Students carrying their own adrenaline injector

Our health educators sometimes get phone calls and emails about students being asked to carry their own adrenaline injectors. Generally this would not occur until late primary school in preparation for secondary school, and in some schools students never carry their own adrenaline injectors except when travelling to and from school.

What is important is that the student and staff (and maybe even other students) understand what to do in an emergency and where to get the person’s adrenaline injector. We strongly discourage leaving an adrenaline injector in a schoolbag in a locked locker or with 30 other bags if that is the adrenaline injector they will need in an emergency. The student should have another device in a central location and the school must have a process for getting the emergency medication to the student quickly.

On page 13 of the Best Practice Guidelines for Anaphylaxis Prevention and Management in Schools it states:

For older students, the parents may prefer the student to carry their adrenaline injector rather than hand it over to the school. A decision about whether this is appropriate is site-specific however, the following issues should be considered:

 – How likely is it that the adrenaline injector will not be forgotten and be with the student while they are in attendance at the school?

 – How easy is it for the school to access the adrenaline injector if it is kept with the student?

 – Does the school have a general use adrenaline injector in case the school cannot access the student’s prescribed device?

On page 27 of the above document it states:

- In primary schools it is recommended that adrenaline injectors are kept in a central location.

The Australasian Society of Clinical Immunology and Allergy (ASCIA) recommends:

The decision as to whether a student can carry their own adrenaline injector should be made when developing the student’s anaphylaxis management plan, in consultation with the student, their parents/guardians and their medical practitioner. This decision is generally based on a combination of factors, including age, maturity and ability to use the device.

ASCIA also advises that if a student carries their own adrenaline injector they may not physically be able to self-administer it due to feeling so sick because of the anaphylaxis. They should also understand that if they self-administer their adrenaline injector, they should immediately alert a staff member and an ambulance must be called. If they do not have the adrenaline injector on them, they must alert a friend or a teacher so the medication can be brought to them. This needs to be discussed and planned for in case of an emergency.

It is important to work with your child’s school to decide whether your child should be carrying their own adrenaline injector. Each child and school are different, so this needs to be taken into account when making this decision. A&AA recommends that younger children generally should not be carrying their own adrenaline injector at school, but that in the pre-high school year children can be given more responsibility for their own injector. If children are travelling to or from school without a responsible adult, they need to have an adrenaline injector with them and be able to know how and when to use it, and to have access to a mobile phone to call an ambulance. If the child is young, has food allergies and has to travel to and from school alone, they should not eat while travelling to and from school. Children with insect allergy can increase safety too by having bus windows closed and wearing long sleeves and pants where possible, but the risk of an allergic reaction is always there and should be discussed.