Emergency stock epinephrine auto-injectors were used in 38 anaphylactic reactions at schools in Chicago during the 2012-2013 school year, according to new research.
More than half of the time, the reactions occurred in people who did not know they had allergies – results that surprised lead author, Dr. Ruchi Gupta, an associate professor of pediatrics at Northwestern University Feinberg School of Medicine.
“Kids start school at a very young age and have often not tried some of the most common food allergens like peanuts, tree nuts, fish, shellfish, etc.,” she said. “Our data that 55 percent of kids who were administered epinephrine had no known history of a food allergy shows the importance of having stock epinephrine in schools,” Gupta told Allergic Living via email.
“Because of the amount of time kids spend in school, and given the fact that many first-time allergic reactions occur on school grounds, it is imperative for school districts across the country to provide access to emergency epinephrine to students who may not otherwise have access to the potentially life-saving medication,” Gupta said in a Northwestern University press release.
Illinois implemented its stock epinephrine law in 2011, making the Chicago Public Schools (CPS) district the first large urban school district in the U.S. to develop and implement a policy of keeping epinephrine available for use for anyone in an emergency. The study, published in the American Journal of Preventative Medicine, concluded that, “the impact of this initiative during its first year underscores the need for stocking undesignated epinephrine in schools across the country.”
Last November, President Barack Obama signed the School Access to Emergency Epinephrine Act, which provides financial incentives for states to adopt laws allowing schools to stock auto-injectors. As a result, most states now allow schools to stock epinephrine, and emergency auto-injectors are required in California, Nevada, Michigan, North Carolina, Nebraska, Virginia, Maryland, and Delaware schools. New Hampshire, Hawaii, Iowa and Rhode Island are the only states that currently have no epinephrine laws or regulations in place.
Food allergies were the cause of most of the documented cases – with peanuts being the most common culprit – but in more than one-third of cases, the trigger was unknown.
Other key findings include:
- 92% of reactions were among students, 8% were among staff.
- Most of the reactions occurred in elementary schools, but more than one-third (37%) took place in high schools.
- A nurse administered epinephrine in most cases (76%).
Gupta emphasized that these results show that it is critically important for schools to know how to recognize anaphylaxis , know to administer epinephrine right away and call for medical assistance – lessons that extend far beyond Chicago schools.
“This is definitely a national issue in schools around the country,” Gupta said in the Northwestern release. “We think the situation in Chicago schools is representative of schools everywhere. Most states now have policies in place for stocking epinephrine in schools. This is an essential step to keep kids with food allergies safe.”
The results were published in October and presented at the American College of Allergy, Asthma & Immunology annual meeting in November.