CHARLESTON, W.Va. -- A new state policy would put free EpiPens in all West Virginia schools and allow any student who suffers a severe allergic reaction -- regardless of whether they have a prescription -- to receive the emergency injection.The policy, proposed by the West Virginia Department of Education last week, removes restraints from the state's current medication administration policy and not only allows schools to stock epinephrine auto-injectors for the general student body, but also trains teachers to administer the drug.EpiPens -- the most common self-injectable form of epinephrine -- contain adrenaline and treat anaphylaxis: a life-threatening, body-wide allergic reaction.The pens can immediately reduce hives and swelling and open constricted airways long enough so a person can reach medical assistance.But under the current state policy, if a student were to have a severe allergic reaction while at school, whether that be because of peanuts or a bee sting, that student is not allowed to receive an EpiPen injection if he or she does not have a prior diagnosis and prescription.That means if a student has a reaction to an unknown allergy and there is no nurse around, all school administrators can do is call 911 and wait -- regardless of whether there are EpiPens in the school prescribed for other students."In rural West Virginia, this is huge because by the time we do get emergency services to respond, it could be too late," said Becky King, a registered nurse who oversees the state Department of Education's health programs. "It puts schools in a bad situation. We're just always taught not to use other people's medicine. What if we did use it, and right after that, something happens to the child who actually had the prescription?""This will provide us with medications that aren't assigned to anyone -- they're just for those who may have an anaphylactic reaction."The policy is up for public comment until Nov. 9, and will not be a statewide mandate, but will instead allow each county school district to choose if they want to participate in the EpiPen program.
Across the nation in recent months, there's been a push for universal access to EpiPens following tragic stories of student deaths caused by allergic reactions.Just last month, a middle school student in Texas died while playing football after an allergic reaction to fire ants.Thirty states now allow schools to keep undesignated epinephrine for emergencies, but only four states -- Virginia, Maryland, Nebraska and Nevada -- actually require it.West Virginia was the ninth state to push for the legislation, according to King."Many of the states that have passed the EpiPen law do it after a child has died, and that's their reaction," state Board of Education President Gayle Manchin said during a meeting last week. "The fact that West Virginia was proactive and did it before they had to lose a child is great. It's a safety factor."
If approved, West Virginia's policy would be effective no later than December, King said.
The new EpiPen4Schools program, sponsored by Mylan Laboratories Inc., allows every school to have up to four EpiPens at no cost.The policy also would allow teachers, secretaries and other aides to receive training from nurses about how to inject the EpiPen and identify symptoms of anaphylactic shock. Before, teachers could step in to administer the injections to diagnosed students, but had not been properly trained, King said.One in 13 children under the age of 18 has food allergies, and a significant portion of severe allergic reactions that occur at school are among students with no prior allergy diagnosis, according to Food Allergy Research & Education (FARE.)King said those numbers are only growing."Allergies have definitely increased over the years. ... Luckily, we've been blessed in the sense that we're taking a more proactive stance," she said. "Education is the key with any allergy. We don't want to create an environment that is allergen-free because we know that's not going to happen in the real world. ... So we want to create allergy awareness."While the policy is new for the state, it's something school nurses have been pushing for years, King said.
Nurses, like King, have simple advice: "Don't hesitate.""I think that there's hesitation ... but epinephrine is more of a benefit than anything. Give the EpiPen immediately because you just never know," she said. "In four minutes, you could have brain damage and airway obstruction ... and your body ends up closing down and eventually you die."Reach Mackenzie Mays at firstname.lastname@example.org or 304-348-4814.