Journal of Allergy and Clinical Immunology
Real-Time Surveillance of Epinephrine Administration in Schools Supports the Argument for ‘Stock' Epinephrine Availability
Section snippets
Rationale
A small number of states have enacted or are considering legislation concerning “stock” (non-individual-specific perscription) epinephrine for schools to allow greater access for emergency treatment; however, relatively little data is available on anaphylaxis and epinephrine use in the schools.
Methods
Massachusetts 105 CMR 210, the Regulations Governing the Administration of Prescription Medications in Public and Private Schools mandates that a standard survey form be completed after every administration of epinephrine. We reviewed epinephrine administrations for the 2010-11 school year.
Results
There were 215 epinephrine administrations in 159 schools (149 public, 10 private) reported during the 2010-11 school year. Food accounted for 77% of epinephrine events for which the trigger was identified (123/166), followed by insect sting (8%), medication (4%) and exercise (3%). In cases where food was the trigger, ingestion was documented more than 80% of the time. Peanut and tree nuts were the most commonly reported trigger foods. Respiratory symptoms were reported in 85% of treated
Conclusions
A significant percentage of epinephrine administrations occurring in the school setting occur in the absence of a diagnosis, supporting the argument for “stock’ epinephrine availability.