RATIONALE: This study was designed to describe anaphylactic events and epinephrine auto-injector (EAI) use in US schools.
METHODS: This exploratory, cross-sectional, web-based survey of schools participating in the EPIPEN4SCHOOLS® program (Mylan Specialty L.P., Canonsburg, PA) captured details of reported occurrences of anaphylactic events and treatment(s) administered at each responding school during the 2013-2014 school year.
RESULTS: A total of 919 anaphylactic events were reported in 607 schools (11%, n=5683 responding schools). Of the 851 events with data on the use of EAIs, 75% (n=636) were treated with auto-injectors while on school property. Of the 636 events treated by EAI, 49% (n=310) were treated using the EpiPen4Schools’ program stock EpiPen® Auto-Injector, and 46% (n=289) were treated using the individual’s EpiPen Auto-Injector. Approximately 4% of EAIs used were not EpiPen Auto-Injectors. Fifty-four (9%) received a second epinephrine injection. Of the 204 individuals not treated with an EAI, 77% (n=157) received antihistamines, 13% (n=26) received another treatment, and 8% (n=17) received no treatment. Of the 850 events with data on hospital transport, 80% of individuals (n=677) were transported to the hospital.
CONCLUSIONS: Over 10% of schools participating in the EpiPen4Schools survey reported an anaphylactic event. Approximately 25% of anaphylactic events were not treated with epinephrine; of these, the majority were treated with antihistamines. Furthermore, 20% of those treated for an anaphylactic event did not receive follow-up emergency treatment. Considering the potential for biphasic reactions, close medical supervision is imperative after an anaphylactic attack. Thus, these data suggest the value of stocking EAIs and providing continuing education for school personnel and family members.
