Researchers from Texas Children’s Hospital in Houston instituted a one-time seminar for nurses in the Houston Independent School System to educate them about food allergies and the use of injectable epinephrine devices to administer lifesaving treatment for allergic reactions. They evaluated the number of children with food allergies, allergic reactions, and injectable epinephrine devices before and 2 years after the educational session.
Targeted instruction increased the availability of epinephrine treatment to children with food allergies, and the effect persisted for more than 2 years. Researchers found a statistically significant increase (P<.001) in injectable epinephrine devices (Texas allows only prescribed student-specific epinephrine in schools), reflecting improved identification of children with food allergies, and a decrease in allergic reactions, perhaps resulting from improved preventive measures.
Nurses reported that the training improved recognition of food reaction symptoms, especially differentiating wheezing caused by reactions to food from asthma exacerbations, which facilitates prompt, appropriate treatment with epinephrine rather than asthma medications.
The researchers note that their training strategy is easily replicated and could significantly improve preparedness for allergic reactions in schools nationwide. Twenty-five percent of first-time cases of anaphylactic shock in children occur at school, and deaths often result from delays in giving epinephrine. Of children with food allergies in the United States, 40% are considered at high risk for anaphylaxis.
The 2013 School Access to Emergency Epinephrine Act provides incentives to schools to stock unassigned (not student-specific) epinephrine to treat allergic reactions.
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