all three of Stacey Lavigne’s children have food allergies, but her 7-year-old son’s condition is severe. “He’s actually so severe he’s off the chart,” the Dudley mother said. “It posed some issues starting school.” Her son Will just started second grade, and his doctor prescribed extra EpiPens so he would always have access if the need arose. Will carries two EpiPens with him at all times, his teacher has one in a locked drawer and the school nurse also has one. Allergies of all sorts, especially food allergies, are on the rise among school-age children. As a result, school nurses are being asked to manage greater numbers of epinephrine auto-injectors, known by the brand name EpiPens. in addition to treating children with more specialized health needs, including children with diabetes and cancer, school nurses are responsible for keeping track of students with prescriptions for EpiPens, as well as other medications. “this is a huge, huge issue because there are so many kids with allergies,” said Dr. Beverly Nazarian, a pediatric primary care physician at Worcester-based UMass Memorial Medical Center and the school physician consultant for the Worcester public schools. “For school nurses, EpiPens is one of the hottest issues out there.” EpiPen and EpiPen Jr. auto-injectors, according to the manufacturer, Mylan Inc., are used for the injection of epinephrine, the first-line treatment for allergic emergencies (anaphylaxis). EpiPen auto-injectors are used to treat signs and symptoms of an allergic emergency, some of which include hives, redness of the skin, tightness in the throat, breathing problems and/or a decrease in blood pressure. Allergic emergencies can be caused by triggers such as food, stinging and biting insects, medicines, latex or even exercise. “you want to have one everywhere the child needs it,” Dr. Nazarian said. “It’s really important that the school knows if a child has allergies or has EpiPens.” When a child requires short-term or long-term medication during the school day, parents are required to contact the school nurse and provide a physician’s order, a parental consent form and the medication. At the start of the school year, nurses are busy collecting and updating students’ medical information. “Absolutely, there’s an increase in allergies, the most common are peanut and nut allergies,” said Ellen Capstick, nurse at Sullivan Middle School in Worcester. she said the school is also noticing a rise of environmental allergies the past few years. About 3 million American children are suffering from food allergies. The number has increased 18 percent since 1997, according to a recent study for the U.S. Centers for Disease Control and Prevention. Students in Worcester brought 364 EpiPens to schools last year, and those were the ones that health officials were aware of in a student population of approximately 24,000. “It’s old-school to think it’s Band-aids and ice packs,” Ms. Capstick said. two nurses at Sullivan Middle School were responsible for 78 EpiPens last school year. Parents send their child’s EpiPen in a clear plastic bag with the child’s name clearly marked. The EpiPens are stored in a large plastic bin in the nurses’ office. “It’s important that they’re not locked — and accessible,” she said. in addition, Ms. Capstick said schools stock an extra EpiPen and EpiPen Jr. in the event a child with unknown allergies has an allergic reaction. according to the state Department of Public Health, 175 administrations of epinephrine for the treatment of allergic reactions in schools were reported during the 2008-2009 school year. of those, in 38 cases, or 22 percent, the student was not known to have an allergic condition at the time of the anaphylactic event. in Fitchburg, Pamela Rivers, district nurse leader, reported an increase in allergies in children, and a corresponding increase in the number of EpiPens being brought to city schools. she said the increase in allergies might be partially because of increased awareness and testing in children. in the past couple of years, there was an average of 90 EpiPens for a student population of 5,000 in Fitchburg. Ms. Rivers said she has had to administer EpiPens twice, one to a child with a food allergy and one to a student allergic to an insect. If a child with an unknown allergy has his or her first allergic reaction in school, Ms. Rivers said, “The only person who can administer an EpiPen is the nurse.” in the Northboro-Southboro regional school district, each of the schools has a nurse, and there are two nurses at the high school, according to Superintendent Charles E. Gobron. The school district sends out a complete description of the policy on the dispensation of medications at the beginning of the school year. From January through July this year, approximately $224 million in single-shot epinephrine pens were sold, according to Danbury, Conn.-based IMS Health, a health care information company. Donna M. Hoey, nurse and coordinator of nursing services for Worcester public schools, said school nurses review EpiPen training at the beginning of every school year. “sometimes nurses have a problem getting an updated EpiPen, or even an EpiPen from some families,” Ms. Hoey said. “They’re expensive.” she said nurses also accompany students on field trips, or make sure another teacher or staff member is trained to administer an EpiPen. many students with known allergies carry their own EpiPens with proper permissions in place. “For the younger children,” Ms. Hoey said, “we try to have the EpiPen follow them through the day. We try to pass them to whatever (gym or recess) teacher is in charge.” If a child has an allergic reaction on a school bus, Ms. Hoey said drivers are instructed to safely pull over and call 911. That is the same procedure for other area school districts. Articles most Read Today
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