Barriers to the Administration of Epinephrine in Schools

Hogue, Susan; Muniz, Rafael; Herrem, C.; Silvia, Suyapa; White, Martha V.

doi:10.1111/josh.12620

Cited by 28 publications

(25 citation statements)

References 27 publications

(81 reference statements)

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“…Evidence is needed regarding optimal placement of epinephrine in schools and training and assignment of responsibility for epinephrine administration. School staff are inadequately prepared to administer epinephrine and are not empowered to respond in a food allergy emergency . Addressing inadequate training is critical, as prompt administration of epinephrine is associated with better anaphylaxis outcomes .…”

Section: Discussionmentioning

confidence: 99%

Food Allergy Management at School

Dupuis

Kinsey

Spergel

et al. 2020

Journal of School Health

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BACKGROUND: Approximately 8% of schoolchildren in the United States experience potentially life-threatening food allergies.They must diligently avoid allergenic foods and have prompt access to epinephrine to treat anaphylaxis. These prevention strategies must be sustained without interruption, posing a range of challenges at school. METHODS:We conducted semi-structured interviews with 178 participants about their experiences managing food allergies outside the home. Interviews were transcribed and analyzed using an iterative approach in NVivo 10. RESULTS:Participants reported highly varied school experiences across the ecological model. They described the need to be proactive and self-sufficient to manage food allergies. Whereas food allergy-related social exclusion was common, participants also described positive peer interactions, including intensive peer engagement and support. They perceived that formal school policies were limited in scope and inconsistently implemented. Prevention-oriented policies were more common in lower grades than in higher grades. CONCLUSIONS:Poorly defined and implemented policies disrupted students' social and educational experiences at school, families' relationships with school staff, and, ultimately, the safety and wellbeing of students with allergies. Given the high prevalence of food allergies among children, these findings demonstrate the need for multiple layers of support to facilitate safe, socially inclusive food allergy management at schools. F ood allergy prevalence is on the rise, and an estimated 8% of children ages 0-17 in the United States are affected. 1 Food-induced anaphylaxis, a severe, life-threatening allergic reaction, resulted in a 285% increase in pediatric (ages 5-17) emergency department visits between 2005 and 2014. 2 Food allergy management demands diligent avoidance of allergenic foods and uninterrupted access to life-saving epinephrine. Both strategies require sustained behavioral control, presenting particular challenges for adolescents. Approximately 18% of children with food allergies experience a reaction at school over

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Section: Discussionmentioning

confidence: 99%

Food Allergy Management at School

Dupuis

Kinsey

Spergel

et al. 2020

Journal of School Health

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“…Our results on school nurse reported administration in school buildings may add data to estimate cost‐effectiveness. In addition, with other emergency preparedness protocols in schools, such as those for AEDs and epinephrine pens, the lack of supply of a medication is not the only barrier to use (Hogue, Muniz, Herrem, Silvia, & White, ). Similar to AEDs and epinephrine pens, appropriate training, policies, support from key school stakeholders and, accessibility of the emergency medication are key to removing barriers.…”

Section: Discussionmentioning

confidence: 99%

School nurse reported supply and administration of naloxone in schools

McDonald

Pinto‐Martin

Compton

et al. 2020

Public Health Nursing

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Objective:To describe school nurse reported naloxone supply and administration in Pennsylvania, as well as nurse and school-level characteristics associated with naloxone availability.Methods: Cross-sectional, online survey with school nurses in Pennsylvania. Data were collected (3/14/18-6/5/18) on school nurse demographic and professional characteristics, school characteristics, naloxone supply and administration, and when not available, reasons for not having a naloxone supply.Results: A total of 362 school nurses met inclusion criteria, representing schools in 56 of the 67 Pennsylvania counties. Over half of the school nurses reported a naloxone supply in their school building (53.6%, n = 194). Additionally, 5.2% of those who had a naloxone supply reported that it had been administered in their school or at a school sponsored activity. The most common reasons for not having naloxone available included lack of support and the belief that naloxone was not needed in their school.Conclusion: Although many school nurses reported having a naloxone supply in their school, and a small percentage reported administration, particular barriers to access and use remain. K E Y W O R D Snaloxone, opioids, school health, school nurses

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“…201 Epinephrine (adrenaline) can be life-saving when administered as soon as possible once anaphylaxis is recognized, namely in community settings including schools, workplaces, and recreational facilities, although several barriers to access this treatment, namely in schools, were identified. 202 When indicated, clinicians should prescribe an epinephrine (adrenaline) auto-injector (EAI/AAI), teach how to use it by means of training devices, and review the procedure in every appointment. Patients should have a written action plan that explains how to recognize the symptoms and how to act in case of anaphylaxis.…”

Section: Radiofrequency Turbinoplastymentioning

confidence: 99%

Section: Devices Used For Treatmentmentioning

confidence: 99%

Medical devices in allergy practice

Popov

Passalacqua

González‐Díaz

et al. 2020

World Allergy Organization Journal

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Medical devices provide people with some health benefits in terms of diagnosis, prevention, treatment, and monitoring of disease processes. Different medical specialties use varieties of medical devices more or less specific for them. Allergology is an interdisciplinary field of medical science and teaches that allergic reactions are of systemic nature but can express themselves at the level of different organs across the life cycle of an individual. Subsequently, medical devices used in allergology could be regarded as: 1) general, servicing the integral diagnostic and management principles and features of allergology, and 2) organ specific, which are shared by organ specific disciplines like pulmonology, otorhinolaryngology, dermatology, and others. The present position paper of the World Allergy Organization (WAO) is meant to be the first integral document providing structured information on medical devices in allergology used in daily routine but also needed for sophisticated diagnostic purposes and modern disease management. It is supposed to contribute to the transformation of the health care system into integrated care pathways for interrelated comorbidities.

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Barriers to the Administration of Epinephrine in Schools

Abstract: Process-related barriers to the appropriate use of epinephrine go beyond access to medication. Widespread staff training and review of school policies are needed to ensure that anaphylaxis is appropriately managed in schools.

Cited by 28 publications

References 27 publications

Food Allergy Management at School

Food Allergy Management at School

School nurse reported supply and administration of naloxone in schools

Medical devices in allergy practice

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