Keeping epinephrine on hand at school saves lives

Schools that stock epinephrine for emergency use to treat anaphylaxis caused by food reactions or other triggers can see striking benefits, a new study shows.

Resource Center: Allergy triggered anaphylaxis

The study, presented at the 2014 Annual Scientific Meeting of the American College of Asthma, Allergy, and Immunology, reviewed the cases of 38 children and adults in the Chicago public schools who received epinephrine to treat severe anaphylactic reactions during the 2012-2013 school year.

A total of 35 students and 3 adults were treated for reactions: 76.3% by a school nurse; 18.4% by another staff member; and 5.3% by the patient. Most reactions occurred in elementary schools; 37% occurred in high schools.

Peanuts (55%) and fin fish, such as salmon, tuna, and flounder (13%), were the most frequent triggers. In 34% of cases, the trigger was unknown.

The researchers were surprised to find that more than half the reactions were first-time emergencies, perhaps because children are encountering some foods for the first time at school. An estimated 25% of children who have received epinephrine at school were unaware they had a food allergy.

Forty-one states have enacted so-called stock epinephrine laws and are in the process of developing policy and procedures to implement them. The Chicago public schools, the site of the current study, was the first large urban school district in the United States to put its state’s stock epinephrine law into practice.

To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics PediaMedia.