New law mandates public schools to obtain EpiPens

OSCEOLA COUNTY – Due to a new state law, area school staffers were trained last month on the administration of an epinephrine auto injector, commonly known as an EpiPen.

Mary Ann Frederick, school nurse at the Mecosta-Osceola Intermediate School District, helped lead the training of about 70 teachers, principals, secretaries and other school staff positions.

“At first, I was hesitant,” Frederick said. “Now, I think it’s a very good thing, because even if it saves one life, it’s worth it. The benefit outweighs the risk.”

House Bill 4353 was originally introduced by Rep. Lisa Lyons (R) on Feb. 28, 2013, to mandate that public schools must train at least two staffers in the administration of EpiPens. Two EpiPens must be on site at all times. The law does not apply to private schools.

An EpiPen is a syringe prefilled with epinephrine, used to treat anaphylactic reactions. Anaphylaxis is a potentially severe or life-threatening allergic reaction that occurs rapidly – within a couple minutes of exposure to an allergen. This reaction can be triggered by allergies to foods, biting or stinging insects, medication, latex and other causes.

The EpiPen has been the most prescribed epinephrine auto-injector for more than 25 years in the U.S.

Frederick is the only school nurse in the Mecosta-Osceola district. Dennis Peacock, principal at Evart High School, said Evart’s school secretaries do their best to perform their jobs while also caring for ill students.

“Times have gotten tight,” he said. “Funding is pretty thin. Schools look at places to save money, and nursing seems to be one of those areas. It’s really crazy that there are so many more expectations now in that realm of health.”

Administering an EpiPen may be overwhelming for school staffers who have no experience with allergic reactions or ill students, Frederick said.

“I think it’s a huge responsibility, especially for a child who has unknown allergies,” Frederick said. “You’re making that assessment, to say, ‘Yes, I do believe this is an allergic reaction.’”

Although not every person will experience the same reactions, common symptoms include hives, itching, and swelling of the lips, tongue and roof of the mouth. A victim’s airway may become blocked, resulting in difficulty breathing, chest pain, low blood pressure, dizziness and headaches.

Peacock, who was trained to administer EpiPens, said nurses taught trainees that some children will show no signs of an allergy for years and suddenly become allergic to a food, insect or other allergen.

“This law is not for the children who have already been identified with allergies and already carry an EpiPen,” she said. “It’s for the children who don’t know they have an allergy.”

If a child who shows anaphylactic symptoms is injected with an EpiPen, but the child is not actually enduring anaphylaxis shock, the child will be OK, Frederick said.

“Their heart might beat fast and they might get sweaty, but they won’t be hurt,” Frederick said.

The medication from the injection typically lasts between 15 and 20 minutes, giving more time for experienced medical professionals to arrive.

“If a child is having a reaction, the EpiPen buys you some time. You can give the shot and then call 911. The injection will keep the child safe until the ambulance arrives.”

When EMS arrives, the syringe should be given to paramedics to dispose of. The time of the injection will need to be logged.

Many children know of their severe allergies and are encouraged by doctors to carry an EpiPen at all times.

“A lot of times, kids who are allergic know they are allergic,” Peacock said. “They know what to do. It’s not difficult to be trained. If I had to, I definitely could use the EpiPen.”

Frederick said she has most commonly seen people with prescriptions for EpiPens due to an allergy of bee stings.

Peacock said he has been working in schools for 32 years in four different school districts and has never dealt with a student who experienced a severe anaphylactic reaction.

Frederick said she has never had to treat a student with an EpiPen while working at the MOISD.

“Avoiding known allergens is the best way to help prevent anaphylaxis,” Frederick said.

School boards may ask any local physician or authorized prescriber to issue an EpiPen prescription, and must obtain funding from private sources. Upon the use of an EpiPen, a replacement should be ordered the day of the event.

Designated school staff must check the expiration dates of their EpiPens at least twice per year. Expired stock is to be disposed of in biohazard containers or at needle disposal facilities.

In 2013, the deaths of two students in Virginia and Illinois prompted President Obama to sign a bill which gave incentives to schools to obtain emergency medication for students who have life-threatening allergic reactions.