Device helps Napa County schools protect against deadly reactions
By PAT STANLEY
Register Staff Writer
It took the 1987 death of a Calistoga boy who had an allergic reaction to peanuts and several years of lobbying by local officials, but parents today can breathe a bit easier knowing their children are better protected against potentially deadly allergic reactions.
Today, every school in Napa Valley Unified School District and most others in the county have at least two Epi-Pen Auto Injectors -- disposable drug delivery systems distributed by Dey Labs of Napa.
The spring-activated device, which looks like an ink pen, injects the proper dose of epinephrine via a concealed needle.
At least one adult can attest to its effectiveness.
"It saved my life," said Susan Hall, assistant principal at Silverado Middle School.
Hall was supervising lunch duty at the east Napa campus in October 2003 when a yellow jacket flew up her pant leg and stung her on the thigh. "I thought it was no big deal," the school administrator recalled. "I thought I'd just get some ice and go to the doctor."
She walked to the office of school nurse Anita Henning, but said by the time she got there "the inner thigh was softball size, red and swollen." Henning had her sit down and hold an ice pack to the swollen area. She also insisted Hall not drive to Kaiser Hospital.
"I told her I felt funny and my throat felt weird. As soon as I mentioned the throat, she went into action," Hall recalled.
Bells went off for Henning, whose training told her Hall may be going into anaphylactic shock, an acute allergic reaction that affects the entire body.
"She got the Epi-Pen and gave me a shot in the leg. That's what saved my life. She's my guardian angel."
Hall realized she was in serious trouble when, before the life-saving medication started to work, "I began tugging at my collar, having difficulty swallowing. It was very scary."
Fire Department paramedics arrived and administered more life-saving drugs before Hall was whisked by ambulance to Queen of the Valley Hospital. She said the paramedics confirmed she could have died had the Epi-Pen not been used within minutes of the sting.
Epinephrine, an adrenaline, can delay reactions to insect stings or food allergies until the victim can arrive at a hospital for more advanced care, according to Dr. George Monteverdi, who testified in Sacramento in support of the law allowing Epi-Pens to be available at schools. He was also instrumental in training school nurses and others in the use of the device.
He said many people are susceptible to severe allergic reactions, and don't realize it. "Generally food (allergies) are more severe, even lethal," he said.
He said the Epi-Pen program provides "potentially life saving intervention," but noted it must be used within 10 minutes of an allergic reaction.
Monteverdi said its use "outweighs by far any side effects." The most serious potential side effect is an irregular heart rhythm of a patient, particularly with an adult with heart disease.
Also, he said, caution must be taken by the person administering the medicine to avoid an accidental needle stick.
Drs. Monteverdi and Larry Posner volunteered to conduct school staff training and helped produce a training video on its use.
Epi-Pens are carried by many adults with known allergies. Such is the case with retired school administrator Virginia Rue, who helped convince Sacramento officials of the need for the law.
Rue said passage of the law involved support from local physicians, local legislative representatives, school nurses, the California and American medical associations, the American Academy of Pediatrics, health and school officials.
At the time, Rue was serving on the Napa Valley Unified School District's school health committee.
New school health protocols allowing the Epi-Pen were implemented at the start of the 2003-2004 school year.
Rue credited Napa Dr. J. C. Pickett for his help while serving as president of the California Medial Association, and said then-Assemblywoman Pat Wiggins, D-Santa Rosa, "became our standard bearer."
Sen. Wes Chesbro, D-Arcata, was also instrumental, Rue said.
Wiggins, who sponsored legislation that enabled to the Epi-Pens to be placed in California schools, said, "It's probably the only legislation I ever carried that saved a life."
It took two tries to get the measure passed then signed into law. At first, school nurses were concerned about putting the devices in the hands of lay people. On the second try, however, it "sailed through," Rue said.
The measure was signed into law by Gov. Gray Davis.
Anna Hie, a special education nurse with the office of Napa County Schools, said she hopes every children's center will eventually have at least one Epi-Pen and personnel trained in its use. "It's absolutely vital," she said.
Hie said the number of children with life-threatening allergies is not known. However, for unknown reasons, serious allergic reactions are believed to be on the increase.
Besides insect bites, many children have allergic reactions to nuts and nut products, shellfish, seed oils and milk.
She said grants are being written to fund the devices in more schools and child centers.
Epi-Pens are manufactured by Meridian Medical Technologies and marketed in the United States by Dey Labs of Napa.
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