Ohio House of Representatives voted Nov. 20 to allow schools to administer epinephrine during emergencies.
Ohio House Bill 296, co-sponsored by Reps. Mike Duffey, R-OH, and Terry Johnson, R-OH, passed unanimously and is awaiting passage from the Ohio Senate. The bill will permit public schools, residential camps and child day camps to acquire and maintain a supply of epinephrine auto-injectors, most commonly known as Epipens, without a license and administer them to any student, staff member or visitor experiencing signs of anaphylaxis, a severe, life-threatening allergic reaction.
“House Bill 296, in my opinion, is good public policy, and it’s overdue,” Johnson said during the House of Representatives session.
Current Ohio law only permits those students with a prescription for epinephrine, also known as adrenaline, to possess and administer Epipens during school hours. The current legislation does not take into consideration those students without prescriptions or those with no prior history of allergy problems.
Food Allergy Statistics
Source: Food Allergy Research & Education
Researchers estimate that up to 15 million Americans have food allergies. Food allergies affect one in every 13 children in the U.S. Food allergies among children increased approximately 50 percent between 1997 and 2011. Every three minutes a food allergy reaction sends someone to the emergency room, resulting in more than 200,000 ER visits per year. Eight foods account for 90 percent of all allergy reactions: milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. A food allergy can begin at any age; however, teenagers and young adults face the highest risk. People with food allergies are more likely to have asthma or eczema.
However, the pending bill allows any properly trained school nurse or staff member to administer the drug, even to those without a prescription.
Twenty-five percent of the reported cases of anaphylaxis at schools occurred in children with no previous diagnosis of food allergies, according to the Centers for Disease Control and Prevention.
“It’s about those unknown allergies that are out there and those first time experiences that somebody has,” Duffey said. If an anaphylaxis reaction goes untreated, it could lead to unconsciousness or even death. Common symptoms include hives or redness of the skin, tightness of the throat, nausea or fainting.
Schools will not be required to adopt the rules established by this legislation, Johnson said, but those that do will be required to develop a protocol that will dictate how they store and administer the epinephrine. This will include where and how the drug is stored, replaced and disposed of, who can use the epinephrine and on whom, proper training procedures and clarifications that 911 is to immediately be called after administering an injection.
“There’s really no downside,” Duffey said in a phone interview. “It’s a naturally occurring hormone. If somebody doesn’t need it, and they get it, it’s just going to make them jittery,” adding that for those who do require the drug, “it can save their lives and buy them the time they need to get down to the hospital to be treated properly.”
Ohio’s bill passed one week after President Barack Obama signed The School Access to Emergency Epinephrine Act into law. The federal legislation, introduced by Reps. Phil Roe, R-TN, and Steny Hoyer, D-MD, provides federal funding incentives to states that establish laws allowing schools to administer epinephrine without prescriptions during emergency situations.
The pending Ohio bill permits drug manufacturers to donate epinephrine auto-injectors to public schools and also allows schools to accept financial donations to purchase the auto-injectors.
“This is a way that parents will be able to save money, and the school districts will be able to save money,” Duffey said.
Duffey credits the drug to saving the life of his daughter, who had an anaphylactic reaction in April after eating peanut butter, and within 10 minutes of his daughter receiving an epinephrine injection, she was better.
“This is not the cure,” Duffey said of the epinephrine drug. “But this is the thing that buys you time, and it keeps it from getting much worse and it can save lives.”
Even with an epinephrine injection, medical professionals recommend seeking immediate attention at a hospital because there is a chance of a secondary reaction.
While the new Ohio bill is meant to save lives, Todd Poole, principal of Franklin Elementary School in Kent, said he is unsure about administering epinephrine to a student experiencing a first time allergic reaction.
“We’re making a judgment and saying that kid has an allergy and needs an Epipen; I’m not a medical professional, so that makes me kind of nervous,” Poole said. “If the kid has never had an allergic reaction, who am I to say this is one?”
Franklin Elementary currently has five students with known allergies severe enough to carry Epipens; however, in the six years Poole has worked at the school, he said no staff member has ever administered the drug to a student.
As a precaution to avoid allergic reactions, Poole said the staff takes common food allergies into consideration with the school menu. The elementary school no longer serves peanut butter, he said, but instead, has replaced it with SunButter, which is made from sunflower seeds.
Kent City Schools subcontract their health services out to Akron Children’s Hospital, Poole said. A certified nurse oversees all the schools and, within each school, a medical assistant is employed for daily school needs.
When determining whether Franklin Elementary would adopt the new regulations of Ohio’s epinephrine legislation if passed, Poole said he would “follow the lead of [Akron] Children’s Hospital to see what our policy is going to be, and how are we going to determine if a kid needs an Epipen or not.”
“We hope that for people who have unknown allergies, this is permissive legislation and allows schools to do what (they) think is going to be the best thing for them,” Johnson said.
Contact Amanda Crumm at [email protected]