Quick-Thinking School Nurse Takes Risk To Save Life Of Teen Suffering Anaphylactic Attack (NAPS)—School nurse Cathy Owens, R.N., is an anaphylaxis hero. She spends most of her days at Murrieta Valley High School in southern California contending with skinned knees and fevers. However, since May 1997, when Ms. Owens saved a 16-year-old student from suffocation due to a type of acute allergic reaction called anaphylaxis, she has also led a crusade to equip schools properly for treating students suffering from unexpected anaphy- lactic attacks. Her crusade began when Corey Lohman, a Murrieta sophomore, suffered a respiratory crisis in the student health office. “He was in distress—he couldn’t speak and was grasping at his neck. I knew his throat was closing and that he was in such severe crisis he wouldn’t survive until the ambu- lance reached him,” said Ms. Owens, who has been a school nurse for ten years. Anaphylaxis Kills Corey experienced what is knownas anaphylaxis, an allergic reaction that can kill within minutes, either through swelling that shuts off airways or through a fatal drop in blood pressure. Ms. Owens knew there was an epi- nephrine auto-injector in the stu- dent health office reserved for another student who wasat risk for severe allergic reactions. Aware that epinephrine (also "My decision was easy because a student’s life had to take precedence over any consequences | would face as a result of breaking the law." Still, Ms. Owens explains, “We as R.N.s are trained to respond to emergency situations, including respiratory crises, and we’re also trained that epinephrine canalleviate an anaphylactic crisis. In this situation, my decision was office, Corey probably wouldn’t have survived,” Ms. Owenssaid. Unfortunately, in using an- other student’s prescribed epi- nephrine to help Corey, Ms. Owensacted against the law. Not only do nurses require a physi- cian’s order to administer any prescription medication, but federal law prohibits dispensing medica- tion to someone other than for whomit wasprescribed. throat, lips or tongue, and diffi- culty breathing or swallowing. Side effects of epinephrine may include palpitations, tachycardia (an abnormally fast heartbeat), sweating, nausea and vomiting, and respiratory difficulty. Cardiac doctor for an EpiPen epinephrine auto-injector, learned to administer it in an emergency andcarried one with him at all times. The school kept another EpiPen epinephrine auto-injector for him in the student health office. During two additional episodes of anaphylaxis that Corey experienced at school, a school nurse adminis- tered it to Corey before he was taken by ambulanceto a hospital. Nurse Commended Because Ms. Owensacted outside the law in saving Corey’slife, should be carefully instructed by a epinephrine, they often go right to their doctor for a prescription for multiple units of epinephrine auto-injectors: one to keep with the child, one for the home and one for school,” said Ms. Owens, who is involved in educational efforts to raise awareness of the benefits of epinephrine for at-risk children. Increased Prevalence A study recently published in the Archives of Internal Medicine the California Board of Registered revealed that as many as 40.9 million Americans maybeatrisk for In the end, the Board commended her for her “resourceful response substantial increase over the number of people previously Nursing investigated Ms. Owens. director of the National Associa- we hadn’t had another student’s epinephrine auto-injector in the symptoms of anaphylaxis, which can include hives, swelling of the physician about the circumstances under which this life-saving medication should be used. “Once parents of children at risk for anaphylaxis learn about to take precedence over any consequences I would face as a result of breaking the law.” After this first episode, Corey received a prescription from his allowed time for him to be transported to the emergency room. “If Corey’s breathing passages and laxis. Epinephrine can reverse the arrhythmias may follow administration of epinephrine. Patients laxis, Ms. Owens administered it to Corey. The epinephrine opened in an emergencyto offset anaphy- medical attention is the standard emergency treatment for anaphy- easy because a student’s life had to a life-threatening emergency” and formed an advisory committee on school nurses to address the need for basic emergency supplies called adrenaline) could be given An immediate injection of epi- nephrine followed by emergency in the schools. Judy Robinson, executive tion of School Nurses, said that Ms. Owens’ experience exemplifies the importance of having severe allergies or anaphylaxis, a thought to be at risk. There is speculation about why incidence is increasing. More than two mil- lion children younger than three years old have severe food allergies, which some experts attribute to early introduction of foods that maytrigger reactions. In addition, risk of anaphylaxis due to insect stings is growing as fire ants and nurses on-site in schools. “School Africanized honey bees spread school staff may not be equipped lent among medical professionals in recent years, largely due to nurses are trained to recognize and treat medical emergencies, such as anaphylaxis, that other to handle.” Usually, anaphylaxis occurs in reaction to an identifiable allergic trigger, such as food, insect stings, medication, latex and, in rare cases, exercise. across the United States. Latex allergy has become more prevapolicies requiring use of latex gloves to prevent transmission of HIV and other diseases. The increase in incidence underscores the need for anaphylaxis awareness and prevention. wenn nena noone noone eee OTa oe eee Note to Editors: Prescribing information for EpiPen epinephrine auto-injector is available at: http:/ /www.deyinc.com /epipen2.pdf