Savanna Hoffman
The increasing prevalence of food allergies, particularly among teenagers and young adults, has made access to epinephrine a critical issue for colleges and universities. While universities are not required to provide epinephrine auto-injectors, some states have passed legislation allowing post-secondary institutions to stock undesignated epinephrine. This legislation may provide civil liability exemptions and outline training, maintenance, storage, and administration requirements. University policies regarding epinephrine auto-injectors, such as EpiPens, vary, and students with potentially life-threatening allergies should consult with their university health services to understand their specific policies and procedures.
| Characteristics | Values |
|---|---|
| Will a university give students an EpiPen? | Some states have passed college and university-specific legislation that allows, but does not require, post-secondary education institutions to stock undesignated epinephrine. |
| Which states have passed this legislation? | The laws differ by state. |
| What does the legislation include? | It may provide exemption from civil liability and outline specific requirements for training personnel, as well as how to maintain, store and administer the epinephrine. |
| What about primary and secondary schools? | Nearly all state laws specify that the school nurse and staff can administer epinephrine. |
| What about students who can self-administer? | Twenty-nine states indicate students can administer stock epinephrine themselves. |
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What You'll Learn
Students' rights to request a 504 Plan
While universities are not required to follow a 504 Plan in the same way elementary and secondary schools are, they are still required to comply with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 (ADA). These laws are major pieces of federal legislation designed to protect the civil rights of individuals with disabilities and prohibit discrimination against people with disabilities in programs or activities that receive federal funding.
Students with potentially life-threatening allergies have the right to request a 504 Plan to document how teachers and staff will address trigger avoidance and anaphylaxis treatment. A 504 Plan details the student's medical needs and the precautions that must be taken to help manage their severe allergies. It may also address the way snacks are served and stored, how often the student should wash their hands, how the classroom should be cleaned, and other issues.
To develop a 504 Plan, the school works in collaboration with the student and their parents or guardians. The 504 team at the school may include the principal, teachers, school nurse, guidance counsellor, and psychologist. They look at the student's grades, test scores, medical records, and teacher reports to decide if the student is eligible for a 504 Plan. If the student is eligible, the team works with the parents to decide on the necessary accommodations, which are listed in the 504 Plan. Accommodations can include sitting in a specific place or with a certain desk or chair in the classroom. It is important to note that most accommodations in 504 plans do not change what the student learns but rather remove barriers to learning.
If a school creates a 504 Plan that does not include the requested accommodations, the parents or guardians do not have to agree to it. They can write a letter to the school, requesting another evaluation meeting and reminding them of their right to be involved in creating the 504 Plan. If the school still refuses to cooperate, a complaint can be filed with the Federal Department of Education Office for Civil Rights or the state Board of Education.
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University liability protection
In the United States, the School Access to Emergency Epinephrine Act, signed into law by President Obama in 2013, encourages states to implement policies requiring schools to stock undesignated epinephrine auto-injectors for emergencies. This federal law provides additional preference for federal grants to states that develop such policies. As a result, nearly every state has passed a school epinephrine stocking law, with the exception of Hawaii. However, these laws primarily focus on schools, and universities are typically considered higher education institutions.
To address this, some states have passed college and university-specific legislation that allows, but does not require, post-secondary education institutions to stock undesignated epinephrine. These laws may provide exemption from civil liability, outlining specific requirements for training personnel, maintenance, storage, and administration of epinephrine. The laws differ by state, and it is important for universities to understand the specific regulations in their respective states.
To ensure liability protection, universities should develop comprehensive policies and procedures regarding epinephrine administration. This includes training designated staff to administer Epipens, establishing protocols for emergency response and medical care, and maintaining accurate records of epinephrine administration. Universities should also encourage students with allergies to self-carry their prescribed auto-injectors and provide necessary accommodations to manage their allergies.
In conclusion, while universities may not be legally required to stock undesignated epinephrine, developing policies and procedures to address allergic emergencies can help protect the health and safety of students while also mitigating potential liability risks. By understanding and adhering to state regulations, universities can create a safer environment for students with allergies.
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University epinephrine access
The increasing prevalence of food allergies, coupled with the fact that teenagers and young adults with food allergies are at the highest risk of fatal food-induced anaphylaxis, makes access to epinephrine a critical issue for colleges and universities. While universities are not required to provide epinephrine auto-injectors to students, some states have passed legislation that allows post-secondary education institutions to stock undesignated epinephrine. These laws differ by state and may provide exemption from civil liability, outline specific requirements for training personnel, and detail how to maintain, store, and administer the epinephrine.
In 2013, President Obama signed the School Access to Emergency Epinephrine Act into law, encouraging states to implement policies requiring schools to stock undesignated epinephrine auto-injectors for emergencies. This federal law has led to nearly every state—except Hawaii—passing a school epinephrine stocking law. However, there is still a need to update and strengthen existing laws to reflect medical advances and ensure schools are fully prepared to respond to anaphylaxis.
Universities can play a crucial role in addressing this issue by advocating for federal and state legislation, as well as regulatory actions that support access to epinephrine. They can also develop their own policies and procedures that align with training standards, emergency care plans, storage, and documentation. According to the National Institute of Allergy and Infectious Diseases guidelines, epinephrine is the only first-line therapy for anaphylaxis. Therefore, universities should consider keeping epinephrine auto-injectors readily accessible on campus for emergency treatment.
Additionally, universities should have a comprehensive management approach that includes planning and coordination of care. This involves ensuring that health staff, such as school nurses, are trained to administer epinephrine and address trigger avoidance and anaphylaxis treatment. In collaboration with university health staff, university principals can also recommend which non-medical staff should be trained to administer epinephrine based on individual student needs and circumstances. It is strongly recommended that teachers of students at risk for anaphylaxis be trained to administer epinephrine.
To summarise, while universities are not mandated to provide epinephrine auto-injectors, they play a vital role in advocating for policies and taking proactive measures to ensure access to this life-saving medication for students and staff experiencing severe allergic reactions. By doing so, universities can help create a safer environment for individuals with food allergies and potentially save lives.
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Epinephrine administration procedures
Epinephrine, also known as adrenaline, is a critical medication in managing various medical conditions due to its potent action on the sympathetic nervous system. It is the only first-line therapy for anaphylaxis and is widely used to treat severe allergic reactions. The following procedures outline the administration of epinephrine auto-injectors in educational institutions, specifically for students.
- Evaluation and Preparation: The first trained person to arrive at the scene should evaluate the student's condition. If two people respond, one should administer the EpiPen while the other calls EMS. If alone, administer the EpiPen first, then call EMS. The EpiPen should be administered by trained staff or school nurses for students who cannot self-administer.
- Dosing and Injection: The dosage depends on the student's grade, weight, and age. For students in second grade or below or weighing 33-66 lbs, administer 0.15 mg (Junior dose) into the outer thigh. For adults and students in third grade or above or weighing 66 lbs or more, administer 0.30 mg (Adult dose) into the outer thigh.
- Post-Injection Care: Keep the student lying down with lower extremities elevated. If vomiting occurs, roll them onto their side. If they have difficulty breathing, help them sit up. Stay with the student and reassure them.
- Documentation and Reporting: Record the name, date, time, dose, route of administration, location, name of the person administering, and manufacturer/lot number of the epinephrine. This is the responsibility of the school nurse or on-site health staff, and it should be kept in the student's health record.
- Emergency Response: After administering the EpiPen, immediately call 911 to activate EMS. The student should be promptly taken to the nearest emergency department for evaluation and monitoring. A second delayed reaction may occur, so parents/guardians should monitor the student according to healthcare provider recommendations.
These procedures aim to provide safe and effective epinephrine administration in schools, ensuring timely and appropriate care for students at risk of anaphylaxis.
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Epinephrine storage
Epinephrine is the first line of treatment for someone experiencing a severe allergic reaction or anaphylaxis. It is essential for those with food allergies to keep epinephrine auto-injectors readily available at all times.
Storage
Epinephrine should be stored at regular room temperature, between 68 and 77 degrees Fahrenheit (20°C to 25°C). It should not be exposed to extremes of temperature, or left in a car during hot summer days or cold winter nights, as this may degrade the medication. It should also not be kept in a refrigerator or freezer, or stored with ice packs.
Epinephrine should be protected from light and stored in a safe place with easy access. A medical carrying case with insulation can help to maintain a stable temperature.
It is important to check the medication for expiration dates and to visually inspect the solution for any particles or discoloration. If the solution is pink, brown, cloudy, or contains particles, it should be replaced.
Administration
In the event of an allergic reaction, the first trained person to arrive should evaluate the student and administer an EpiPen. If two people respond, one should administer the EpiPen while the other arranges for emergency medical services. If a staff member is alone, they should administer the EpiPen and then call for emergency services.
Epinephrine auto-injectors should be injected into the outer side of the thigh. For adults and students in third grade or above, or weighing 66 lbs or more, a dose of 0.30 mg should be administered. For students in second grade or below, or weighing between 33 and 66 lbs, a dose of 0.15 mg should be given.
After epinephrine is administered, the individual should be taken to the nearest hospital for evaluation and monitoring. A record of all EpiPen administrations should be kept, including the recipient's name, date, time, dose, location, name of the administrator, and manufacturer and lot number of the epinephrine.
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Frequently asked questions
An EpiPen is a device used to inject epinephrine, the only first-line therapy for anaphylaxis.
In the US, nearly all states specify that school nurses and staff can administer EpiPens. However, only a few states indicate that staff may volunteer to administer EpiPens. The laws differ by state, and some states have passed college and university-specific legislation that allows, but does not require, universities to stock undesignated epinephrine.
The individual should be promptly taken to the nearest emergency department for evaluation and monitoring. A record of all persons to whom epinephrine has been administered must be kept, and emergency medical services must be notified.
In 2013, President Obama signed the School Access to Emergency Epinephrine Act into law, encouraging states to implement policies requiring schools to stock undesignated epinephrine auto-injectors. As a result, nearly every state has passed a school epinephrine stocking law, except Hawaii.
