Should schools stock "general use" epinephrine pens? That seems to be the big question that many people are asking after first grade student Ammaria Johnson died after suffering a severe allergic reaction last week.
With a general stock, an EpiPen could be used for any student who was having a severe allergic reaction, even if they hadn't left their own prescription medication at the school.
While increasing access to epinephrine seems like a great idea, we should likely all be talking about something else that might affect access to life-saving treatment - limited availability of school nurses to help care for medical issues in school. For example, in the Chesterfield County Public Schools, where Ammaria was a student, there are only 28 nurses for about 58,578 students in 62 schools, including 38 elementary schools, 12 middle schools, 11 high schools, and 1 technical school. That is one nurse for 2.2 schools or just over 2,000 students.
The Chesterfield County Public Schools ratio is well below the nurse-to-students ratio recommended by the National Association of School Nurses and Healthy People 2010 guidelines of about 1:750 (well students) or 1:225 (student population that may require some daily school nursing services) or 1:125 (students with complex health care needs).
Does your child's school have a nurse? If you live in Vermont, Connecticut, New Hampshire, Delaware, or Washington, D.C., then they likely do. According to the latest 2010 Student-to-School Nurse Ratios from the National Association of School Nurses, they led all states with the best ratios.
The worst nurse-to-students ratios were in Oklahoma, Florida, Utah, North Dakota, and Michigan. These states, and unfortunately many others, have nurse-to-student ratios that make it unlikely that your child's school has their own nurse. It is more likely that they have to share a school nurse with two or three other schools, which makes it harder to help manage kids with specific conditions or special needs, do screening for obesity, vision, and hearing, etc., and help figure out when sick kids need to go home.