Nevada schools stock shots for allergic attacks

LAS VEGAS (AP) — It looks like the sort of oversized pencil a first-grader might use in learning how to print, albeit one that’s more colorful, a lot thicker and goofier in appearance.

Like those pencils that first-graders might use, an EpiPen is a handy thing to have around during the school day. But, unlike those pencils, an EpiPen can save a student’s life.

EpiPen is a brand name for autoinjectable epinephrine used in treating anaphylaxis, a sudden, severe, systemic and potentially fatal allergic reaction to a food, bug bite or sting, or other allergen. When symptoms of anaphylaxis appear, the jab of an EpiPen into the outer thigh delivers a premeasured dose of epinephrine into the body, which helps to alleviate symptoms until help can arrive.

EpiPens are simple to use, easy to store and pose few, if any, side effects to healthy kids. And now, thanks to a Nevada law that took effect July 1, EpiPens can be found in every public school in the state.

Just in case.

Lynn Row, the Clark County School District’s director of health services, told the Las Vegas Review-Journal (http://bit.ly/1g5LBfa) many students in the district who have known allergies already keep at their schools EpiPens that have been prescribed to them by their doctors. Now, under the new law, public schools also must keep on hand so-called stock EpiPens, which are prescribed to the school for use on students or adults who don’t have a history of severe allergic reactions but who may suffer an anaphylactic reaction during the school day.

Medical professionals see overwhelming potential life-saving benefit to the new mandate.

“I think it’s great,” said Dianne Cyrkiel, a certified pediatric nurse practitioner and lecturer at the University of Nevada, Las Vegas School of Nursing, given that anaphylaxis is “a life-threatening condition that can occur, and children can die.”

Dr. David Park, chairman of the primary care department at Touro University of Nevada College of Osteopathic Medicine, said anaphylaxis is a severe allergic reaction that affects the entire body.

Symptoms can occur rapidly. Among them: hives or skin rash; swelling or tingling of the mouth, tongue or ears; nausea and vomiting; blueness or pale coloring; a drop in blood pressure causing light-headedness or fainting. More dangerously, anaphylaxis can cause rapid swelling of the victim’s airway that can result in hoarseness, wheezing, breathing difficulty and death, sometimes within minutes.

An estimated 2 percent of people will experience anaphylaxis during their lifetimes, Park said, while Row noted that an estimated 25 percent of first-time anaphylactic reactions in kids occur during the school day.

Cyrkiel said most of the allergic reactions she sees in kids are related to foods, with peanuts and shellfish representing the bulk of those.

The problem, however, is that kids may not know they are allergic to something until they suffer their first reaction. If a child should experience a severe allergic reaction at school, the EpiPen can provide help until paramedics arrive.

Epinephrine administered during an anaphylactic episode must be injected. So, the EpiPen is “an autoinjector, kind of like a small thick pen that’s very simple to use,” Park said. “Take the cap off, stick it in, and a little shot goes into the thigh, and (the epinephrine) goes into the bloodstream and helps to stop swelling.'”

The needle is long enough to administer it through clothing.

“It’s a pretty slick little device,” Cyrkiel said. “It’s not like you’re dealing with needles or a syringe. It’s very easy: You put it right up on the skin, push it and it injects.”

Park said that even if the potential signs of anaphylaxis aren’t slam-dunk obvious to a parent or teacher, there are no significant side effects associated to using an EpiPen on an otherwise healthy child.

“It’s always best to err on the side of caution,” he said. “So if a child has any type of swelling in the mouth or has difficulty swallowing or difficulty breathing, give them the EpiPen.”

Row said the Clark County School District has been preparing for the mandate for more than a year.

“We had started a lot of training the year prior to the bill being implemented,” she said. “We kind of knew it was coming.”

Already this year, stock EpiPens at district schools have been used more than a half-dozen times, Row said. In most of those cases, allergic reactions were due to previously unknown allergies. In one, she said, a student had a peanut allergy but didn’t know that what he was eating contained peanuts and didn’t have his medication with him.

“The outcome has been good for all of them,” Row added.

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Information from: Las Vegas Review-Journal, http://www.lvrj.com

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