Should college students leading class trips be allowed to give emergency injections to classmates experiencing acute allergic reactions?
While state law allows injections of the drug epinephtine to be administered in kindergarten through 12th grade by nurses, teachers or other adults, a recently passed Senate bill – S-2448 – would let student leaders who undergo training to administer the potentially life-saving shots in an emergency.
Epinephrine shots can treat severe reactions if delivered within minutes of their onset, but their effectiveness is reduced beyond 20 minutes, noted Dr. Janet Neglia, associate director of medical services at Princeton University.
College students “may be exposed to new insects or foods for the first time,” while on student-led trips like Outdoor Action, a Princeton program intended to teach leadership skills and civic engagement during six-day outdoors trips. More than 800 first-year students annually take the trips, which are led by more than 250 upper-class student leaders.
Neglia told the Senate Higher Education Committee that the number of children with food allergies seems to be increasing and currently includes one in 10 preschoolers. This has made it important for colleges to be ready for a rising number of severe cases.
While many students with allergies carry their own epinephrine, they could benefit from having classmates able to administer the shots if they are experiencing allergic reactions.
Neglia said that last September a student leader gave epinephrine to a first-year student who had received two bee stings and then experienced swelling of the tongue and face. The students were in a remote trail in Pennsylvania, two hours from where emergency personnel could meet them.
“Without that dose of epinephrine I shudder to think of what the outcome might have been,” she said. Princeton officials didn’t respond by the deadline for this story to a question about whether the shot used epinephrine that the allergic student brought or whether the student leader was not following the law by providing the epinephrine.
Neglia emphasized that the shots are safe, with the needle extending and retracting during the shot. “It’s relatively foolproof nowadays,” she said, adding that students can be trained to safely administer the shots during one 90-minute session.
Bill sponsor Sen. Shirley K. Turner (D-Hunterdon and Mercer) said she introduced the measure after talking with Neglia and other Princeton officials.
Turner noted that on trips to other countries students may encounter unfamiliar sources of allergies while in remote areas far from medical facilities.
“In the event someone has a bee sting or a food allergy, this I something that could very well save a life,” Turner said.
The bill has bipartisan support, with Senate Minority Leader Thomas H. Kean Jr. signing on as a primary sponsor, who said he recognized the importance of the measure based on his own past experience as an emergency medical technician in wilderness areas.
Allison Inserro of the Food Allergy Coalition of New Jersey said college-age students face several risks for severe allergic reactions.
“For many, it may be the first time that you are eating foods away from home on a regular basis, that someone else is cooking other than your parents or guardians,” Inserro said. She noted that a 20-year-old Georgia student died from a food allergy in 2011 after failing to properly inject himself with epinephrine.
“While you’re on the verge of passing out, your judgment may be distorted and you may not have the dexterity and coordination to do that (inject oneself) and it doesn’t matter whether you’re 5 or you’re 15 or your 20 or you’re 50,” she said.
In addition, Inserro noted, college students may be inclined to take more risks.
“Now is their chance to assimilate and blend in with a whole new group of people who don’t know them and who don’t know about their food allergy. This raises the stakes and increases the chance that an accidental food ingestion will occur, whether because they’re taking risks with drugs and alcohol that will distort their judgment, or because they don’t want to appear that they’re making a big deal of their condition if they’re out on a date; if they don’t want to mention it; or if they’re just out with a group of friends,” Inserro said.
Turner said she initially hoped that the Assembly version of the bill – A-3766 — would be passed before the new school year but she now hopes that it can be enacted before the spring semester. The Legislature isn’t scheduled to reconvene before the November election.