Greg E. Sharon, MD
I am on the Medical Advisory Board of West Chicago District 33. I have been the sole physician in the past but currently we have two or three primary care practices represented. We interact with the administration of the district in conjunction with the school nurses. We meet to discuss the health of the students and policy and procedures that impact the students at our schools. We have representatives from the DuPage County health department, Access DuPage, WeGo a local non-profit, a local dentist, Nutritionist, and a local optometrist. We have found ways to encourage healthy eating, parenting classes, exercise for students and parents, access local care for illness due to dental, eye, mental health, or physical ailment.
We recognized 5 years ago the need to educate staff on allergic emergencies. I set up a lecture series with the elementary schools to discuss what an allergic reaction is and how to use Epinephrine appropriately. Originally we worked with Twin-Jet who supplied samples. Then I wrote and supplied each school RN with Epi written in their names to hold for an emergency. Then we finally got the go-ahead to have an extra Epi for the school itself. This led to the problem of who is buying the Epi and who is taking the liability of writing the Rx? Myself and another doctor had decided to pay for the pens ourselves in the past and we did so again. I had done this already for my district but the whole DuPage School District now needed this and I felt uncomfortable as I didn’t know the other districts nor the nurses. Ms. Madigan, Illinois helped remove the liability for this process. The Epi-Pen manufacturer has agreed to supply each school with 4 pens. Two for adults and two for children.
The current challenge we are facing is due to the wording of the law. We can only have “school” RN’s administer the Epi. We have 3 school nurses for 5 schools. We do have other RN’s in the schools because of students who have to have a nurse for inclusion but they are not certified “school” nurses and therefore cannot hold nor administer the Epi-Pen.
Our current law of Illinois:
Under Public Act 97-0361 schools may maintain a supply of emergency epinephrine autoinjectors (EpiPens) for students who have forgotten their EpiPen at home or who do not have a known food allergy. A school nurse may administer an EpiPen to any student who he or she, in good faith, professionally believes is having an anaphylactic reaction and who does not have an Emergency Action Plan in place.
Access to Epinephrine in Schools
This Act permits physicians to issue a standing protocol and to prescribe EpiPens to a school district or non-public school to be used, as necessary, by a school nurse. Without this emergency supply, dialing 911 is the only option school personnel have if a student forgets their EpiPen and has an anaphylactic reaction or has a first-time reaction. Any delay in administering epinephrine can be fatal.
The supply of emergency epinephrine allowed under this Act is not intended to replace epinephrine prescribed to students with known allergies. Physicians should still prescribe epinephrine as appropriate and encourage parents whose children are suffering from a severe allergy to put in place an Emergency Action Plan, an Individual Health Care Plan, or a Section 504 Plan with their child’s school.