Should all school children, not just those who have diagnosed food allergies, have access to the emergency medication epinephrine and should more adults be ready to administer it? This question was recently answered, in part, on Capitol Hill on November 27th. In an effort towards groundbreaking and lifesaving legislation a bill was introduced on entitled the School Access to Emergency Act. This bill would enable schools to maintain a supply of epinephrine and enable staff to administer an Epipen to a student having an anaphylactic reaction. The School Access to Emergency Act would be given a preference when federal funding is allocated for asthma education and prevention grants. The bill was introduced and championed by U.S. Senators Dick Durbin (D-IL) and Mark Kirk (R-IL) of Illinois. Earlier this year, the state of Illinois passed a law that allows schools to obtain and administer a non-student specific prescription for epinephrine, the first-line treatment for anaphylaxis.
Currently, as many as six million children in the US have food allergies. My son is among those six million and he attends a private school with a full time nurse and Epipens readily available for any child showing signs of anaphylaxis. The latter part is crucial. Studies have shown that as many as 24 percent of epinephrine administrations in schools involved children with a previously unknown allergy. As a result, they do not possess their own prescription for epinephrine. In other words, many children discover their food allergies the hard way, with the onset of an anaphylactic or life threatening reaction.
Eight years ago, I watched my child (then a baby) bloat helplessly during his first anaphylactic reaction and no, I did not have an EpiPen in my home. Instead I went to the nearest emergency room where he was saved by an injection of epinephrine. Now an Epipen is always in his near proximity. But many children have their first onset of allergies after entering into school age.
Food-allergic school children rely on the entire school staff for safety and an auto injector of epinephrine (an EpiPen) is an easy-to-use device that laypeople (not necessarily school nurses) can be trained to utilize. CEO of the Food Allergy and Anaphylaxis Network, Maria Acebal, points out, "EpiPens are easy to use but there is no substitute." Further, unlike other emergency medications pediatricians commonly agree that children cannot be harmed by administration of an EpiPen. There isn't any data to suggest that a normal child would suffer any long term effects from an Epipen injection.
The School Access to Emergency Act addresses what I call "preventable hindsight." As I wrote in earlier post titled, It Is Time for National Education of Life-threatening Allergic Reactions "... Unlike other emergency medical conditions, like choking or loss of breath, anaphylaxis cannot be halted without medication." So no, CPR training won't help a child in his first onset of allergic anaphylaxis.
And yes, schools would have to account for the monetry costs of maintaining a supply of Epipens. However, under the School Access to Emergency Act, schools would receive a fifty percent cost discount for each "twin pack" of epinephrine. It fairly obvious that the alternative -- the loss of a child to preventable anaphylaxis -- isn't worth waiting for.
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