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Emergency Epinephrine Needed in Chicago Public Schools

Many who used the emergency medication had no known history of allergic reaction

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October 20, 2014 | by Erin Spain

CHICAGO --- During the 2012-2013 school year, 38 Chicago Public School (CPS) students and staff were given emergency medication for potentially life-threatening allergic reactions. This finding is detailed in a new Northwestern Medicine® report in partnership with CPS. 

Following national and local legislation, CPS was the first large, urban school district in the nation to develop and implement an initiative to supply all public and charter schools in Chicago with epinephrine auto-injectors (EAIs) -- medical devices used to treat acute allergic reactions.

The impact during the initiative’s first year, the 2012-2013 school year, underscores the need for stocking undesignated epinephrine in schools across the country, according to the report.

“Currently, there is no treatment or cure for food allergy,” said Ruchi Gupta, M.D., Northwestern Medicine® pediatrician and the corresponding author of the report. “Timely administration of an EAI is a child’s first and primary line of defense in the event of anaphylaxis resulting from allergic reaction.”

Gupta is an associate professor of pediatrics at Northwestern University Feinberg School of Medicine and a physician at Ann & Robert H. Lurie Children’s Hospital of Chicago.

Anaphylaxis, a severe, potentially life-threatening allergic reaction, can occur within seconds or minutes of exposure to an allergen.

Since last year, 41 states passed policies encouraging schools to stock undesignated epinephrine auto-injectors in their schools for a possible anaphylactic emergency.

The report will be published Oct. 20 in the American Journal of Preventive Medicine, and Gupta will present the findings at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting, to be held Nov. 6 to 10 in Atlanta.

Other highlights from the report:

  • The majority of those receiving an EAI were students (92 percent)
  • More than half didn’t know they had an allergy (55 percent)
  • Twenty-one of the EAIs given were to treat food induced allergic reactions
  • Among food-induced reactions, peanut was the most common followed by fin fish
  • The trigger of more than a third of all reactions are unknown
  • Elementary schools had the most cases of EAIs administered
  • School nurses administered the medication the majority of the time

“At CPS, it is our goal to prevent any health-related barriers to learning, which is why we have worked with all of our schools to address this critical issue by equipping them with tools and guidance that they need to keep students safe and healthy,” said Stephanie A. Whyte, M.D., study coauthor and chief health officer of CPS.

The district-issued medication is available at all CPS schools and is to be used when a person is having a severe allergic reaction and his/her own epinephrine is unavailable or if he/she has no history of allergic reactions.

“Because of the amount of time kids spend in school, and given the fact that many first-time allergic reactions occur on school grounds, it is imperative for school districts across the country to provide access to emergency epinephrine to students who may not otherwise have access to the potentially life-saving medication,” Gupta said.

Most district-issued EAIs were administered on the city’s north-northwest side where the rate of food allergy has been found to be higher, the report found. However, a large number of these EAIs were used on the far south side, too -- an area of the city with a low reported rate of food allergy. This highlights the need for access to district-issued EAIs citywide, as children on the far south side may not have access to food allergy diagnosis and could experience their first allergic reaction at school. 

“This is definitely a national issue in schools around the country,” Gupta said. “We think the situation in Chicago schools is representative of schools everywhere. Most states now have policies in place for stocking epinephrine in schools. This is an essential step to keep kids with food allergies safe.”

Victoria Rivkina served as the other Northwestern investigator, and other CPS project team members include Lilliana DeSantiago-Cardenas and Blair Harvey-Gintoft.

Topics: Research