Many Schools Not Prepared to Handle Emergencies Involving Children with Food Allergies and Asthma

New research from Northwestern University has found that schools are woefully unprepared to deal with anaphylaxis and other emergencies stemming from student allergies.

The study, which was published in Pediatrics, found that only half of all students who have been diagnosed with serious food allergies have emergency health management plans in place at their school. For children with serious asthma, the numbers are even worse. School officials only have emergency plans in place for a quarter of them.

In a news release that accompanied publication of the study results, Northwestern Medicine pediatrician Ruchi Gupta, MD, lead author of the study, said “Given the amount of time kids spend in school, it’s critical for school staff, clinicians and parents to make sure there’s a health management plan in place for students with health conditions.”

“Not having a health management plan leaves students without a vital safety net during the school day. With kids now returning to school, this is the time to get it done,” Gupta added.

Current guidelines for allergy and anaphylaxis care urge schools to create such plans for each student with diagnosed problems (and to be prepared to deal with any allergic reactions that occur in students who have never been diagnosed). Each plan should specify each child’s trigger or triggers and explain what medication or medications (if any) should when the child suffers an allergic reaction such as anaphylaxis.

Researchers from Northwestern looked through databases from Chicago Public Schools and identified about 18,000 students with asthma and 4,000 who had food allergies. Overall, 50.9% of students who had food allergy (and 24.3% of students with asthma) had a school health management plan on file.

Looking at particular subgroups, the researchers found that the nearly 1,700 students who were diagnosed with both allergies and asthma were considerably more likely to have an emergency plan in place than those who had only been diagnosed with one condition. Students from low-income families, on the other hand, were less likely than average to have an emergency plan in place, as were black and Hispanic students.

“This is definitely a national problem in schools around the country,” said Gupta, who is an associate professor of pediatrics at Northwestern’s medical school and a physician at Ann & Robert H. Lurie Children’s Hospital of Chicago. “We think the situation in Chicago schools is representative of schools everywhere. It’s critical for all students with any chronic condition to have a health management plan in place at school.”

Severe allergies have become significantly more common among American children over the past couple decades, so schools have come under increasing pressure to guard against triggers and to prepare for any emergencies that do arrived. Many districts around the country have committed to stocking every school with epinephrine autoinjectors and other vital treatments. Several states have even passed laws that require such devices not only in schools but also in other public facilities.

Still, several recent studies have found that many schools have yet to purchase a single autoinjector let alone create individual emergency management plans for all students. Those studies, like the new one from Northwestern, have generally found bigger problems at schools that serve poor students than those with relatively affluent kids.