Fighting anaphylaxis one student at a time


Anthony Soave

Administration of an epinephrine auto-injector is a process of a few simple steps that any person can follow when someone suffers from an anaphylactic reaction.

By Sports & Health Editor

The prevalence of allergic reactions among youth in the U.S. is increasing, leaving school nurses and officials looking for new ways to help combat the dangerous anaphylactic responses.

The presence of allergies in the form of skin conditions, food and respiratory allergies has more than doubled during the last 30 years, according to Mike Tringale, senior vice president of external affairs at the Asthma and Allergy Foundation of America. The Foundation published an article Oct. 2013 titled “Anaphylaxis in America,” which showed that up to 5 percent of the nation’s general population experienced anaphylactic reactions in 2011. Anaphylaxis affected almost 3 percent of youth.

A 2013 U.S. Department of Health and Human Services report showed that respiratory, skin and food allergies among youth began to steadily increase in 2006 and have not declined since.

“If it was more of a deadly disease, it would be considered an epidemic,” Tringale said.

Anaphylaxis is an allergic reaction that breaks down various body systems and causes a number of symptoms shortness of breath and nausea, according to Tia Campbell, school health specialist at the Virginia Department of Education. There are only two ways to combat anaphylaxis: avoiding triggers and taking emergency action. There are no treatments or cures for the allergic reactions; they can only be dealt with in emergency situations with the use of an epinephrine injection, according to Tringale.

Because injections are the only current method to combat an anaphylaxis, The School Access to Emergency Epinephrine Act was signed in November 2013 to better equip all public elementary and secondary schools in case of a life threatening allergy situation. The law encourages schools to have nurses train teachers and staff to properly administer epinephrine auto-injectors and have injections at all times.

More than 20 states have laws or guidelines allowing schools to stock epinephrine auto-injectors, according to the Food Allergy Research & Education’s wbsite. The Illinois Emergency Epinephrine Act passed in August of 2011, allows Illinois school nurses to supervise the stocks of injectors. The law states that any student who experiences anaphylaxis may self-administer the drug on school grounds if he or she has a prescription. In situations that call for a school nurse or trained personnel to inject the epinephrine, the law protects employees from liability if something goes wrong.

Emergency administration of epinephrine auto-injectors does not require certification and can be performed by anyone, including a fellow student, but students do not enjoy the same liability protections as teachers, according to Maura Possley, press secretary for Illinois Attorney General Lisa Madigan.

Students would need to be properly trained and certified to be protected from liability, Possley said. But Mary Ellen Conley, school nurse for the Abington, Mass. school district and board member of the Asthma and Allergy Foundation of America, said it is always good for someone with severe allergies to have a peer who knows how to properly administer an injection.

She said school nurses could train older students to use epinephrine auto-injectors in the same way they teach school personnel. While younger students may not need to be trained in the actual administration, it would be helpful to teach them the signs and symptoms and severe reactions so they can report to an adult in the event of an emergency, Conley said.

Although Campbell said students should not be expected to give their peers injections, she said its easy to do. The entire process consists of only a few steps: taking the cap off, jabbing the needle into the thigh muscle, counting to 10 and then removing the needle. Once the epinephrine has been injected, emergency services should always be contacted for further treatment and care, Campbell said.

Tringale said he thinks it is important to educate, prepare and make people, including students, more aware of anaphylaxis, because awareness saves lives.

“That’s why [the AAFA] fights for school education about anaphylaxis,” Tringale said. “We’ve been pushing these state laws and school policies that require training about anaphylaxis.”

Until students are given epinephrine administration training, it is important that schools stock supplies of auto-injectors and have school nurses and staff trained on site during school hours, Conley said.

“We’re seeing more states looking at putting regulations into place where schools will maintain a supply of epinephrine,” Conley said. “My pitch is to get more [nurses] into the schools to do all the things that we do so well to manage anaphylaxis in a school setting.”