McIntyre CL, Sheetz AH, Carroll CR, Young MC. Pediatrics. 2005;116:1134–1140
PURPOSE OF THE STUDY. To ascertain the incidence of anaphylaxis in schools, characterize the circumstances surrounding anaphylactic episodes, and evaluate practices that are used to manage students with life-threatening allergies.
STUDY POPULATION AND METHODS. School districts in Massachusetts (N = 109) that completed an epinephrine-administration form whenever epinephrine was injected at school. Data were obtained from September 2001 to August of 2003.
RESULTS. Forty-eight school districts noted a total of 159 administrations of epinephrine during the 2-year period of reporting. The individual was not known to have a life-threatening allergy in 24% of the cases. Thirty-one percent of the students who received epinephrine had allergy to multiple antigens, and 25% had allergy to tree nuts or peanuts only. Nineteen percent of the cases occurred outside the school building on a playground or when transporting them to or from school or on field trips. The registered school nurse in the health office administered the epinephrine in most cases. The average time from development of symptoms until epinephrine was delivered was 10 minutes. In 92% of the cases, the student involved was taken to a medical facility using the emergency medical system.
CONCLUSIONS. Anaphylactic reactions in schools, although not frequent, are not uncommon events. A systematic review of anaphylactic events that required epinephrine administration identified opportunities for improvement in the treatment of students with life-threatening allergies.
REVIEWER COMMENTS. The limitation of this study is that it was based on voluntary reporting. There are variations in reporting among regions in the state, but it is not possible to determine if the differences are attributable to reporting practices or actual difference in epinephrine administration. Because there were no unique identifiers for subjects in the study, there is no assurance that allergy events are not recurring repeatedly in the same student. In summary, a thorough program should be in place in the schools to evaluate, treat, and manage students with life-threatening anaphylaxis to foods.
- Copyright © 2007 by the American Academy of Pediatrics