Of Course There Should be Epinephrine in Our Schools

The death of Ammaria Johnson, a first-grader with food allergies, earlier this year, has caused an out-pouring of outrage, grief, sadness, and concern among those in the food allergy community. Ammaria suffered cardiac arrest after eating a single peanut, handed to her by a classmate on the playground. Those who have written on the topic point out that this was a death that was avoidable, but none do so better than Margaret Carlson in her article for Bloomberg titled Death Shows Schools Need Power of EpiPen.

Carlson makes the point that defibrillators are more common in our schools than epinephrine, a point that really hits home with me. Yes, the high school my sons recently graduated from has a defibrillator. Nobody questions the need for the defibrillator. That same school also has a trainer who is with the sports teams during practices and games. For many games he isn’t called in action, but when he’s needed parents are sure glad he is there.

During high school football games there is an ambulance sitting ready at the field (unless responding to another emergency). During my years of watching football at the high school that ambulance was needed three times. The rest of the time it was waiting, just in case.

In the cafeteria there is a large sign posted prominently with the instructions to recognize if someone is choking and how to perform the Heimlich maneuver, should it be necessary. Nobody questions that it should be hanging there. There should be a poster right next to it that explains how to recognize an allergic reaction, and how to administer epinephrine, if needed. For those not familiar with food allergies, epinephrine can save a life, as Dr. Sarah M. Boudreau-Romano so expertly explains here.

Of course there should be epinephrine in our schools. And it should be easily accessible.

The most recent estimates of food allergy in our children is now between 4 and 6 percent; that means that most classrooms will have a child with food allergies. Not every child with food allergies will have had an episode serious enough to prescribe epinephrine. And there’s always a first time for an allergic reaction. Given that many of our children eat two out of three meals a day (plus snacks) at school, there’s a good chance that first reaction will happen there.

The School Access to Emergency Epinephrine Act was introduced in the Senate late last year. The proposed bill would provide States with incentives to require elementary schools and secondary schools to maintain, and permit school personnel to administer, epinephrine at schools. The findings note that more than 15% of students with food allergies have had an allergic reaction while at school, and 25% of epinephrine injections at school involved individuals with a previously unknown allergy.

It’s not just parents of children with known food allergies that need to be concerned. Of course there should be epinephrine in our schools.