title: EpiPen4Schools pilot survey: Occurrence of anaphylaxis, triggers, and epinephrine administration in a U.S. school setting.
abstract: BACKGROUND
  Although epinephrine is the treatment of choice for anaphylaxis, it remains underused.
  
  
  OBJECTIVE
  This study was designed to describe anaphylactic events and epinephrine autoinjector (EAI) use in U.S. schools enrolled in the EpiPen4Schools program.
  
  
  METHODS
  This exploratory, cross-sectional, Web-based survey of 6019 schools that participated in the EpiPen4Schools program assessed anaphylactic events and EAI use at responding schools during the 2013-2014 school year.
  
  
  RESULTS
  A total of 919 anaphylactic events were reported in 607 schools. Of the 852 anaphylactic events with data on those who experienced an event, most 88.8% (n = 757) occurred in students, and 21.9% of events (n = 187) occurred in individuals with no known allergies. Of the 851 events with data on EAI use, 74.7% (n = 636) were treated with EAIs and 8.5% (n = 54) received a second epinephrine injection. Of the 204 individuals not treated with an EAI, 77.0% (n = 157) received antihistamines, 12.7% (n = 26) received another treatment, and 8.3% (n = 17) received no treatment. Of the 850 events with data on hospital transport, 79.6% of individuals (n = 677) were transported to the hospital. Common triggers varied seasonally, with food listed most frequently overall (62.5%).
  
  
  CONCLUSIONS
  More than one in ten schools that participated in the EpiPen4Schools survey reported an anaphylactic event. Approximately 25% of individuals with anaphylactic events were not treated with EAIs, and 20.4% of patients were not taken to the hospital after an anaphylactic event. Analysis of these data supports the value of stocking EAIs and of providing continuing education regarding the recognition and proper treatment of anaphylaxis for school personnel.
authors.affiliation: Institute for Asthma and Allergy, Wheaton, Maryland, USA.
authors.forename: Martha V
authors.initials: MV
authors.lastname: White
authors.forename: Susan L
authors.initials: SL
authors.lastname: Hogue
authors.forename: M Elizabeth
authors.initials: ME
authors.lastname: Bennett
authors.forename: Diana
authors.initials: D
authors.lastname: Goss
authors.forename: Kimrey
authors.initials: K
authors.lastname: Millar
authors.forename: Kelly
authors.initials: K
authors.lastname: Hollis
authors.forename: Peter H
authors.initials: PH
authors.lastname: Siegel
authors.forename: Ray A
authors.initials: RA
authors.lastname: Wolf
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Wooddell
authors.forename: Suyapa
authors.initials: S
authors.lastname: Silvia
mesh_terms: D000293:Adolescent; D000707:Anaphylaxis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010865:Pilot Projects; D012574:Schools; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D004837:Epinephrine