Appropriate Storage and Administration of Epinephrine
- Parent Guidelines
- Become Informed and Educated
- Information About Your Child's Food Allergy & Medication
- Build a Team
- Help Reduce Food Allergens in the Classroom(s)
- Consider School Meals
- Address Transportation Issues
- Prepare for Field Trips and Extracurricular Activities
- Prevent and Stop Bullying
- Assist Your Child with Self-Management
- Appendix 1: Selected Resources
- Appendix 2: Facts About Food Allergy
Knowing a) where your child’s prescribed epinephrine is located, b) who has access to it, and c) who will administer the medication in the event of an emergency is critical to supporting your child’s health and well-being at school.
When determining the location of the epinephrine, consider the following:
- Depending on their age and maturity level, many children carry their epinephrine (in a waist pack or in a book bag). This practice is generally allowed by state law and/or local school board policy and is based on parental and physician consent. Even in the event that the child does carry his or her prescribed epinephrine, a responsible adult should always be available in case an emergency arises.
- Local school policy may require that prescribed epinephrine be kept under lock and key. If so, discuss who has access to epinephrine and how conveniently it can be accessed in an emergency or after normal school hours.
- Local policy may allow epinephrine to be kept in the classroom (in a container mounted to a wall, out of the reach of the other students, or in the teacher’s desk), or passed from teacher to teacher as your child changes locations during the school day.
Make sure that the epinephrine you provide the school has not expired, and is clearly labeled with your child’s name and classroom information.
Epinephrine is generally administered by the school nurse. However, because a school nurse may not be available during an allergic reaction, other school personnel (often called delegates) can be trained to administer the medication. This process of delegation is generally determined by local school board policy and by the judgment of the school nurse.[1] Training of delegates is done by a school nurse, a district nurse, or other licensed health care provider.
Whenever epinephrine is administered, the following procedures should be followed:
- Emergency medical services (i.e., 911) must be contacted immediately, and the responding emergency personnel must be authorized to carry and administer epinephrine. In many locations, only certain types of emergency personnel are allowed access to epinephrine. Check with your local ambulance provider(s) to learn about their policies.
- In the event that your child self-administers epinephrine, he or she must notify an adult staff member as quickly as possible, and the adult should call emergency medical services (i.e., 911) immediately. Children should never self-administer epinephrine when alone, although this circumstance might be beyond the child’s control.
- Your child should be transported to a hospital and observed for 4 hours. In some allergic reactions, the symptoms go away, only to return 2 to 3 hours later. This is called a biphasic reaction and may be more severe than the first-phase symptoms.
If your child has an allergic reaction at school, discuss the event with appropriate school personnel. Review how the reaction occurred and how it could have been prevented. In addition, note the successes and challenges that were evident in the response to the emergency.
[1] Delegation. Position Statement from the National Association of School Nurses. Available online at: http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatementsFullView/tabid/462/ArticleId/21/Delegation-Revised-2010.
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