In the allergy world, my son has what’s known as the Allergy Trifecta – asthma, eczema and food allergies. He has a life-threatening allergy to peanuts and tree nuts, which was diagnosed at the age of two. Being diagnosed with the trifecta means that his chance of having a life-threatening reaction to a food to which he is allergic is vastly increased. He’s had a few accidental allergen exposures and I’ve had to epi pen him once – an experience that neither of us will ever forget.
My son never goes anywhere without his EpiPen®, and we have multiple sets at school, in my purse, and his sports bag. He’s trained in self-administration, is hyper-vigilant with label reading, knows more about cross-contamination and allergic markers than most adults I know – and yet, I still worry for his safety.
What if his reaction comes on so fast that he can’t self-administer? What if the EpiPen® fails, as more than a few have been known to do? What if there is no one around to help him?
Yesterday, President Obama signed legislation that will directly affect my son. H.R. 2094, the School Access to Emergency Epinephrine Act, was passed with bipartisan support to help protect students with food allergies, especially in a school setting. At the same time, Obama shared that his own daughter, Malia, has been diagnosed with a peanut allergy.
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Peanut and tree nut allergies are most likely to cause a fatal allergic reaction, so people with nut allergies make up the majority of the EpiPen® -holding population. The Asthma and Allergy Foundation of America reports that about 200 people die every year from food allergies.
Why is the signing of this legislation a big deal? After all, my son carries his own life saving medication, and he knows what to do. Shouldn’t that be enough for me?
Epinephrine auto-injectors (EpiPen®) are the single most important medication to treat a severe allergic reaction. They are designed to allow a person without medical training to easily inject someone having a serious allergic reaction with the drug epinephrine, which should halt the reaction and could save the person’s life. They are designed to halt anaphylaxis, which is "defined as a life-threatening allergic reaction that is rapid in onset and may cause death, either by restricting airways, or through a significant drop on blood pressure."
Anaphylaxis involves two or more body systems – skin, cardiovascular, gastrointestinal and respiratory. If someone is experiencing an allergic reaction, you would remove the safety cap, hold the device against the thigh and push the plunger to release the spring-loaded hypodermic. EpiPen® come as a set of two, because the reality is that one may fail or a second dose may be needed. Use of an EpiPen® means that the medication is injected intramuscularly, and will be available to the body in less than two minutes, as opposed to a subcutaneous administration, which can take between 5-120 minutes – and that’s much too long.
Every minute counts with an allergic reaction.
But what does this have to do with the new legislation? Conceivably, those who have food allergies should have their own medication on hand at all times, right? Well, what if he forgot his medication at home, or left it in the classroom? What if he’s in Spanish class and his seatmate is eating nuts, and his EpiPen is in homeroom? (True story; this happened to us this week!) What if both EpiPens failed?
Additionally, there are a number of fatal food reactions that are first time food reactions, or happen to children with no previous food allergy diagnosis. This means that those individuals, most of whom are under the age of 18, won’t have an EpiPen® available. The new legislation means that schools have the ability to have life saving medication on hand for those individuals, and will provide for extended training for the staff in order that allergic reactions can be quickly recognized and life saving treatment provided.
The bill isn’t designed to be used in place of individuals self-carrying their prescribed medications – it is designed to be used as a safe guard against undiagnosed allergies. This new law provides incentives to schools to set up plans to have EpiPens on hand and to train staff members in the use of them. It gives funding preferences for asthma treatment grants to states where schools keep emergency supplies of epinephrine, allows school employees with training to administer it and develop a plan to make sure trained staffers are available during all school hours. Additionally, the makers of the EpiPen® , BioRidge Pharma, have created an EpiPen4Schools™ Program, designed to help provide all schools with up to four EpiPen® auto injectors at no cost, and additional medication at a reduced rate.
This legislation is a tremendous victory for those who are afflicted with food allergies, those who care for them and helps to protect the schools and keep students safe, and I am very grateful to President Obama for his support.
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