2012-02-22 / News

Lawmakers quick to act after death of Hopkins Elementary School student

New law eases restrictions on schools’ use of EpiPens
By Michael Buettner

Epinephrine, administered with an EpiPen, is an effective treatment for potentially fatal anaphylactic shock. 
Stock photo Epinephrine, administered with an EpiPen, is an effective treatment for potentially fatal anaphylactic shock. Stock photo The death of a Chesterfield County child from a severe allergic reaction last month has prompted the General Assembly to act with unusual speed to pass changes in state law that could help prevent the same thing from happening to another Virginia student.

Bills to make it easier for schools to treat students for the life-threatening allergic reaction known as anaphylactic shock were introduced in the House of Delegates on Jan. 11 by Del. Thomas A. Greason (R-Loudoun) and in the state Senate on Jan. 20 by Sen. A. Donald McEachin (D-Henrico).

Both bills were approved last week, unanimously by the Senate and on a 95-1 vote by the House of Delegates. On Friday, they were awaiting Gov. Bob McDonnell’s signature.

The legislation aims to address current law that prohibits school employees from administering epinephrine, often delivered using a device called an EpiPen, even if it could save the life of a child threatened by anaphylactic shock.

The bills follow the death Jan. 2 of 7-year-old Ammaria Johnson, who went into anaphylactic shock after eating a peanut given to her by a child on the playground at Hopkins Elementary School.

Johnson was given CPR by emergency medical workers, who also used a defibrillator on her, according to an investigation by Chesterfield County police. But the police report did not indicate that she was treated with an EpiPen, which might have saved her life.

Under the county’s current school board policy, which is based on existing state law, school employees can only use EpiPens when students have prescriptions for them and their parents have supplied schools with the devices.

The recently passed legislation will give school employees the ability to use EpiPens without meeting those conditions.

Boiled down, the changes will allow schools to keep a supply of EpiPens on hand and administer them to any child who appears to be suffering anaphylactic shock, even if the child has no prescription for epinephrine, without worrying about being sued for trying to help.

The new legislation makes changes in three sections of state law:

State law currently requires that all schools have employees who are trained in CPR. Also, if a school has students who have been diagnosed with diabetes, the current law requires that at least one employee be trained to administer insulin and glucagon. The new law requires that at least “two employees have been trained in the administration of auto-injectable epinephrine” at schools with at least 10 or more administrative employees and with one or more students who have been diagnosed with life-threatening allergies. For schools with fewer than 10 administrative staffers, only one person with such training is required.

The new law mandates that “local school boards shall adopt and implement policies for the possession and administration of epinephrine in every school, to be administered by a school nurse, an employee of the school board or a volunteer who is authorized and trained in the administration of epinephrine to any student believed to be having an anaphylactic reaction.”

In the state code chapter dealing with prescription drugs and who is allowed to administer them, the new law adds the provision: “Pursuant to an order or standing protocol issued by the prescriber … a school nurse, or any school board employee who is authorized and trained in the administration of epinephrine, may possess and administer epinephrine.”

The new law also adds an exemption from civil liability for anyone who is “a school nurse or an employee of a school board, authorized by a prescriber and trained in the administration of epinephrine … who provides, administers or assists in the administration of epinephrine to a student believed in good faith to be having an anaphylactic reaction.”

This year, there are 540 students attending Chesterfield County schools with documented food allergies, and all of them have prescriptions for epinephrine, according to a school system memo.

However, supporters of the changes in state law note that there may be additional children in Virginia schools who have undiagnosed allergies. In addition, some have suggested that low-income families may not be able to afford to provide EpiPens, as current law requires.

Different concerns were raised by a coalition of school administrators and health professionals, who lobbied the General Assembly to delay passage of the changes until next year. The group argued that education officials need more time to consider changes in policy. Coalition members also worried that the changes might discourage parents from providing schools with the details of their children’s medical conditions and needs.

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