The UK is experiencing a shortage of adrenaline auto-injectors which are used to treat anaphylactic shock (severe allergic reactions) in children and adults with allergies. Since around three children per classroom are likely to have food allergies, this is a huge concern for schools. Sophie Keay chatted to Emma Hammett, CEO and Founder of First Aid for Life, to learn more.
What is anaphylaxis?
Anaphylaxis is an extremely severe allergic reaction. Reactions usually begin within minutes and progress rapidly, however, they can occur up to 2-3 hours after exposure and exercise can also initiate symptoms a while after exposure to an allergen. Common allergens include food and insect stings. Food allergies have been on the rise in recent years.
What are the access issues?
Currently there is a global shortage of autoinjectors. Major distribution problems are affecting all three drug companies manufacturing the auto-injectors. As a result, many pharmacies have been advised only to fulfil two auto-injectors – even if more have been prescribed – causing problems for schools, parents and pupils desperately trying to fulfil all requirements with a reduced supply.
Why is this such a problem for schools?
Children at risk of anaphylaxis are prescribed adrenaline auto-injectors (AAI) by their doctor. These devices should be swiftly accessible to them at school and they should also have immediate access to the auto-injectors all times, outside of school. They should ideally carry 2 auto-injectors with them at all times. AAIs deliver a potentially life-saving dose of adrenaline in the event of a severe allergic reaction (anaphylaxis).
Most schools require pupils to keep two adrenaline auto-injectors on the school premises. Schools should also able to buy spare auto-injectors as an emergency back-up device. Pharmacies across the country are unable to dispense these additional devices.One fifth of all fatal reactions in children occur at school and failure to administer adrenaline rapidly that has been associated with fatalities.
Should parents seek alternatives?
Many parents are resorting to buying auto-injectors on-line but it is not possible to be sure of the quality or source of their purchase.Due to these extreme shortages, some pharmaceutical companies have advised use of specific auto-injectors up to 3 months beyond their expiry dates despite the medicine’s efficacy reducing beyond the expiry date.
What advice would you give to those who are prescribed with adrenaline auto-injectors?
• Always carry two adrenaline auto-injector devices with you at all times.
• Register devices with the drug manufacturers to receive expiry date alerts and get new prescriptions for replacement devices early.
• Never discard an old device until you have received your replacement.
• If you are prescribed an alternative AAI device, ensure that you know how to use it and train others that may need to use it in an emergency.
• Before using auto-injectors, check the viewing window to ensure the solution is clear and colourless.
• Keep up to date with the latest drug company and Allergy UK and Anaphylaxis Foundation guidance.
What do schools need to know and what staff training is needed?
A change in the law in 2017 enabled schools in the UK to buy a spare auto-injector from pharmacies without a prescription for emergency use. This legislation allows school staff to administer an emergency AAI to any child who has been assessed as being at risk of anaphylaxis. The change in legislation applies to local authority-maintained nurseries, primary, secondary and special schools, academies, pupil referral units and independent schools in England, Scotland and Wales.
These auto-injectors are intended for children who are known to have a history of anaphylaxis and have already been prescribed an auto-injector. These spare auto-injectors are for emergency treatment when their device is unavailable; because it is out of date, not immediately to hand, faulty or been wrongly administered. Or they may require an additional dose following the administration of their own auto-injector.
Schools must arrange specialist anaphylaxis training for staff where a pupil in the school has been diagnosed as being at risk of anaphylaxis. This should include practical instruction on how to use the different AAI devices available.
First Aid for Life specialise in first aid for schools and they are the leading provider of first aid training for staff, parents and pupils. Anaphylaxis training is incorporated in all their school first aid courses. Please visit www.firstaidforlife.org.uk, firstname.lastname@example.org or tel: 020 8675 4036 for more information about their courses.
First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.