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A provision in the final budget (Appropriations Act of 2014) allows trained non-medical personnel to administer the anti-allergy medication epinephrine to school children who show signs of anaphylaxis. Anaphylaxis is a severe, potentially life-threatening allergic reaction that can occur within minutes of exposure to anything a child might be allergic to, such as a bee sting or peanuts. The only proven treatment for this type of allergic reaction is an injection of epinephrine as first aid.
The life-saving drug is most-often administered through device called an EpiPen. An EpiPen is a pre-designed hand-held medical device used to deliver a dose of epinephrine through a spring-loaded needle that pops out of the tip when pressed against the thigh.
The danger is that anaphylaxis can happen quickly and without warning, and children are among the most at risk – approximately one in 13 U.S. children has a potentially life-threatening (severe) food allergy.1
Some of the things that can cause an anaphylactic seizure are: foods, such as peanuts, walnuts, pecans, almonds, cashews, wheat, fish, shellfish, milk and eggs; stings from bees, yellow jackets, wasps, hornets and fire ants; some medications, like penicillin.2
The new law requires that each school be allowed to keep two EpiPens on hand in a secure but easily-accessible location. School personnel will be trained in identifying symptoms and in administering the emergency first-aid to a student suffering from an anaphylactic reactions during the school day and at school‑sponsored events on school property.
Concern over the lack of first aid for students at risk of anaphylaxis comes after some recent tragedies. In one case, a Virginia first-grader suffered an allergic reaction at school when she was given a peanut by another child. “When emergency crews arrived, she was already in cardiac arrest in the clinic,” said a fire department spokesman. The girl was rushed to a hospital where she was pronounced dead. Quick action by a teacher with an EpiPen would have most likely saved the girl’s life.
Surprisingly, allowing school personnel to use this kind of life-saving first aid has seen opposition in other states. In San Francisco, similar legislation faced strong opposition from, of all places, teachers’ unions. The California Teachers Association, the California School Employees Association and California Federation of Teachers fought to keep EpiPens out of the classrooms. They claimed that using this simple device was “beyond the scope” of teacher training and worried about the “potential for teachers to be ‘highly encouraged’ to become trained in administering medication against their will.” They argued that only school nurses should be handling medication.
According to a 2010 study in the Journal of Allergy and Clinical Immunology, the incidence of food allergies is on the rise nationally, with incidence of peanut allergy more than tripling from 1997 to 2008. The latest research suggests one in 13 children have a food allergy.3
To date, 45 states have enacted laws or policies allowing or requiring schools to stock epinephrine auto-injectors. States that have such laws in place are eligible for federal grant money to administer the program.
The original EpiPen legislation (House Bill 824), allowing the use of EpiPens in schools, passed unanimously in the House before being placed in the final Appropriations Bill. The EpiPen provision of the 2014 budget becomes effective today.
- Market Watch, “EpiPen4Schools® Program Enhances Support of National Movement to Improve Anaphylaxis Preparedness and Access to Emergency Treatment in Schools“
- Mayo Foundation for Medical Education and Research, “Anaphylaxis”
- NBC News, “New EpiPen law could save lives of schoolkids with severe allergies”