Implementation of Stock Epinephrine in Chartered Versus Unchartered Public‐School Districts

Abstract

BACKGROUND:Access to unassigned epinephrine is critical for schools to treat anaphylaxis. Low socioeconomic status is associated with decreased access to epinephrine in the school setting. In and around New Orleans, physicians partner with schools to assist with stocking unassigned epinephrine autoinjectors (EAIs). New Orleans' decentralized public charter school district makes widespread adoption challenging. METHODS:Physicians partnered with New Orleans decentralized public charter schools, as well as neighboring centralized public school districts, to perform training on recognizing and treating anaphylaxis, assist with the adoption of school policy for stock epinephrine, and aid with obtaining stock EIAs free-of-cost through the EpiPen4Schools ® program. We used publicly available school enrollment data and our own calendar records to calculate how many children we covered with stock epinephrine per hour of physician or administrator time. RESULTS:For centralized school districts, we cover approximately 4000 children with stock epinephrine per hour of time. For the decentralized district of New Orleans, we estimate covering only 400 children with stock epinephrine per hour of time. CONCLUSION:Decentralized school districts reduce educational disparities, but require more time and energy to get EAIs in place than centralized school districts do.

Diagnosis and Management of Insect Allergy: Barriers and Facilitators in the United States

“…48 The use of stock epinephrine in schools can increase access to EAIs in resource-limited settings. 49 The availability of stock epinephrine should be promoted in schools and other public spaces. As with other causes of fatal anaphylaxis, most patients will not have a history of anaphylaxis to draw upon to predict the need for avoidance, auto-injectable epinephrine, or desensitization.…”

“… 48 The use of stock epinephrine in schools can increase access to EAIs in resource-limited settings. 49 …”

Availability of stock epinephrine in schools is needed to address health disparities in anaphylaxis

“…Ten years after this case, our team has trained staff, edited policies, and prescribed epinephrine to 55 of the 90 public schools in New Orleans. 1 …”