title: Availability of the epinephrine autoinjector at school in children with peanut allergy.
abstract: BACKGROUND
  Peanut allergy accounts for most severe food-related allergic reactions, and accidental exposures are frequent. Delayed administration of epinephrine and the allergic individual's failure to personally carry epinephrine contribute to fatal outcomes.
  
  
  OBJECTIVE
  To describe epinephrine autoinjector availability at school and to determine factors that might affect autoinjector availability in children allergic to peanut.
  
  
  METHODS
  Two hundred seventy-one children with peanut allergy living in Quebec were queried about their autoinjector. Logistic regression models were used to select factors associated with device availability.
  
  
  RESULTS
  Four of 271 children diagnosed as having peanut allergy were not prescribed autoinjectors. Forty-eight percent of the children did not carry the autoinjector with them at school. In 78.0% of those, the autoinjector was located in the nurse's or another school office, which was staffed by a full-time nurse only in 18.5%. Of all the respondents, those administered epinephrine for a previous reaction (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.3-5.7), older children (OR, 1.1; 95% CI, 1.0-1.2), and those living only with their mother (OR, 3.4; 95% CI, 1.0-11.0) were more likely to carry the autoinjector with them at school. Of children 7 years or older, those who experienced a severe reaction were more likely to carry their autoinjector (OR, 3.3; 95% CI, 1.4-8.1).
  
  
  CONCLUSIONS
  Almost 50% of children allergic to peanut might experience a delay in anaphylaxis treatment due to limited access to their device. More education is required regarding the importance of a readily available autoinjector.
authors.affiliation: Division of Pediatric Allergy and Clinical Immunology, McGill University Health Center, Montreal, Quebec, Canada. daliamoshebs@gmail.com
authors.forename: Moshe
authors.initials: M
authors.lastname: Ben-Shoshan
authors.forename: Rhoda
authors.initials: R
authors.lastname: Kagan
authors.forename: Marie-Noël
authors.initials: MN
authors.lastname: Primeau
authors.forename: Reza
authors.initials: R
authors.lastname: Alizadehfar
authors.forename: Nina
authors.initials: N
authors.lastname: Verreault
authors.forename: Joyce W
authors.initials: JW
authors.lastname: Yu
authors.forename: Nathalie
authors.initials: N
authors.lastname: Nicolas
authors.forename: Lawrence
authors.initials: L
authors.lastname: Joseph
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Turnbull
authors.forename: Claire
authors.initials: C
authors.lastname: Dufresne
authors.forename: Yvan
authors.initials: Y
authors.lastname: St Pierre
authors.forename: Ann
authors.initials: A
authors.lastname: Clarke
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004837:Epinephrine / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000295:instrumentation; D008297:Male; D016017:Odds Ratio; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D021183:Peanut Hypersensitivity / Q000188:drug therapy*; D011792:Quebec; D020954:Single-Parent Family; D011795:Surveys and Questionnaires
chemical_list: D001993:Bronchodilator Agents; D004837:Epinephrine