By Kevin Dooms, M.D.
Imagine a child with a life-threatening food allergy. Now imagine that child having a severe reaction while at school.
If that student is fortunate enough to have an epinephrine autoinjector on school grounds, he or she may receive a dose to help reverse the reaction and potentially save a life.
But what about students with a food allergy who don’t have their injector with them? What about students who haven’t been diagnosed with an allergy, but experience their first life-threatening reaction while at school?
In such cases, it is currently illegal in our state’s schools for these children to receive epinephrine, even to save a life. The school’s only option is to call 9-1-1 and hope help arrives in time.
Fortunately, legislators in Olympia are considering a bill that would change this and save lives.
We know food allergies have been on the rise in recent years. Studies have shown that up to one in 13 U.S. children has a food allergy – nearly two students in every classroom. Currently, there is no approved treatment for a food allergy. Instead, we rely on an accurate food allergy diagnosis and avoiding foods that trigger symptoms.
Schools are already skilled at managing food allergies: food-allergic students are kept away from harmful foods and allergy “action plans” tell school staff what to do in the event of a severe reaction. As a result, only a handful of students with a food allergy will ever experience anaphylaxis, a severe and potentially life-threatening allergic reaction.
Unfortunately, it can be very difficult to know which children will have a severe reaction, even with state-of-the-art testing methods. Being prepared is key.
The best treatment for anaphylaxis is epinephrine, or adrenaline. This life-saving medicine is injected into a thigh muscle with an autoinjector device. Epinephrine is generally safe in children, even when given unnecessarily.
During anaphylaxis, it is extremely important to give epinephrine as quickly as possible. Minutes can mean the difference between life and death.
The safety of the treatment, combined with the significant risks of a severe allergic reaction, means it only makes sense to allow schools to keep a supply of epinephrine on hand. This unassigned or “stock” epinephrine could be used to treat students whose lives can be at risk.
Senate Bill 5104, currently before the Legislature, would allow licensed health care providers to prescribe a supply of stock epinephrine directly to schools. School nurses could then administer epinephrine to any student having a severe allergic reaction. The bill would apply to both public and private schools. The legislation is not a mandate — schools could choose whether to participate.
As a physician, one of my roles is to educate and advocate for my patients. I’m certain SB 5104 would increase student safety in our state’s schools. In fact, similar laws have already been enacted in other states.
For example, a student in Virginia was rescued from a life-threatening bee allergy reaction thanks to stock epinephrine at his school. His life was saved only months after Virginia passed a law similar to the one being considered in Olympia.
Now it’s our turn to act. SB 5104 gives schools more flexibility to treat students with potentially life-threatening allergies. Thousands of school children across Washington have severe allergies. Many don’t even know it yet.
This common-sense legislation would give schools one more option to protect our students. It is time to follow the lead of other states that have already had success with this legislation. Let your legislator know you support their work to increase student safety.
Kevin Dooms, M.D., a board-certified allergy and immunology specialist in Bellevue. He is a clinical assistant professor of pediatrics at the University of Washington, and a member of the Adverse Reactions to Foods Committee with the American Academy of Allergy Asthma and Immunology.
