By Marcia Frellick
A bill signed into law in New Jersey in February helps school nurses with issues surrounding epinephrine injectors for students in anaphylaxis, a life-threatening allergic reaction that can kill within minutes.
Under the law signed by Gov. Chris Christie, starting in September, epinephrine pens, or EpiPens, must be stocked at all New Jersey schools, public and private. Epinephrine is the only treatment for anaphylaxis and is available only by prescription. The law also extends legal protections to licensed providers who prescribe those stock pens.
Before the law, some schools had the stock pens; others had only the pens prescribed to individual students with diagnosed allergies. This law expands access for students, especially those with undiagnosed allergies, and was conceived in response to a growing percentage of children with food allergies nationwide.
That percentage rose 18% from 1997 to 2007. Now, food allergies affect 4% to 6% of all students, according to the CDC.
Gina Emge, MSN, PhD, RN, legislative co-chairwoman for the New Jersey State School Nurses Association, applauds the new legislation.
She works as a school nurse at Lenape High School in Medford, N.J. She said 74 of the nearly 2,000 students in her school have been diagnosed with a life-threatening allergy and the potential for anaphylaxis. Her school already had stock epinephrine prescribed by a physician, but she said not all New Jersey schools have it and not all schools even have a full-time school nurse.
The second part of the law allows people other than school nurses — such as a teacher on a field trip, an athletic trainer or a parent — to get training on administering epinephrine. With training by a licensed provider, others can administer epinephrine, even if a student has not been diagnosed or has not filled out the paperwork for a known allergy, but is suspected to be having an anaphylactic reaction.
“This is a big, big deal,” Emge said.
Nurses and those they train no longer have to worry that administering the drug in an emergency situation without a prescription could put their jobs or their licenses in jeopardy.
New Jersey State Assemblywoman Nancy Munoz, (R-21), MSN, RN, co-sponsored that legislation. She also co-sponsored previous related legislation signed into law in July 2014 for use on college campuses.
Known as the Higher Education Epinephrine Emergency Treatment Act, the legislation allows colleges and universities to develop a policy for administering emergency epinephrine to a member of their campus community to treat an anaphylactic attack.
That law provides legal immunity for a licensed campus medical professional, a trained designee, and a prescribing physician for good faith acts in administering the epinephrine.
Munoz said the most important feature of both laws is that they allow greater access to treatment in an emergency.
“Say you’re doing environmental science and a professor takes the kids into the woods, and a kid gets stung by a bee,” and may or may not know if the student is highly allergic, Munoz said. With this law, the professor could be trained to administer epinephrine before the trip, provide quick access on site and have legal protections. It also eliminates the need for a medical provider on all excursions off campus.
“At the K-12 level, without this law, the school nurse would have to go on every field trip or you’d have to hire a substitute nurse to go on the field trip,” Munoz said.
With passage of this legislation, New Jersey joins a growing number of states with school epinephrine laws in place or in process. At least 40 states, according to the National Conference of State Legislatures, authorize schools of varying types to keep or administer epinephrine to students.
Marcia Frellick is a freelance writer.