Implementation of Stock Epinephrine in Chartered Versus Unchartered Public-School Districts
Kathryn B Neupert1,2, Margaret P Huntwork1, Chioma Udemgba1,3
1School of Medicine, Tulane University, 1430 Tulane Avenue SL-37, New Orleans, LA, 70112, USA.
Background:
Access to unassigned epinephrine is critical for schools to treat anaphylaxis. Low socioeconomic status is associated with decreased access to epinephrine in the school setting. In and around New Orleans, physicians partner with schools to assist with stocking unassigned epinephrine autoinjectors (EAIs). New Orleans' decentralized public charter school district makes widespread adoption challenging.
Methods:
Physicians partnered with New Orleans decentralized public charter schools, as well as neighboring centralized public school districts, to perform training on recognizing and treating anaphylaxis, assist with the adoption of school policy for stock epinephrine, and aid with obtaining stock EIAs free-of-cost through the EpiPen4Schools® program. We used publicly available school enrollment data and our own calendar records to calculate how many children we covered with stock epinephrine per hour of physician or administrator time.
Results:
For centralized school districts, we cover approximately 4000 children with stock epinephrine per hour of time. For the decentralized district of New Orleans, we estimate covering only 400 children with stock epinephrine per hour of time.
Conclusion:
Decentralized school districts reduce educational disparities, but require more time and energy to get EAIs in place than centralized school districts do.
Related Concept Videos
Adrenergic Agonists: Therapeutic Uses
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
Adrenergic Agonists: Mixed-Action Agents
Ephedrine and pseudoephedrine lack a catecholamine group, making them less susceptible to degradation by metabolic enzymes. They have increased oral bioavailability and lipophilicity, resulting in a longer duration of action. Their response is reduced by...
Cardiopulmonary Resuscitation III: AED Use
Cardiopulmonary Resuscitation IV: Pharmacological Management
Adrenergic Agonists: Direct-Acting Agents
These agents can be classified...
Allergic Reactions


