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Park JS, Kim JK, Kwon JW. Anaphylaxis-related interventional demand and the response status of pediatric and youth educational institutions in Gangwon-do Province, South Korea: A school nurse and childcare teacher survey. ALLERGY ASTHMA & RESPIRATORY DISEASE 2022. [DOI: 10.4168/aard.2022.10.1.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jin-Sung Park
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ja Kyoung Kim
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jae-Woo Kwon
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
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McCaughey RA, McCarthy AM, Maughan E, Hein M, Perkhounkova Y, Kelly MW. Emergency Medication Access and Administration in Schools: A Focus on Epinephrine, Albuterol Inhalers, and Glucagon. J Sch Nurs 2020; 38:326-335. [DOI: 10.1177/1059840520934185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Access to emergency medications is a growing concern, particularly regarding the availability, safety, and use of these medications in schools. The purpose of this article is to report results not previously published from a national survey, specifically regarding the emergency use of epinephrine, albuterol inhalers, and glucagon. A nonexperimental, cross-sectional design was utilized for this descriptive study. An online survey was distributed to school nurses in 2015, and data from 6,298 school nurse respondents are presented in the analysis. Findings related to stock and student-specific emergency medication use and storage, epinephrine usage data, and delegation of emergency medication administration to unlicensed assistive personnel are presented in this article. Further development of policies and procedures regarding emergency medication administration in schools is needed. School nurses are a valuable resource for obtaining knowledge in this area and keeping students safe at school.
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Affiliation(s)
- Rebecca A. McCaughey
- College of Pharmacy, University of Iowa, IA, USA
- College of Public Health, University of Iowa, IA, USA
| | | | - Erin Maughan
- Department of Research, National Association of School Nurses, Silver Spring, MD, USA
| | - Maria Hein
- College of Nursing, University of Iowa, IA, USA
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Canon N, Gharfeh M, Guffey D, Anvari S, Davis CM. Role of Food Allergy Education: Measuring Teacher Knowledge, Attitudes, and Beliefs. ALLERGY & RHINOLOGY 2019; 10:2152656719856324. [PMID: 31258953 PMCID: PMC6587383 DOI: 10.1177/2152656719856324] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction Almost 6 million children suffer from food allergies with roughly 2 affected per classroom. Deficiencies in knowledge and discrepancies in attitudes within school staff when addressing food allergies are associated with barriers to care. In this study, school teacher knowledge, beliefs, and attitudes were measured before and after a food allergy educational session. Methods Three hundred seventy-five personnel of similar age, socioeconomic status, ethnicity, and educational level completed the Chicago Food Allergy Research survey before and after a 1-hour educational session in 6 private schools in Houston randomly assigned into an intervention (n = 4) and control group (n = 2). Responses were measured using frequencies and percentages. The group score differences and survey question comparisons were evaluated with a linear mixed-effects model. Results Posttest, the intervention group had knowledge scores 19.58% points higher than control (95% confidence interval = 16.62–22.53; P < .001) with no differences pretest. Odds of agreeing that injectable epinephrine is important was higher in the intervention schools posteducation. Within the intervention group, personnel were more likely to agree to injectable epinephrine use for children posteducation. Conclusion A 1-hour educational session improved knowledge and attitudes in personnel in the intervention schools. Given the growing prevalence of food allergy, the emphasis on food allergy education is crucial to allow for familiarization of the condition, early recognition of anaphylaxis, and promotion of injectable epinephrine use.
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Affiliation(s)
- Nicole Canon
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Maya Gharfeh
- Department of Pediatrics, Section of Immunology, Allergy and Retrovirology, Baylor College of Medicine, Houston, Texas
| | - Danielle Guffey
- Dan L. Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
| | - Sara Anvari
- Department of Pediatrics, Section of Immunology, Allergy and Retrovirology, Baylor College of Medicine, Houston, Texas
| | - Carla M Davis
- Department of Pediatrics, Section of Immunology, Allergy and Retrovirology, Baylor College of Medicine, Houston, Texas
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Vale S, Netting MJ, Ford LS, Tyquin B, McWilliam V, Campbell DE. Anaphylaxis management in Australian schools: Review of guidelines and adrenaline autoinjector use. J Paediatr Child Health 2019; 55:143-151. [PMID: 30523652 DOI: 10.1111/jpc.14307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/21/2018] [Accepted: 10/23/2018] [Indexed: 12/15/2022]
Abstract
Food allergy and anaphylaxis is increasing in Australian children, and anaphylaxis is relatively common in Australian schools. This review aims to provide an overview of current policies and practices for anaphylaxis management in Australian schools, including approaches to risk mitigation and anaphylaxis training. We reviewed literature related to anaphylaxis training in the school setting published between 2010 and 2018. Current anaphylaxis policies/guidelines were obtained from Australian education and health departments, and reports of suspected anaphylaxis and adrenaline autoinjector (AAI) use for 2016-2017 were obtained from education departments where available. Our review of policies/guidelines across Australian jurisdictions indicates inconsistent approaches to anaphylaxis management training. Almost half of Australian school anaphylaxis events required a general-use AAI, administered to students not identified as at risk of anaphylaxis. Development of clear, evidence-based, consistent guidelines related to anaphylaxis management and training in the school setting is imperative to minimise risk.
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Affiliation(s)
- Sandra Vale
- National Allergy Strategy, Sydney, New South Wales, Australia.,Australasian Society of Clinical Immunology and Allergy, Sydney, New South Wales, Australia
| | - Merryn J Netting
- Australasian Society of Clinical Immunology and Allergy, Sydney, New South Wales, Australia.,Healthy Mothers Babies and Children's Theme, South Australian Health Medical Research Institute, Adelaide, South Australia, Australia.,Discipline of Paediatrics, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.,Nutrition Department, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Lara S Ford
- Australasian Society of Clinical Immunology and Allergy, Sydney, New South Wales, Australia.,Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Briony Tyquin
- Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Vicki McWilliam
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Dianne E Campbell
- Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
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Tarr Cooke A, Meize-Grochowski R. Epinephrine Auto-Injectors for Anaphylaxis Treatment in the School Setting: A Discussion Paper. SAGE Open Nurs 2019; 5:2377960819845246. [PMID: 33415240 PMCID: PMC7774401 DOI: 10.1177/2377960819845246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 03/04/2019] [Accepted: 03/23/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction:Anaphylaxis is a serious, life-threatening systemic allergic reaction that may occur in individuals not previously diagnosed with an allergy. Emergency first-line treatment of choice for acute anaphylaxis is intramuscular administration of epinephrine via an auto-injector. In the school setting, students with known allergies typically keep or carry an epinephrine auto-injector (EAI). For students who do not have a known allergy or for those whose personal EAIs are unavailable, an anaphylactic event could have serious adverse outcomes if an EAI is not available via an undesignated stock supply in the school. Methods:We searched the published literature from 2000 through 2018 in CINAHL, MEDLINE, and PubMed using the following search terms: anaphylaxis, school setting, epinephrine auto-injector, and food allergies. Throughout this article, undesignated stock EAIs, stock EAIs, EAI stock, and open-order EAIs are used interchangeably. Conclusion:Anaphylaxis is increasing worldwide as the incidence of food allergies increases. Although stock EAIs for students in schools can have important benefits, the availability of EAIs in the school setting is limited. Barriers to undesignated stock EAIs include the lengthy administrative process for developing school policies and protocols; gaps in nurses' self-perceived knowledge versus objective knowledge on the topic of anaphylaxis; limited resources in many school districts; and complex role demands, lack of confidence in trained staff, or insufficient school nurse staffing. It is important that epinephrine be readily available in schools. Barriers to facilitating stock EAIs include those that can be addressed directly by nurses and those that may require policy changes. Nurses, particularly those working in school settings or pediatrics, could take the lead in discussions about the benefits of stock EAIs in schools, advocating for policy changes as warranted. Fully informed nurses can be better prepared to serve as advocates in ensuring that EAIs are available in school settings.
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Affiliation(s)
- Abigail Tarr Cooke
- Department of Nursing, San Juan College, Farmington, NM, USA
- College of Nursing, University of New Mexico, Albuquerque, NM, USA
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Wang Y, Allen KJ, Suaini NHA, Peters RL, Ponsonby AL, Koplin JJ. Asian children living in Australia have a different profile of allergy and anaphylaxis than Australian-born children: A State-wide survey. Clin Exp Allergy 2018; 48:1317-1324. [PMID: 30025179 DOI: 10.1111/cea.13235] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/31/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Asian children born in Australia have higher rates of eczema and nut allergy than non-Asian children. However, it is not known whether this country of birth differential exists for other allergies or anaphylaxis risk. OBJECTIVE We investigated the influence of maternal and child's country of birth on the prevalence of parent-reported eczema, asthma, food allergy and being diagnosed by a doctor as being "at risk of anaphylaxis." METHODS We assessed the relationship between mother and child country of birth and allergies using the 2010 School Entrant Health Questionnaire, completed for 57 005 5-year old children (85.8% response rate) in Victoria, Australia. Analyses were conducted using logistic regression with results presented as odds ratios (OR) with 95% confidence intervals (CIs). RESULTS Children born in Australia to Asian-born mothers were more likely to have parent-reported food allergy (OR 2.33, 95%CI 1.96-2.77) and eczema (OR 2.04, 95%CI 1.73-2.41), but not more likely to have asthma (OR 0.87, 95% CI 0.74-1.02) than non-Asian children. By contrast, children born in Asia who subsequently migrated to Australia had a lower risk of food allergy (OR 0.33, 95%CI 0.20-0.55), eczema (OR 0.37, 95%CI 0.24-0.57) and asthma (OR 0.29, 95% CI 0.21-0.40). Patterns of anaphylaxis risk differed depending on the trigger. Compared with Australian-born non-Asian children, Australian-born Asian children were more likely to be diagnosed as being at risk of both food-induced and non-food-induced anaphylaxis. For children born in Asia, risk was lower for anaphylaxis to milk, peanut and tree nuts compared to non-Asian children, but higher for soy, wheat and non-food triggers. CONCLUSIONS AND CLINICAL RELEVANCE Patterns of allergy/anaphylaxis risk and their triggers differed according to both ethnicity and country of birth, suggesting a gene-environment factor is in play. The difference in patterns for asthma compared with other atopic diseases is surprising and warrants further exploration.
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Affiliation(s)
- Yichao Wang
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Katrina J Allen
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Noor H A Suaini
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Rachel L Peters
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer J Koplin
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,The School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
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Bellanti JA, Settipane RA. The atopic disorders and atopy … "strange diseases" now better defined! Allergy Asthma Proc 2017; 38:241-242. [PMID: 28668105 DOI: 10.2500/aap.2017.38.4074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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