FeaturesDec/Jan 2014 Issue

All About Epinephrine

Social Dynamics and Awareness

Pistiner’s experience navigating life with his own food-allergic child opened his eyes to some of the difficulties involved in day-to-day living with food allergies. He remembers bringing his son to a drop-off party only two days after the boy’s first allergic reaction. He hadn’t thought about some of the practical aspects before showing up, such as talking to the party parent about food and training on when and how to use the auto-injector. So much to his son’s embarrassment, Pistiner stuck around for the entire party.

“I had all of this knowledge at my fingertips and I knew the evidence-based medicine about food allergies and anaphylaxis but I had absolutely no idea how socially complicated and emotionally challenging it was,” Pistiner says.

Parents have the responsibility to educate others about food allergies and the proper care for their children but the social dynamics can make it difficult, says Pistiner, who created the website allergyhome.org with John Lee, MD, to provide practical education about living with allergies.

For instance, family members might challenge the allergen-avoidance strategies parents have put in place to keep their child safe. In that case, sites like allergyhome.org can act as a third party, providing unbiased information from a credible source.

“Sometimes it’s tactically challenging and socially awkward but social pressure or relationship issues must never compormise safety,” Pistiner says. “Yes, we need to educate—and we need to do it effectively.”

Allergyhome.org includes a school site that provides free resources to augment the training school nurses give to school staff.

“This free tool provides basic education about food allergies, increasing awareness in schools,” Pistiner says.

School nurses play a key role in training staff and implementing standards for emergency care. They work with the schools and families to develop individual healthcare plans and emergency action plans for children with known allergies.

In states with stock epinephrine laws, school nurses must develop an emergency action plan to ensure staff members, if allowed by law, are properly trained to recognize symptoms and treat an anaphylactic reaction, says Duff of the National Association of School Nurses. NASN provides food-allergy programs such as “Get Trained,” which prepares nurses to train unlicensed school staff to administer epinephrine.

“School nurses must know and comply with laws in their states,” Duff says. “They need to develop policies and procedures to ensure that epinephrine is available, is stored properly and is easily accessible in an emergency.”

Next: Challenges Ahead

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