Stocking Epinephrine in Schools Essay

Introduction

The need to stock epinephrine (EpiPen) in schools to treat anaphylactic reactions in students and faculty staff is policy priority issue in this paper. It puts an emphasis on sudden severe allergic reactions and students whose death could be prevented with an emergency treatment of epinephrine.

Problem statement and background information

This paper addresses emergency situations in schools and the need to have the right medication and equipment to handle emergencies. Currently, there are Automatic Emergency Defibrillators (AED) in schools for use by students and staff. Epinephrine (EpiPen) should be available in schools to supplement AED’s.

There is a need for a campaign to ensure this law passes as it did not pass the last session and will be reviewed during the next session. Hence, the need for mass campaigns by parents, teachers, students and health professionals.

There are several instances where children have allergic reactions even though they have never been diagnosed with allergies. These reactions occur suddenly and thus, should be treated as an emergency. The availability of epinephrine in schools along with the health staff and students can save the lives of these students.

Regulatory issues

Currently, the law only allows students with a history of anaphylaxis to use epinephrine prescribed by their physicians while at school. There are some situations where a student may experience an allergic reaction, although it has never occurred to them that they lack individual medication. Thus, allowing epinephrine will be beneficial to them.

Evidence supporting the need to Stock Epinephrine in Schools

According to Asthma, and Asthma Network Mothers of Asthmatics, school going children die every year due to delays in accessing medications for anaphylactic reactions. Asthma and allergies are a leading cause of absenteeism in school going children; probably because parents are afraid of letting their children go to school as they fear an anaphylaxis attack on their children. Thus, ensuring that schools have the required resources and equipment to manage anaphylactic reactions will increase the parents’ confidence in the school’s ability to manage emergency situations and reduce the rate of absenteeism.

Accidental ingestion of substances that result in anaphylactic reactions commonly occurs at school. Management of anaphylactic reactions is by the use of epinephrine since it has no contraindication in emergency situations (Managing Food Allergies in Mississippi Schools-Guidelines, 2008). The Center for Disease Control has also noted that food allergies are a serious problem among school going children.

The National School Boards Association Policy Guidance also recommends that Schools should have standing orders for treating anaphylaxis and also stocking of epinephrine. It also takes less time, about one or two minutes for an allergic reaction perceived mild to complicate to an anaphylactic reaction. This does not allow time for transportation to the hospital hence, the need for easily accessible epinephrine (Allergy and Anaphylaxis Network, 2012).

Following up the issue

The current status of this is accessible from “The Mississippi Legislature 2013 Regular Session, Report of All Measures” website. It provides the actions required in solving different scenarios in case of emergencies.

The level of government that is involved with this issue

The immediate target is for the law to be passed in the state of Mississippi. This involves the local and state government as they are the laws governing the state.

Empirical evidence that supports the need to Stock epinephrine in Schools

Food allergies are increasing among school going children. Statistics show that, between 1997 and 2007, there was an increase of about 18% (Young, Munoz-Furlong, & Sicherer, 2009). At the moment, 7 out of 100 school going children have food allergies. 40-50% of those diagnosed with food allergies have a high risk of developing anaphylactic reactions (Young, Munoz-Furlong, & Sicherer, 2009). 16-18% of allergic reactions due to food allergens, usually have a history of ingestion of the allergen at school. The prevalence of asthma among school going Children aged between 0 and 17years is about 10%.

In addition, reports show that most students who are diagnosed by allergic reactions have not suffered from the same previously. This emphasizes on the need to have epinephrine stocked in all schools. They should not be specific to a given patient as such emergencies can occur at any time, and a student may not have their own medication to treat the reaction.

Illinois state law

Some states, such as Illinois have already passed the law to allow schools to stock epinephrine, doctors are required to write a prescription of the same under the school’s name. Teachers and assistant teachers are trained by a registered nurse or a physician on the use of emergency epinephrine.

Importance and impact of this policy to Nursing

The School Nurse is charged with the responsibility of providing direct care to students; including management of acute illness (American Academy of Pediatrics, 2008), and is also the most accessible medical personnel during emergency situations in school. Without access to equipment and resources necessary for the management of anaphylaxis, the school nurse’s knowledge of the ways of managing anaphylaxis is of no value to the victim. In addition, it is not necessary having a medical personnel present if he or she cannot have the resources to prevent death and promote life (Massachusetts Department of Public Health, 2010).

The impact of Stocking Epinephrine in schools is that, it will improve the nursing care provided by the school nurse to victims of anaphylaxis within their area of service, as in case of anaphylaxis, epinephrine will be accessible.

In addition, it will improve the nurse’s knowledge on the management of anaphylaxis as all the school nurses will be required to attend an educational training on the management of anaphylaxis. The nurse will be in a position of training teachers and assistant teachers on the use of epinephrine; this will improve the public knowledge on anaphylaxis and this knowledge may be of benefit in other areas, not just the school environment.

The policy will also give the school nurse (and any other trained person) the mandate to administer epinephrine to someone who the nurse makes a diagnosis of anaphylaxis that may lead to life threatening complications. In the absence of the nurse, any other trained person can give epinephrine medication. It also allows the nurse to use the epinephrine on students, who have a history of anaphylaxis, have their own medication, but they cannot easily access their medication, or maybe they forgot it at home. It will promote life which is one of the core values of the nursing profession.

In summary, it is evident that allergies and asthma are a serious problem in school going children. These allergies may also occur in students who have not been previously diagnosed with allergies. It is also evident that epinephrine is vital in the management of anaphylaxis; epinephrine also has no contraindications in emergency situations. School nurses are charged with the responsibility of taking care of student’s health while they are in school. Stocking Epinephrine in Schools will play a crucial role in preventing complications of anaphylaxis, and will also ensure that the school nurses meet their objectives of taking care of the health needs of the students.

References

Allergy and Anaphylaxis Network. (2012). School access to emergency epinephrine Act. Web.

American Academy of Pediatrics. (2008). The role of the school nurse in providing Food Health services. Pediatrics, 21(5), 1052-1056. Web.

Massachusetts Department of Public Health (2010). Data health brief: Epinephrine Administration in schools 1-6. Web.

National School Boards Association. (2011). Safe at school and ready to learn a Comprehensive policy guide for protecting students with life threatening food Allergies. Web.

Young, M.C., Munoz-Furlong, A., & Sicherer, S.H. (2009). Management of food allergies In school: A perspective for allergists. Journal of Allergy Clinical Immunology, 124(2), 175-183.