St. Mary’s schools prepare for severe allergic reactions

September 26, 2012

St. Mary’s County public schools will begin to stock emergency medicine this month to help calm reactions students might haver to peanut butter, bee stings and other allergens.

Anaphylaxis, a severe allergic reaction that often results in hives, rashes or swelling of the throat or tongue, requires immediate medical attention, said Trish Wince, supervisor of health services for the school system. It can be fatal if not treated.

Epinephrine is used to treat anaphylaxis; the most common prescribed auto-injectable used to administer the drug is sold under the name EpiPen.

At a Sept. 12 school board meeting, Wince demonstrated how the medicine is administered by pressing a syringe-type device into a person’s thigh.

More than half of Maryland school systems already stock the devices, she said. The device will be available in all St. Mary’s public schools by the end of the month to comply with a new state law requiring school officials to administer the medicine to any student having an anaphylactic reaction, Wince said.

The most common items in schools that cause anaphylaxis are peanuts and other nuts, Wince said. Bee and other insect stings also occasionally cause extreme reactions, as can shellfish.

In the last school year, 238 St. Mary’s students were known to be at risk of anaphylaxis. Of those, 191 had EpiPens supplied to the school from parents, Wince said. The rest were known to have an allergy that would cause anaphylaxis shock, but had no direct access to an epinephrine autoinjector, she said.

The medical devices now stored at every school would be available to help those students and others who might have an unknown allergic reaction. Nurses will train any school staff member who has direct oversight of a student with a known risk of anaphylaxis.

Although the condition is rare, anyone could have an anaphylaxis allergy, Wince said. Food-induced anaphylaxis data showed that 25 percent of anaphylaxis reactions in schools occur among students without a previous food allergy diagnosis, according to the Centers for Disease Control and Prevention.

Nurses have administered about one epinephrine treatment each year in St. Mary’s public schools, Wince said.

Wince praised the county’s volunteer emergency medical technicians but said that in some cases, it could take them 20 to 30 minutes to respond to a school, especially if emergencies were occurring elsewhere.

“That’s too long for somebody having an anaphylaxis reaction,” she said.

School board Vice Chairman Marilyn Crosby asked how long it could take before a nurse or other staff member could reach a student in need of epinephrine.

“Most nurses are like me, and when you’re called for an emergency you don’t walk, you run,” Wince said, adding it could take five minutes to get from one end of a high school to another, but in most cases the nurse would be just a minute or two away.

Wince said there generally is no harm caused by giving epinephrine, except in the rare situation in which a person is allergic to the drug. She said parents should notify schools of any such circumstance.

Cathy Allen, a school board member and registered nurse, said certain adverse reactions have been shown in people with some health conditions.

Wince said parents should tell school personnel about those, too.

The Maryland legislature this year called for epinephrine to be available in schools.

“My frustration was the legislation was not clear, saying ‘if available,’” Allen said.

Maryland State Department of Education officials have said the law means all schools should have the emergency medication stocked.

Allen said she sees the value of requiring epinephrine autoinjectors to be stocked in schools, similar to having automated external defibrillators in each school — a requirement put in place a few years ago.

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