Recently my grandson came back from the community pool with what looked like a real shiner on his eyelid. It almost looked like a bee had stung him. When I looked closer it appeared that it could be a serious allergic reaction to something, so off to the emergency room he, my daughter, and I went. My concern was that this could morph into anaphylaxis, and we did not want to wait around the house to confirm this diagnosis, especially when we do not have rescue epinephrine in our possession, which is the only rapidly effective intervention for such an episode.
We know that anaphylaxis and anaphylactic shock is not all that uncommon for people with a history of allergic reactions. One would think that these simple rescue devices, such as AEDs, would be commonly available in public. Unfortunately, this is not the case. Because of this, many professional and patient advocacy organizations are taking up this issue. The Allergy and Asthma Network (AAN) has long been leading the effort to make sure children have access to rescue medications in schools and beyond. The AARC has also partnered with AAN and supported these efforts.
Because of the preventable deaths that occur due to anaphylaxis, there was a move to do something about it. In 2013, the President signed the School Access to Emergency Epinephrine Act and it became law. The law makes an important change to the Children’s Asthma Treatment Grants Program and other federal asthma programs, which authorize the Department of Health and Human Services to give funding preferences to states for asthma-treatment grants if they: 1) maintain an emergency supply of epinephrine (EpiPens); 2) permit trained personnel of the school to administer epinephrine and 3) develop a plan for ensuring trained personnel are available to administer epinephrine during all hours of the school day. Since this was signed, it is estimated that over 1,000 unnecessary deaths annually have been avoided simply by allowing access to emergency epinephrine in schools.
That was a good start but we are not done yet. How many times have you been in a plane and have been exposed to dander-producing animals? Dogs are most commonly seen in the passenger compartment and certainly produce dander, which can trigger a respiratory episode for susceptible patients. Keeping in mind that the air in planes is recirculated, there is the possibly that a fellow passengers may find themselves in a situation where they risk going into anaphylaxis due to exposure to this trigger. It’s not just animals — it could also be an exposure to peanut dust. Unfortunately, not all airlines have stopped serving peanuts. Southwest Airlines is one that serves them to its customers. So there is a real possibility that a person at 30,000 feet can experience an allergic reaction from a number of triggers.
Fortunately, in August of 2015, U.S. Senators Mark Kirk (R-Ill.) and Jeanne Shaheen (D-N.H.) introduced the Airline Access to Emergency Epinephrine Act (S.1972), which would improve access to life-saving medication for airline passengers with food and other severe allergies. The act would require commercial airlines to maintain at least two epinephrine auto-injectors (one adult dosage and one child dosage) on each aircraft and, like the School Access to Emergency Epinephrine Act, would require airlines to train crewmembers to recognize allergy symptoms and administer epinephrine in the event of an allergy attack.
The AARC is supportive of this bill and lobbied for it when the Political Advocacy Contact Team (PACT) made their hill visits in March 2016. I would encourage you to make sure that your senators know about the bill and ask for them to co-sponsor it. Remember, this summer there will be a break in Congress, and your member will likely be back home. In addition to the Airline Access to Emergency Epinephrine Act (S.1972), it would also be a great time to visit with them and tell them more about H.R.2948 — the Medicare Telehealth Parity Act of 2015. Let them know that we are in need of a Senate companion bill and you would be appreciative if they would consider introducing it. While there are other telehealth bills, this one in particular specifies the respiratory therapist as a professional who could provide this service. Let them know it is important to our patients that a respiratory therapist is a key player in assessing, managing, and educating patients about their chronic pulmonary disease and this bill will make that happen. Download our FAQs PDF to learn more.
Getting back to my grandson, Bentley. He is doing fine and thankfully he needed no further intervention. I only hope that should he or anyone ever require lifesaving measures, wherever he would go, that they would be close by.
“Executive Office Update: Keeping Lifesaving Measures Close By” was republished from the July 2016 edition of AARC Times.
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