Wash. schools can now give allergy meds without prescription

SEATTLE -- Parents of children with known allergies are used to providing schools with prescribed epinephrine in case their child has an emergency reaction. But what if a child has their first allergic reaction at school? A new law may help save their lives.

Until recently, school nurses could not administer epinephrine to a child having the potentially life-threatening reaction unless the medication had already been prescribed in that child's name. In cases where children were having a first-time reaction, the school had to rely on emergency medical responders to arrive at the school and inject the medicine in time.

But last month a new law took effect that will allow doctors to prescribe epinephrine directly to a school. If a student has a first-time reaction, a trained nurse may use the school's supply of the drug.

Senator Mark Mullet of Issaquah sponsored the legislation after a local mother presented the issue to him.

"A couple other states had passed laws after a child had died in the school," Mullet said. "These kids were surrounded by a sea of epinephrine but the law prevented the school from giving it."

For students with known allergies, the law allows both nurses and trained volunteers to administer the supplied epinephrine.

"There isn't going to be a nurse in every school 24/7," Mullet said. "We wanted to make sure there was some flexibility in there."

The Washington Education Association initially opposed this legislation over concerns that school staff without medical training might feel obligated to administer the medication.

"Our concern is making sure that students are safe and if being administered any medication it is by someone who has the training and knowledge to do that safely," said Rich Wood, WEA spokesperson. "To not force a school employee to administer a medication they are not comfortable with or trained in administer."

The WEA worked with legislators on the bill so that school staff can "opt out" of any obligation to administer epinephrine to students.

Still, Wood said the WEA encourages lawmakers to focus on providing schools with enough funding so that a trained nurse is always available to address student health concerns, including allergic reactions.

"If we had trained school nurses full time in every school in the state that would help with issues like this," he said. "There would be no question whether the person administering the drug has the knowledge and experience to do so in a safe way."

Dr. Russell Migita, clinical director of Emergency Services at Seattle Children's Hospital, says the risk of hurting a child by administering epinephrine is far outweighed by the risk of not treating an allergic reaction.

"What we're dealing with here is a potentially fatal condition that needs to be recognized and treated early," he said. "The people who are going to have first-time anaphylaxis are more likely to be kids."

The law applies to all public and private schools in Washington state, though schools may decide whether they will participate. It gives doctors, nurses and schools legal protection if a child has a poor reaction to epinephrine.

Parents who want a supply of epinephrine in their child's school can ask their health care provider to write a prescription for the school.