Epinephrine Auto-Injectors for Anaphylaxis Treatment in the School Setting: A Discussion Paper

Area of Science:

• Allergy and Immunology
• Public Health
• Pediatrics

Background:

• Anaphylaxis, a severe systemic allergic reaction, is increasing globally, often linked to rising food allergies.
• Emergency treatment relies on epinephrine auto-injectors (EAIs), vital for immediate intervention.
• While students with known allergies may carry personal EAIs, those without or with unavailable devices face risks if stock EAIs are absent in schools.

Purpose of the Study:

• To review the literature on anaphylaxis and epinephrine auto-injector availability in schools.
• To identify barriers to implementing undesignated stock EAIs in educational settings.
• To highlight the role of school nurses in advocating for improved EAI access.

Main Methods:

• A systematic literature search was conducted in CINAHL, MEDLINE, and PubMed.
• The search covered the period from 2000 to 2018.
• Keywords included "anaphylaxis," "school setting," "epinephrine auto-injector," and "food allergies."

Main Results:

• The availability of stock EAIs in schools is limited despite their potential benefits.
• Significant barriers include complex policy development, knowledge gaps among staff, resource limitations, and staffing issues.
• Nurses' perceived knowledge of anaphylaxis may not align with objective understanding.

Conclusions:

• Epinephrine availability in schools is critical due to increasing anaphylaxis rates.
• Barriers to stock EAIs require both direct nursing interventions and broader policy changes.
• School nurses are pivotal in advocating for policy changes and ensuring EAI availability.