Allergies are the cause of great concern in many schools across the United States. As we continue to designate nut-free zones in cafeterias, and ban latex balloons from school grounds, a question remains: what happens if a severe allergic reaction occurs? In the most severe of cases where a person’s airway is closing, antihistamines like Benadryl won’t do the trick. In that case, epinephrine is the life saving drug that needs to be administered immediately. An EpiPen is an epinephrine auto-injector, available in most schools, that makes it simple and relatively harmless to inject epinephrine. One of the major problems, however, is that many times the emergency action plans of nurses conflict with set guidelines, leading to ineffective and under-treatment of sever allergic reactions (Wahl et al. 2015, 97). To fix this critical problem, nurses must be trained to use EpiPens, so that they may respond effectively and without delay or confusion. This would allow to keep our children safe from fatal allergic reactions while on school grounds, and ease some of our concern.
It is the responsibility of school nurses to respond appropriately when a child suffers an allergic reaction from an unknown allergen. Unfortunately, conflicting policies between health care providers and the school district may cause confusion and therefore increase the child’s risk of anaphylaxis. Increasing the use of epinephrine as a treatment in schools has the potential to decrease that risk, and ensure the children’s safety while in school.
(Wahl et al. 2015, 97)
Allergies present a common problem in many schools that can potentially have severe implications. For this reason, many schools deem it necessary to have emergency plans in place to care for those with known allergies; this responsibility commonly falls on school nurses. However, recent studies have shown that emergency response plans laid out by the school are not always followed. This can be attributed to one of several factors: “a lack of prescribed medication, calling parents or health care providers first, or because the reaction was to an unknown allergen.” (Wahl et al. 2015, 97) This presents a major threat to the safety of children in schools, to which training is the most viable solution. Educating school nurses on the causes and treatments of common allergic reactions would benefit students who are prone to allergic reactions, and the emergency officials who must promptly and properly respond to them.
Recent studies confirm the importance of school nurses, faculty, and staff properly knowing how to respond to incidences of anaphylactic shock. When dealing with younger students especially, a reaction to a previously unknown allergen may occur at any time. However, school nurses have to reconcile health care providers’ specific emergency action plan for their patients with the school standards and the “American Academy of Asthma, Allergy, and Immunology guidelines.” The differences between the two guidelines can create confusion and lead to an inappropriate treatment for many students (Wahl et al. 2015,97).
When a child in school has an allergic reaction to something he or she was exposed to for the first time, it is important that the adults around that child know how to react. In these cases the child may not have prescribed medication and the parents may be unavailable, therefore it is important that proper medical emergency plans are in place. Furthermore, all faculty and staff should be prepared to enact these emergency plans because there is no telling when these emergencies will occur. In order to ensure their readiness for emergencies the staff should be learn how to use an EpiPen through hands on training administered by the school nurse. In order for the nurse to be able to provide this kind of demonstration and training they must have the proper resources and the time. (Wahl et. al, 2017, 97)
Studies have found that those who work with children should be trained by a nurse on how to react in case of an allergic reaction. This can lead to “increased knowledge about food allergies” and allow in the prevention and quick action upon them (Wahl et al. 2015,97). The study found that often times measures were in place to react to food allergies however treatment was delayed for a variety of reasons. As such, nurses should have the time to train all professionals working with children on how to respond.
School nurses are responsible for children’s health and safety. Children who are allergic to epinephrine should receive the correct treatment. However, school nurses have to contemplate over both the medical instructions provided by the children’s health care providers and the rules and guidelines provided by school district and the American Academy of Asthma, Allergy and Immunology. While the nurses waver over the two, treatment for children are often delayed, leading to severe harms like anaphylaxis and “severe reactions with epinephrine” (Wahl et al. 2015, 97). It would help for the school nurses to be familiar with the possible treatments, including the use of EpiPens.
Wahl, Ann, Hilary Stephens, Mark Ruffo, and Amanda L. Jones. 2015. “The Evaluation of a Food Allergy and Epinephrine Autoinjector Training Program for Personnel Who Care for Children in Schools and Community Settings.” Journal of School Nursing 31, no. 2: 91-98. doi: 10.1177/1059840514526889.
School nurses across the country have to reconcile health care providers’ specific emergency action plan for their patients with the school standards and the “American Academy of Asthma, Allergy, and Immunology guidelines.” The differences between the two can create confusion and risk in nurses not using the appropriate treatment for its students. School nurses have the special position of being able to work with both health care providers and parents of students in determining a treatment option (Wahl et al. 2015, 97).
School nurses teaching staff that work with children how to properly use an Epipen would solve many of the problems that children with severe allergies are faced with in that environment. If people who work with children aren’t trained to recognize an allergic reaction or are unaware how to treat it, there will be precious time wasted to find a treatment that isn’t immediate and could therefore put a child’s life at risk. Emergency plans such as calling the parents of kids that have documented food allergies could help the child after a certain amount of time, however that time might have a stronger affect on the reaction. In many other cases, children have allergic reaction to unknown allergens in which case, calling a parent would not be effective. School nurses should be given the resources to train those that work with children how to immediately respond to a reaction using an Epipen as well as back up emergency plans. (Wahl et al. 2015,97)
A major problem that school nurses encounter is doctors advising young patients with the wrong emergency medical treatment that do not comply with their “current school district and the American Academy of Asthma, Allergy and Immunology guidelines.” This lack of immediate and proper treatment poses dangers for the patient, perhaps even causing anaphylaxis. As a result, school nurses are unable to do their job efficiently and face complications that can be easily avoided if doctors treated the patients correctly the first time. (Wahl et al. 2015, 97).