By Bethany J. Royer
PIQUA —On Sept. 18, 2013, Cameron Espinosa, 12, of Corpus Christi, Texas, died after being bitten multiple times by fire ants at his middle school football game. He had no known allergies and no epinephrine (EpiPen) was available to combat anaphylaxis, a severe allergic reaction, to save his life.
“It’s the body’s reaction to a peanut, an insect sting, it can be latex,” explained Keri Scott, RN, BSN, CSN for Piqua city schools Nicklin Learning Center, High Street Primary and Wilder Intermediate, of the many potential allergens and subsequent reactions including — but not limited to — difficulty breathing and/or swallowing and a decrease in blood pressure after exposure. “It can be life threatening and fatal.”
Epinephrine or the EpiPen can combat these reactions, however, many schools only have the life-saving autoinjector on hand for those students who have been identified as having an allergen. Those, approximate, one in 25 school-aged children who are affected by food allergies alone, according to the American Academy of Pediatrics. Statistics that does not include those who may have reactions to medications and the aforementioned latex and insect bites, too. Or those 25 percent of students who may experience anaphylaxis but were not previously diagnosed with an allergen.
It is for those undiagnosed that concern has been voiced by not only the school nurse but a number of organizations on the safety of schoolchildren when a simple tool, an EpiPen, could save lives but is not readily on hand.
“You just don’t know,” said Scott on students like Espinosa who may not have a known allergy and fail to initially show a reaction to an eventual and potentially fatal allergen. Some taking a second, third, even fourth exposure to an insect sting, for example, before showing a reaction. This is the same for food allergies, as she briefly explained how her own son was exposed to peanuts multiple times before having an allergic reaction.
“This is why this legislation is so important,” said Scott on Ohio House Bill 296 currently under consideration by state leaders that would allow epinephrine to be stocked in schools regardless of whether or not a child has been identified as needing it.
The bill is backed by the National Association of School Nurses (NASN), American Academy of Asthma Allergy Immunology (AAAI), American Academy of Pediatrics (AAP) and the Food Allergy Anaphylaxis Network (FAAN). It aims to reduce the deaths of children such as Epsinosa and Ammaria Johnson, 7, of Virginia, who died Jan. 2, 2012, from untreated anaphylaxis. No EpiPen was available at her school.
School staff are well-trained to recognize, respond to, and treat potential life-threatening anaphylaxis, so students already identified with a life-threatening allergy have an EpiPen autoinjector available at the school with an emergency action plan in place. However, the hope with HB 296 is to equip schools with the needed tools, says Scott, that will save a life and avoid an unnecessary tragedy.
While schools would not be forced to stock EpiPens, if passed, HB 296 would allow non-patient autoinjectors to be stocked without a prescription from a doctor and allow those trained to administer the autoinjectors to any student suspected of anaphylaxis.
“It gives us the tools to respond appropriately,” said Scott who, under current restrictions, has no EpiPen available as no student has been identified as needing one on location so, “If a student on the playground is stung by a bee, I have no tools.”
Bethany J. Royer may be reached at 773-2721 or on Twitter @TheDailyCall