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New Survey Shows Three in Four School Nurses Have Students at Risk for Severe Allergic Reactions Who Do Not Bring Auto-Injectable Epinephrine to School

Parents of students with known allergies are urged to put auto-injectable epinephrine at the top of the school supplies list

Silver Spring, MD (August 27, 2008) /PRNewswire/ — A new survey conducted by the National Association of School Nurses (NASN) found that 72% of school nurses have students with a known history of allergies or prior use of epinephrine whose parents have not provided the school with auto-injectable epinephrine. Also known as adrenaline, epinephrine is the first-line standard of care for treating anaphylaxis. Anaphylaxis is a severe allergic reaction that can be caused by nuts, insect bites or stings and other allergens.1,2,3 Eight out of ten school nurses (82%) surveyed have also seen increased numbers of children at risk for anaphylaxis in the past few years.

"We cannot overlook the importance of preparation when sending students back to school," said Amy Garcia, RN, MSN, executive director of NASN. "It is crucial that parents of children at risk for severe allergic reactions provide the school with auto-injectable epinephrine."

As many as 45 million Americans have allergic sensitivities that put them at risk for anaphylaxis.4 It takes only one to two minutes for a mild allergic reaction to escalate to anaphylaxis.5 The faster the onset of an anaphylactic reaction, the greater the likelihood that it will be severe.6 Most anaphylactic deaths have occurred when auto-injectable epinephrine was not used or not used in time.7,8,9

The online survey of 489 school nurses also found that:

  • 56% have witnessed anaphylaxis at school
  • 68% support or strongly support making stock auto-injectable epinephrine universally available in schools
  • 72% said that establishing a policy by the local school district would strengthen support for creating a stock auto-injectable epinephrine program in their school(s)
  • 93% have students with prescribed auto-injectable epinephrine for whom the school stores the medication

Larry S. Posner, MD, FAAAAI, assistant clinical professor at UC San Francisco said, "Being prepared in case of an emergency is critical in preventing the most serious effects, since accidental exposure to known food allergens are the rule rather than the exception and anaphylaxis may progress very quickly. We know that in fatal anaphylaxis, respiratory or cardiac arrest will usually occur within 10-20 minutes for bee stings and within 20-45 minutes for food reactions.10 That gives very little time for an appropriate response."

Due to the quick onset of anaphylaxis, being prepared is vital to keeping children safe. "Creating a plan to prevent exposures and respond to severe allergic reactions in our schools requires informing classmates, teachers and other school staff about the student's allergy and teaching them to recognize the symptoms so they can assist if an emergency arises. It also means having auto-injectable epinephrine handy that is easy to use and can be quickly administered in a crisis situation," Ms. Garcia said.

About the NASN Survey

NASN's "Management of Asthma and Anaphylaxis in Schools Survey" was an anonymous online survey conducted between May 17 and July 11, 2008 among U.S. school nurses. 489 nurses completed the 80-question survey, which included multiple choice questions and free-form responses.

The survey was adapted from a survey conducted with the California School Nurse Organization (CSNO) and West Coast Allergy and Asthma Network (WestCAAN). Dr. Larry Posner and Nancy Spradling, executive director of the CSNO developed the CSNO/WestCAAN survey.

About NASN

The National Association of School Nurses is a non-profit specialty nursing organization, incorporated in 1977, which represents school nurses exclusively. NASN has over 13,000 members and 51 affiliates, including the District of Columbia and overseas. The mission of the NASN is "to advance the delivery of professional school health services to promote optimal health and learning in students." To learn more about NASN, please visit us on the web at www.nasn.org or call 866-627-6767. For state specific information, please select "Affiliate Organizations" under "QUICKLINKS" on the NASN homepage.

References:

1Boudreau-Romano et al. A Retrospective Review Of Anaphylaxis Management In A Pediatric Emergency Department. J Allergy Clin Immunol. 2008; (121:2): S25
2Jarvinen et al. Use Of Epinephrine In Food-induced Anaphylaxis In Children. J Allergy Clin Immunol. 2007; (119:1): S29
3Gold and Sainbury. First aid anaphylaxis management in children who were prescribed an epinephrine autoinjector device (EpiPen). J Allergy Clin Immunol. 2000; (106:1): 171-176
4Neugut AI et al. Anaphylaxis in the United States. Arch Int Med. 2001;161:15-21.
5The Merck Manual. Merck Research Laboratories. 2006-2008.
6Nicklas et al. Anaphylaxis. Supplement to: J Allergy Clin Immunol. 1998;101(6:2):498S-501S;S469
7Boudreau-Romano et al. A Retrospective Review Of Anaphylaxis Management In A Pediatric Emergency Department. J Allergy Clin Immunol. 2008; (121:2): S25
8Jarvinen et al. Use Of Epinephrine In Food-induced Anaphylaxis In Children. J Allergy Clin Immunol. 2007; (119:1): S29
9Gold and Sainbury. First aid anaphylaxis management in children who were prescribed an epinephrine autoinjector device (EpiPen). J Allergy Clin Immunol. 2000; (106:1): 171-176
10 Pumphrey RSH. J Allergy Clin Immunol. 2003;112(2):451