EpiPens, and Why Schools Should Have and Use Them

A child who has severe allergies should never be far from an EpiPen. School personnel and all caregivers should be trained to use them.
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Last week, a seven year old girl, in Richmond, VA died. She had an anaphylactic reaction to something she ate, likely a peanut product. Many details have not been reported, but here is the information I have gathered from what I've read. She had known food allergies to nuts, eggs and shellfish. Another child gave her something with one of these products in it. She had a severe allergic reaction. At 2:30pm EMS was called. She was pronounced dead at the hospital a short time later.

Facts Important to Understanding What Happened

1. Anaphylaxis is a severe allergic reaction that causes massive amounts of fluid to leak from the vessels into the surrounding tissue. The airways swell, the blood pressure drops and without intervention, the victim can die. Anaphylaxis usually results from a food allergy, an insect sting, a medication allergy or a latex allergy.

2. Most allergic reactions DO NOT result in a life-threatening reaction. There are different types of reactions -- an allergist can help discern what type a patient has.

3. About 6% of school aged children have food allergies, a number that, for unclear reasons, has been climbing in recent years. About 1,500 people die each year in the U.S. from an anaphylactic reaction.

4. An EpiPen is an injection that comes pre-dosed with epinephrine. In the case of a severe allergic reaction, epinephrine will constrict the vessels preventing further release of fluid, it will relax the airways allowing a patient to pass air into his lungs and it will increase the heart rate. It can save a life. There are only two doses -- EpiPen Jr. and EpiPen. Children get the Junior form and adults receive the regular dose. They come in packs of two, and they are incredibly simple to use.

5. If a dose of epinephrine is given to a healthy person, they will experience an accelerated heart beat, an increase in blood pressure and nausea. If epinephrine is given to a person with cardiovascular disease who is not in anaphylaxis, there can be serious cardiac consequences.

Before I continue, give me a minute to climb on my soap box. Ah, yes, much better. The death of this little girl, from what I have read, (that is my disclaimer because I wasn't there) could have been avoided. A child who has severe allergies should never be far from an EpiPen. School personnel and all caregivers should be trained to use them. Every child should have her own in the school and there should be extras in case of an emergency. School officials in Richmond said they cannot give medication to a child unless they have an order from a physician and a consent from a parent. Normally, I would agree this is responsible. However, all bets are off when a little girl is dying.

In my kids' school, there are about 500 kids, 30 have severe food allergies. In addition to the Epipens in the school labelled with the names of these kids, there are a few extras on-hand. The teachers and staff all know how to use one, and they bring one on field trips.

I cannot stop thinking about the adults who were trying to help this little girl. I pray there was no Epipen in the building. If there was, they will have to live with that and my heart breaks for them. Would you make sure a life-preserver belonged to a drowning child before tossing it to her? Still, if there was a dose of epinephrine in the vicinity, I can't place all the blame on the adults in that school. I blame you. I blame me. I blame society. We live in a world where the fear of litigation paralyzes us to the point of watching a child die. Shame on us.