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Review
. 2022 Feb;92(2):209-222.
doi: 10.1111/josh.13119. Epub 2021 Nov 25.

A National Review of State Laws for Stock Epinephrine in Schools

Anna Volerman  1 , Claire Brindley  2 , Nancy Amerson  3 , Tiffanie Pressley  3 , Nikki Woolverton  3
Affiliations
Review

A National Review of State Laws for Stock Epinephrine in Schools

Anna Volerman et al. J Sch Health. 2022 Feb.

Abstract

Background: Anaphylaxis is a life-threatening allergic reaction with significant risk for children with allergies. Access to potentially life-saving medication is critical for these children. This review aims to describe state laws and policies guiding stock epinephrine in schools for allergic or anaphylactic events and detail recommendations for best practices.

Methods: This paper is a comprehensive review of the 50 states and the District of Columbia's (DC) laws and policies for stock epinephrine at schools for children in pre-kindergarten through 12th grade.

Results: All 50 states and DC allow undesignated epinephrine in schools to use for allergic or anaphylactic reactions. A key difference arises in whether states allow (N = 37) or mandate (N = 14) that schools stock epinephrine. States exhibit differences in the body responsible for developing stock epinephrine policy (N = 48), along with stakeholders responsible for developing procedures (N = 30) and implementing them (N = 19). Differences also exist in state epinephrine procurement, administration, training, and liability.

Conclusions: This review of stock epinephrine laws and policies highlights the significant variation in state legislation despite widespread adoption. Only one-quarter of states mandate that schools have stock epinephrine available for emergency use, underscoring need for a more unified approach with consistent guidelines, comprehensive training, and possible funding for implementation.

Keywords: allergic reaction; anaphylaxis; epinephrine; food allergy; legislation; school policy.

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Conflict of interest statement

Conflict of Interest Disclosure Statement:

All authors of this article declare they have no conflicts of interest relevant to this work. Dr. Volerman serves on the Executive Board of the Chicago Asthma Consortium (unpaid). She also receives funding from the Health Resources and Services Administration.

Figures

Figure 1.
Figure 1.
Storage conditions of stock epinephrine at school, as indicated in state laws (N=51)
Figure 2.
Figure 2.
Persons who can administer stock epinephrine at school, as indicated in state laws (N=51)
Figure 3.
Figure 3.
Training topics for individuals administering stock epinephrine in schools, as indicated by 39 states addressing training content
See this image and copyright information in PMC

Comment in

References

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