state guidelines.
"We were surprised to see that of those who received the epinephrine, more than half of the reactions were first time incidents," said Ruchi Gupta, MD, MPH, lead study author. "Many children are trying foods for the first time at school and therefore it is critical that schools are prepared for a possible anaphylactic reaction."
It's estimated that 15 percent of school-aged children with food allergies have had a reaction at school and that about a quarter of epinephrine administrations in schools involved kids who didn't know they had an allergy at the time of the reaction.
Of those who had an allergic reaction, 35 (92 percent) were students and 3 (8 percent) were school staff. The majority of reactions happened in elementary schools, but 37 percent happened in high schools. The most common trigger foods for the reactions were peanuts (55 percent) and fin fish (ie; salmon, tuna, flounder - 13 percent) but the allergic trigger was unknown in 34 percent of the cases. A school nurse administered the epinephrine 76 percent of the time.
"Stocking emergency epinephrine is a medical necessity for schools in every state," said allergist Bryan Martin, DO, ACAAI vice president. "In addition to protecting those whose epinephrine auto-injector isn't immediately accessible during a reaction, stock supplies help save the lives of those who experience an anaphylactic reaction and don't have a prescribed epinephrine auto-injector."
A total of 41 states now have stock epinephrine laws, including the recent addition of Alabama, Connecticut, Delaware (signed into law on July 21, 2014), Maine, Ohio, and Wisconsin. Each state is at various stages of implementing policy and procedures for their stock epinephrine laws. To see a state-by-state map, go to epinephrine laws by state.