EpiPens, or epinephrine autoinjectors, are the first line of defense against anaphylactic shock, a form of extreme allergic reaction that can be deadly within minutes. At least two American schoolchildren — one in Illinois and one in Virginia — have died recently after suffering anaphylaxis due to peanut allergies.
Most states have passed laws allowing schools to stock undesignated EpiPens that can be used on any student or faculty member whether or not they have a prescription. Onlysix states require(rather than simply allow) schools to stock epinephrine, while two more are considering legislation that would require the stocking of epinephrine in schools. Recent federal legislation sweetens the pot by making financial incentives available for states that require schools to stock this life-saving medication.
What Is Anaphylaxis?
Anaphylaxis is a severe and life-threatening allergic reaction to an allergen like bee sting venom, peanuts, certain prescription drugs or other foods or chemicals. It occurs rapidly after an allergic person is exposed to his or her allergen. Symptoms include difficulty breathing, wheezing, anxiety, abdominal pain, swelling of the throat, light-headedness, hives, itchiness, diarrhea, coughing, chest tightness, nausea, vomiting, redness of the skin, palpitations, loss of consciousness, slurred speech and swelling of the tongue, eyes or face.
Prompt medical intervention is necessary for most people who suffer anaphylaxis. Like the unfortunate schoolchildren in Virginia and Illinois who died due to peanut allergies, people who do not have access to first-aid epinephrine can easily die in the time it takes an ambulance to arrive.
EpiPens Are Easy to Use
The EpiPen is an epinephrine autoinjector that’s easy to use, even for a child. EpiPens come with a practice device that allows patients, caregivers and first aid responders the opportunity to practice using the device without administering any medication. Adult EpiPens contain 0.3 milligrams of epinephrine, while the EpiPen Jr., the children’s version, contains 0.15 milligrams.
The dose of epinephrine in the EpiPen stops the anaphylactic reaction until emergency medical care can be administered. Many children and adults with food or other allergies carry EpiPens in case they go into anaphylactic shock. However, as many as 25 percent of those who experience a potentially fatal allergic reaction did not know they had allergies.
That’s because allergies aren’t just something you’re born with. They can develop at any time during your life. Allergies can come, go, worsen or improve. Scientists don’t understand what causes allergies, but one in 13 children today has a food allergy. Between 1997 and 2007, rates of childhood food allergies have increased 18 percent, and rates of peanut allergies in children have tripled.
Like other medications, EpiPens expire. People with known allergies must buy EpiPens regularly to make sure their medication is up-to-date. They also need to have more than one EpiPen on hand; in the event of anaphylaxis, an allergy sufferer may need more than one dose of epinephrine.
While epinephrine can stop anaphylaxis, it does not cure it. The medication can wear off, causing the life-threatening symptoms to return. If that happens before emergency responders can arrive, a second dose of the medication may be necessary to stave off symptoms until medical care is available. With treatment, however, most patients make a full recovery from anaphylaxis.
Law Provides Incentives for Schools to Keep EpiPens on Hand
Last November, President Obama signed into law the School Access to Emergency Epinephrine Law, which provides financial incentives for states that require schools to keep a stock of emergency EpiPens on hand and train school personnel in their use. These states will receive preferential treatment when it’s time to hand out federal grant money for programs that treat childhood asthma. Since 2004, states that allow schoolchildren to self-administer epinephrine and asthma medication have received the same preference.
Seven-year-old Amarria Johnson was one of the two students who died of her peanut allergy. She passed away after eating a peanut given to her by a classmate on the playground of her Richmond, Virginia school in January 2012. Though the school had EpiPens on hand, Amarria did not have a prescription. State law prohibited school officials from administering medication prescribed to one student to another student.
Amarria’s Law, passed months later, requires schools in Amarria’s home state of Virginia to stock EpiPens and allows school officials to administer it to children whether or not they have a prescription on record at the school. Similar legislation has been passed in five other states. It could be life-saving not only for children who don’t have their own prescribed EpiPens with them at school, but also for those who didn’t know about their allergies. Of the 38 people injected with epinephrine in Chicago public schools during the 2012-13 school year, 21 had no previous knowledge of their allergy. The oldest of the student recipients was 19; two recipients were not students at all, but faculty members.
A federal law passed in 2013 has provided incentives for states to require schools to keep EpiPens on hand and train school personnel in their use. The measure could save lives, especially since a significant portion of people with life-threatening allergies don’t know they have them.
EpiPen photo by Intropin from Wikimedia Commons.