Food Allergy Research

New Study: Training School Nurses Increases Availability of Epinephrine

A single food allergy education session for school nurses helps ensure better management of the disease and increased availability of epinephrine auto-injectors, according to a recent study published online Nov. 8 by the Journal of Allergy and Clinical Immunology: In Practice.


In 2011, nurses employed by the Houston Independent School District participated in a training session that focused on identifying and treating food allergy reactions, including hands-on practice with auto-injectors. To evaluate the effectiveness of this education initiative, the nurses took two surveys: the first in 2010, before they took the class, and the second in 2012. The surveys evaluated the number of students with food allergies, the number of allergic reactions and the availability of auto-injectors.

(It is important to note that Texas does not yet have a separate, specific stock epinephrine law and according to the study, students must have their own prescribed epinephrine auto-injector in order to receive treatment for anaphylaxis. Stock epinephrine is referenced in the state’s school food allergy guidelines; FARE is working to improve access to epinephrine in Texas by supporting legislative efforts to pass a stock epinephrine law.)

The study was designed to test the hypothesis that one training session would increase identification of children with food allergies, decrease allergic reactions, and increase the availability of auto-injectors. Importantly, 84 percent of the schools were low socioeconomic schools, where availability of epinephrine is lower.

After the nurses received training, both low- and non-low socioeconomic schools showed a significant increase in auto-injectors. In addition, from 2010 to 2012, allergic reactions decreased: 15 percent of children with food allergies experienced reactions in 2010, while there were no reactions in 2012. The number of students with prescribed auto-injectors also increased. Noting that the impact of the training continued without further education, the authors conclude that “this single educational session made a dramatic and sustainable impact on the availability of lifesaving epinephrine in a large urban school district,” providing “a model for a feasible, nationwide school food allergy education plan to enhance the safety of children with food allergies.”

Learn more about managing food allergies at school.

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