Availability of the epinephrine autoinjector at school in children with peanut allergy.
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.
Ben-Shoshan
Moshe
M
Division of Pediatric Allergy and Clinical Immunology, McGill University Health Center, Montreal, Quebec, Canada. daliamoshebs@gmail.com
Kagan
Rhoda
R
Primeau
Marie-Noël
MN
Alizadehfar
Reza
R
Verreault
Nina
N
Yu
Joyce W
JW
Nicolas
Nathalie
N
Joseph
Lawrence
L
Turnbull
Elizabeth
E
Dufresne
Claire
C
St Pierre
Yvan
Y
Clarke
Ann
A
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
D001993:Bronchodilator Agents; D004837:Epinephrine