HB 1608, a bill introduced Thursday by Washington State Rep Dan Bronoske (D-Lakewood) is intended to increase access to epinephrine in schools and reduce costs.
Epinephrine is the only drug that can halt and reverse the progression of anaphylaxis, a life-threatening allergic reaction to a food, drug, insect venom, or environmental substance.
The drug is most often administered via auto-injector, a hand-held device that automatically inserts a needle and injects a premeasured dose when jabbed into the outer thigh. But the drug can also be administered via a syringe by trained medical professionals.
The idea for this bill came from a call that I went on in my other job as a firefighter. We were called to a local high school to monitor a student who was stung by a bee and may have had a severe allergic reaction. We were required on the scene because the school did not have an auto-injector available as they are cost-prohibitive to always have on stock. With the skyrocketing costs of auto-injectors, it is time that we allow registered nurses to administer epinephrine from a vial. This will deliver considerable cost savings to schools and ensure that school nurses can save the life of a student with a severe allergic reaction.
Washington schools are currently allowed to have stock epinephrine auto-injectors on hand for anaphylactic emergencies. Still, the devices are expensive costing up to $700 per two-pack and expire within a year. A vial of epinephrine costs $20-$30 with a similar time to expiration.
When someone needs an auto-injector, calling emergency services might not be quick enough. Schools need to have epinephrine readily available to protect their students, but high prices for auto-injectors combined with tight budgets have prevented some schools from keeping it on hand. This commonsense measure will allow a registered nurse to dispense epinephrine from a vial, saving schools hundreds, possibly thousands of dollars and ensuring that students have quick access in an emergency. This is especially important in rural areas where emergency services can take longer to arrive.
We at SnackSafely.com see this legislation as an important but suboptimal solution.
We would prefer stock epinephrine auto-injectors be made available at every school together with training on how to recognize the symptoms of anaphylaxis and administer the devices. Such training is relatively simple as there are few steps to using an auto-injector.
If vials and syringes are introduced, more schools may be able to keep epinephrine on hand but fewer individuals on staff would be permitted to administer the drug due to the added complexity of preparing a syringe for use. School nurses are in short supply and are not available all day at every school.
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