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Board of Education Wants Anaphylaxis Protocol for Schools

EpiPens® at Schools

Press release courtesy of the State Board of Education.
At its March 2002 meeting, the State Board of Education approved a revised timeline and plan that calls for schools to put in place a protocol for responding to life-threatening asthma attacks or other allergic reactions.

Under the revised plan, the medical community would cover the costs of implementing the program, which would be mandated effective August 2003.

"School districts will not have to pay the cost of the program," Education Commissioner Doug Christensen said, noting that members of the Nebraska medical community supporting the protocol have indicated that they intend to fully fund the project.

The State Board of Education also voted unanimously to allow school districts an additional year before they must implement the protocol. Christensen emphasized that school could, however, move forward now to protect students, even though the mandate won't be effective until August 2003.

Christensen said the timeline for requiring school districts to implement the process was pushed back to allow the medical community time to raise funds and to train school personnel across the state and to include more participation from educators and parents. Christensen and state board members applauded the state's medical community led by Stephen Lazoritz, physician and vice president of medical affairs at Children's Hospital in Omaha, Kevin Murphy, an Omaha physician, and Linda Ford, an Omaha area physician, for bringing the issue to the State Board of Education and for working in partnership with the state on this issue. School personnel will be trained on how to respond to life-threatening asthma attacks or other allergic reactions.

The Nebraska Department of Education and the medical community are working together to develop a partnership agreement with the medical community, rules and an implementation plan, Christensen said, noting that school administrators and the Nebraska Board of Pharmacy will be asked to participate. The group that will oversee the program is open to physician participation statewide. For more information, contact Kristin Petersen at 402-471-6591.

The board has been studying the importance of having EpiPens® available in schools for students or staff with severe asthma attacks since 2001.

The EpiPen Jr.® for small children and the EpiPen® for adults, delivers epinephrine to people with severe allergic emergencies. Epinephrine is often used because it quickly begins to reverse symptoms of an anaphylactic reaction.

Allergic reactions may be from foods (e.g. nuts, shellfish, eggs), stings (e.g. bees, wasps, hornets, yellow jackets), environmental items, or products, such as latex.

According to Dey Laboratories, the distributor of the EpiPens®, these devices are a disposable drug delivery system featuring spring activation and a concealed needle. It provides a rapid, convenient dose of epinephrine for individuals needing protection from potentially fatal allergic reactions. Adults may be able to self administer this medication.

The EpiPen® should only be injected into the outer thigh. Use of epinephrine will give time for the patient to get to the emergency room for further treatment. EpiPens® are manufactured by Meridian Medical Technology, Inc.

Benefits about having EpiPens® at school include:
  • Giving an injection of epinephrine minutes after a serious reaction begins can be lifesaving and give time for the patient to get to the emergency room for further treatment;
  • The patient will have relief of airway constrictions so that CPR can be successfully performed;
  • In rural areas the response time can be up to 30 minutes. Most rural rescue squads don't carry the EpiPens® or are able to give them;
  • The EpiPens® are simple and easy to give;
  • They are small (about the size of a highlighter) and the needle is not exposed and retracts after the dose is given.
Concerns about having EpiPens® at schools have been:
  • They are available by prescription only and must be given by trained personnel; and
  • They lose effectiveness when stored at above room temperature or past their shelf life.

Dr. Ally Jorgensen, assistant executive vice president of the Nebraska Pharmacists Association and director of its Drug Utilization Review, believes that saving lives is the most important reason for organized medicine to exist. In that light, she said having lifesaving drugs available where emergencies are most likely to occur is vital. She explained that the Nebraska Pharmacists Association introduced the legislation to change the definition of prescription to allow physicians to authorize emergency legend drugs without being required to know "who" would have the emergency.

"Until that passed, there was no legal way for the school to possess the lifesaving drug," Jorgensen said. "We did that to help save lives and because, in the opinion of our Board of Directors and Legislative Committee, it was the right thing to do."

For more information about this program, contact Betty VanDeventer at (402) 471-4537, or visit the Attack on Asthma web site at You may also wish to see the Emergency Response to Anaphylaxis form.

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