Food Allergy Friday 03.14.2025
Expert Updates for Pediatric Healthcare Providers
🧭 Your weekly compass in the evolving landscape of pediatric food allergies
No academic article this week, but did you see this report? 😔
“Family Settles in Lawsuit over Florida Teen’s Nut Allergy Tragedy”
⚡️ Key Points in 30 Seconds
- Epinephrine is the first-line treatment for anaphylaxis.
- Antihistamines are NOT first-line treatment for anaphylaxis.
- Stock epinephrine is epinephrine prescribed to a school or other entity to be administered to someone having anaphylaxis.
- All states except Hawaii permit or require schools to stock epinephrine.
- Stock epinephrine should be in the form of an easy to use auto-injector or nasal spray.
- Most states’ laws explicitly state the prescriber is not liable should there be a bad outcome.
- Stock epinephrine requires training, which itself can save lives during anaphylaxis.
- Please prescribe stock epinephrine in your community.
👉 Why This Matters for Your Practice
How many patients in your practice have an anaphylactic food allergy?
How many of them have epi? Have it at school? Have people at school trained to recognize and respond to anaphylaxis?
While you cannot be all things to all people, you do have the unique ability to prescribe life-saving medication - epinephrine - to those patients’ schools. Schools who choose to stock epinephrine also train staff on how to recognize and respond to anaphylaxis. Both the device and this training can be life-saving.
Interested in prescribing stock epi? Reply to this email and I will personally walk you through the process. 💛
Hoyt Commentary
In this day in age, there really is no reason every school doesn’t stock epinephrine.
Cost?
Epi for schools is available for FREE through epipen4schools and through neffy in Schools. While it takes time to sign a prescription, it otherwise doesn’t cost a prescriber anything to write the prescription.
Training?
School nurses are empowered by most states to use and provide training to their staff on stock epinephrine, and Code Ana makes available resources to schools with and without school nurses so everyone can get trained.
Getting sued?
Most laws specify that everyone involved, from staff to prescriber, is indemnified.
So there really isn’t any reason a school should be unprepared. Will you help your community stock epi?
So why prescribe stock epi?
Because it is a relatively easy way to make a potentially huge impact.
You don't have to be an allergist to prescribe stock epi!
Any healthcare provider who is licensed to prescribe medications in a state can prescribe stock epi. This is a great service for pediatricians and pediatric NPs and PAs because you are some of the healthcare providers who are most familiar with the schools and whose patients actually attend the schools. Plus, growing your relationships with local schools can prove especially helpful when managing clinically and/or socially challenging patients. At the end of the day, we are our patients' best healthcare advocates, and this is a great way to show up for them.
Patient Communication Tips
🗣️ Key Messages for Families
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Schools should stock epinephrine.
Sample Script:
"Does your child’s school have stock epinephrine? I’m happy to help them have it and get good training on how and when to use it.”
Learn how to prescribe stock epi and earn free CME
🧐 Quick Quiz
After perusing this email, test your knowledge with this single question:
Question: Have you ever prescribed stock epinephrine?
- If yes, reply to this email and let me know how it makes you feel to provide such a tremendous yet easy service.
- If no, reply to this email with the biggest barrier you foresee or have encountered.
Answer and explanation provided in next week's newsletter. ✔
Last week’s answer: Xolair is NOT superior to OIT in treating food allergies. These therapies do different things and achieve different goals for different patients. As with much of medicine, each patient is unique and thus should have a personalized treatment plan that best fits them.
'Food Allergy Friday' is curated and written by Dr. Alice Hoyt. Dr. Hoyt is board-certified in allergy & immunology, internal medicine, and pediatrics. Her clinical expertise is in food allergies, and she serves patients with her team at the Hoyt Institute of Food Allergy.
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