Stock albuterol inhalers and epinephrine auto-injectors are critical for schools. They can ensure timely emergency treatment for students and staff having severe asthma or allergy symptoms. How can schools and parents improve access to these medications at school?

Allergy & Asthma Network spoke with board-certified allergist Andrea Pappalardo, MD, on this topic. She discusses why state advocacy laws are important for increased access to stock albuterol and stock epinephrine.

Q: How can schools improve access to stock emergency medications for asthma and severe allergies?

Andrea Pappalardo, MD: Asthma and allergies are common conditions. However, access to extra epinephrine auto-injectors and asthma inhalers at school is an issue for many children and school staff. And in about a third of the cases, allergic reactions and/or asthma symptoms can present for the first time when a child is at school. That means you wouldn’t even know about it yet!

These facts are compounded with the unfortunate persistent health disparities in asthma and food allergy, where prevalence is higher and outcomes are worse in certain populations.

What we do know is that in the event of an emergency, or with any symptoms of food allergy or asthma, access to quick-relief inhalers and epinephrine auto-injectors is standard of care. Schools should be no exception!

A simple policy solution exists in all 50 states allowing for stock or undesignated epinephrine auto-injectors in schools. For asthma, 17 states allow for stock albuterol inhaler medications. This means that an extra “epi” or an extra inhaler is there for children or staff when someone may need it – even if they never were able to get to the doctor, get the prescription, get the medication, or didn’t even know they had asthma or allergies in the first place.

Epinephrine and quick-relief inhaler access saves lives and it is simple and smart.

In Illinois, we work with government officials, school nurses, advocacy groups, clinicians, and administrators to figure out how best to implement these laws in a practical way. In speaking with stakeholders from Illinois, other states, and nationally, we are figuring out what works and what doesn’t to get medications in schools for when a child may need them.

Access is critical. If a child has an allergic reaction, and there is no epinephrine, or has asthma symptoms and doesn’t have the inhaler they need to calm the symptoms and stop the reaction, this puts a child needlessly at risk. And that is unacceptable.

So what can you do? Advocate. Educate. Be aware that your child’s or your patient’s school can have these medications for the “Just in case.”

And, in fact, when stock inhaler laws were implemented in Arizona, most children with symptoms were able to go back to class, where kids need to be to get the education that they deserve.

Andrea Pappalardo, MD, FACAAI, practices in the Division of Pediatric Allergy-Immunology at University of Illinois in Chicago Hospital. She specializes in the care of adults and children with asthma, eczema and environmental, food and drug allergies.

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