Chicago Public Schools' District-Issued Emergency Epinephrine Initiative

Food allergy prevalence has increased by 50% between 1997 and 2011.  One of every 13 children in the US has a food allergy.  More than 15% of children with food allergies have had a reaction in school, and 20-25% of epinephrine administrations in schools involve previously unknown allergies.  Schools must have undesignated emergency epinephrine available in the event of an anaphylactic emergency.

The aim of this presentation is to describe how Chicago Public Schools (CPS) was the first large, urban school district in the country to develop and implement its comprehensive District-Issued Emergency Epinephrine Initiative and to present outcomes.

After updating policy to include the Initiative, epinephrine auto-injectors (EAIs) were distributed to all schools in the district prior to the beginning of the 2012/2013 school year.  Administration data was collected through school nurse and principal reporting mechanisms.

Thirty-eight district-issued EAIs were administered during Year 1 of the Initiative, and 32 EAIs were administered during Year 2.  More than half of epinephrine administrations were to students with no prior history or diagnosis of food allergy, and the trigger in over 30% of cases was never identified.  Data collection for Year 3 is on-going.

After evaluating the distribution and tracking the usage of district-issued EAIs, CPS learned key lessons which will inform future years of the Initiative.  As the first large, urban school district to implement such a project, CPS is poised to be a national model of what a schools can do to prevent potential mortality and morbidity among their students.