Siskiyou County Office of Education, Mount Shasta, CA 96067, USA.
J Sch Health. 2011 Aug;81(8):471-6. doi: 10.1111/j.1746-1561.2011.00616.x.
Schools are responsible for handling life-threatening events due to a variety of conditions, including anaphylaxis. California is one of a few states that permits school districts to stock emergency epinephrine auto-injectors and to train unlicensed assistive personnel to administer epinephrine for a life-threatening event. We surveyed school nurses in California to explore their experience with life-threatening anaphylaxis, implementation of allowable stock epinephrine auto-injector programs, and the barriers to program implementation.
An exploratory, cross-sectional, descriptive design was used for this study. Data was obtained from a convenience sample of 171 credentialed California school nurses via an online survey service. Descriptive statistics and Pearson's chi-square were used to analyze the data.
Thirty percent of school nurses reported using 1 student's prescribed medication to rescue another student in distress. Despite the frequency of using another student's rescue medication and California's permissive policy, only 13% of nurses reported having stock epinephrine programs. Barriers to stock epinephrine programs included: (a) limited availability of school nursing services, (b) lack of policies or guidelines, (c) inadequate funding for training and medication, and (d) lack of education. Limited awareness of susceptibility and the immediate life-threatening nature of anaphylaxis were also contributing factors.
Legislative initiatives are sufficient to develop safe, effective policies and protocols to manage life-threatening allergic reaction in schools. The findings indicate that more education is needed for school personnel and research is needed to determine an effective mechanism to remove barriers for emergency care during school hours.
学校有责任处理各种情况下的危及生命的事件，包括过敏反应。加利福尼亚州是少数几个允许学区储备紧急肾上腺素自动注射器并培训无执照的辅助人员在危及生命的情况下使用肾上腺素的州之一。我们对加利福尼亚州的学校护士进行了调查，以探讨他们在危及生命的过敏反应方面的经验、允许的储备肾上腺素自动注射器计划的实施情况以及实施计划的障碍。
本研究采用探索性、横断面、描述性设计。通过在线调查服务从 171 名有证书的加利福尼亚州学校护士中获取了数据。使用描述性统计和 Pearson's chi-square 分析数据。
30%的学校护士报告说曾使用 1 名学生的处方药物来抢救另一名处于困境中的学生。尽管经常使用另一名学生的急救药物，而且加利福尼亚州的政策允许，但只有 13%的护士报告说有储备肾上腺素计划。储备肾上腺素计划的障碍包括：（a）学校护理服务有限，（b）缺乏政策或指南，（c）培训和药物资金不足，以及（d）缺乏教育。对过敏反应的易感性和即时危及生命的性质的认识有限也是促成因素。
立法举措足以制定安全、有效的政策和协议，以管理学校内危及生命的过敏反应。研究结果表明，学校人员需要更多的教育，需要研究确定在上课时间消除紧急护理障碍的有效机制。
