Methods: This cross-sectional, web-based pilot survey assessed anaphylactic events in US schools participating in the EpiPen4Schools program.
Results: Among 6574 responding schools, 1140 anaphylactic events were reported. Of the 1059 events with data on epinephrine auto-injector (EAI) use, 76.5% (810/1059) were treated with EAIs on school property. Stock EAIs from the EpiPen4Schools program were used to treat 38.0% of events (385/1012). Of the 6088 schools reporting on staff training for anaphylaxis recognition, 37.3% (2268/6088) provided training for the school nurse and select staff; 28.2% (1717/6088) and 30.4% (1851/6088) provided training for most and all staff, respectively. More than half of schools (55.0%, 3332/6053) permitted the school nurse and select staff to administer epinephrine to treat anaphylaxis; 15.6% (942/6053) and 21.5% (1300/6053) permitted most and all staff, respectively, to administer epinephrine.
Conclusions: Thirty-eight percent of anaphylactic events were treated with EAIs provided by the EpiPen4Schools program, highlighting the importance of stocking EAIs. Because a majority of schools permitted only the school nurse and select staff to treat anaphylactic reactions, students may frequently be in settings without personnel trained to treat anaphylaxis. Results emphasize the need to provide training to manage anaphylaxis and improve access to EAIs in schools.