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Anaphylactic Events in Schools More Common in Classrooms than Cafeterias

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Anaphylactic Events in Schools More Common in Classrooms than Cafeterias

By Katherine Bortz
March 6th, 2017

ATLANTA — Among the anaphylactic events reported in United States schools, nearly half occurred in the classroom rather than the cafeteria or playground, according to survey data presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology.

However, since 55% of schools did not allow teachers to administer epinephrine and only half staffed a full-time nurse, students undergoing a severe allergic reaction in these locations may not be treated promptly.

“This research highlights an opportunity for schools to be better prepared in the event of anaphylaxis,” Susan Hogue, PharmD, MPH, from RTI Health Solutions, told Infectious Diseases in Children. “Having a broader range of staff members trained to recognize anaphylaxis and administer epinephrine would provide better coverage, since anaphylaxis events occur at various locations throughout schools.”

To determine how anaphylactic events are managed within individual schools, Hogue and colleagues conducted a survey of schools participating in the EPIPEN4SCHOOLS® program, which had provided stock EpiPen Auto-Injectors to more than 60,000 qualifying schools.

Schools that participated in the program were asked to complete the cross-sectional, web-based survey concerning the locations of events and the staff permitted to administer provided epinephrine injection auto-injectors during the 2014-2015 school year. Surveys responses were received from 12,181 schools.

According to survey findings, 2,191 anaphylactic events were reported, and the majority of events occurred in the classroom (46.6%), the cafeteria (19.9%) or the playground (9.7%).

Additionally, the researchers found varying levels of staff involvement in the administration of epinephrine were reported. While the overwhelming majority of schools (89.8%) allowed school nurse to administer epinephrine, 73.2% also allowed some teachers to administer epinephrine. Of these schools, 44.9% permitted all teachers to administer epinephrine, and 35.1% allowed students to self-administer.

When participating schools provided data about nurse availability, only 53.6% had a full time nurse available on-site and 32% had a part-time nurse.

“Less than half the schools allowed all teachers to administer epinephrine and nearly half did not have a full-time nurse available, indicating that students suffering an anaphylactic attack may not encounter a staff member permitted to administer epinephrine,” Hogue and colleagues wrote.

Dr. Susan Hogue


Dr. Susan Hogue, et al. Abstract 696. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 3-6, 2017; Atlanta.

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