This article springs from a recent news story that I found about a first grader who, after presenting symptoms of hives and wheezing, died of cardiac arrest. Not much detail has been divulged in the news about the actual cause of the child’s death but the mother claims that her daughter has allergies to peanuts. According to the report, the school does not have any EpiPens in stock and even if they had, they would not be able to administer it to the child since the medication is given by prescription and any medication whether prescription or OTC should be specific to the child. The mother on the other hand said that she had an EpiPen on stock for the child but the school refused to take the medication and told her to keep it at home so she authorized the use of Benadryl at the first sign of allergic reaction as an alternative which also was not done. Issues on how anaphylactic reactions on the school level are now being raised. Should schools have EpiPens on stock as part of their medical kit? There are a few states that allow schools to have EpiPens on hand and be administered without prescription in cases of severe allergic reactions but this law doesn’t apply yet to the state where this child lives in.
These kind of stories are really heartbreaking since as a healthcare provider, you know that there is a possibility of saving this child had the proper actions been done. It has not been clarified whether the child’s death was really due to an allergic reaction but if it was, then a shot of Epinephrine, had it been available, would have saved the child’s life. The dilemma, I think, isn’t whether or not schools should stock EpiPens. It is when someone should use the EpiPen. We are aware that school nurses are not always there and should there be a need to use an EpiPen, the responsibility of deciding on whether to use it or not lie on the teachers or whoever school staff is there at the moment. Now, since Epinephrine is a prescription drug, someone who is unsure whether there is a need for it or not might hesitate to give the drug and when they have decided to give it, it might already be too late.
Here is where parents and teachers have to work together. Parents who are aware of their child’s allergies should inform the school and update their school health records on any known allergies and how severe these allergies might be. Any medications prescribed should also be there and if possible, provide the school stocks for emergency use. Teaching a child who has allergies on what their allergies are and what foods, drinks, plants, objects or medications they should avoid can also be done as a preventive measure.
There is nothing wrong with schools stocking on EpiPens. Having an EpiPen on hand for a child who has unknown severe allergic reactions could actually be life-saving. The potential danger that comes in stocking EpiPens is the improper use of it. To reduce this danger, teachers and school staff should be educated on recognizing the signs of the severe allergic reaction including when and how to properly use an EpiPen. The school nurse can set-up a short seminar for school staff and provide a presentation on allergic reactions and anaphylaxis. She can show pictures on what severe reactions look like to give her audience a better understanding of what they’re looking for and to better recognize the signs of anaphylaxis. These pictures can be left or posted next to the storage area where EpiPens are kept to at least remind the person who is about to use the EpiPen on what they should use it for. These are just some suggestions that can be done to prevent the previous incident. Hopefully, this child’s case would awaken both school officials and health departments on reviewing their school’s response plan not only for allergies but for other child health emergencies as well.
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Original article from hufftingtonpost.com, Ammaria Johnson, First Grader, Dies After Alleged Allergic Reaction At School
