Spare, Back-up AAIs

The  Department for Health now allows schools to purchase spare, back up AAI’s without prescription. These can be stored in the school for use in emergencies on pupils who are known to be at risk of anaphylaxis. Medical authorisation and written parental consent must be provided for the spare, back-up AAI to be used on such pupils.

The spare device should act as a back-up and an addition to any devices already prescribed to pupils. It is not a replacement of the pupil’s own devices.  MHRA guidance states patients should always have access to two devices. This does not include the school’s spare, back-up AAI.

Currently there are no funding arrangements in place, so schools are required to purchase the spare, back-up AAI as a retail item.

The medical professionals should provide the school with their signed authorisation, stating that the child’s allergy has been medically diagnosed and the spare, back-up AAI should be used in an emergency as a back-up where anaphylaxis is suspected. This can be done via the personalised allergy action plan (e.g.  BSACI Allergy Action Plan).

Brands of AAI available in the UK are Epipen, Jext and Emerade. AAI’s are available in different doses, depending on the manufacturer. The  Resuscitation Council (UK) recommends that healthcare professionals treat anaphylaxis using the age-based criteria as follows:

*Product not available, see BNFc important Safety Information

** If > 60 kg; if small or pre-pubertal offer 0.3 mg

Medical professionals should be able to advise schools on the dose, brand and quantity of spare, back-up AAI’s required in individual schools. This is assessed based on the number and age of at risk pupils at school.

The school would normally be advised to purchase the brand used by the majority of pupils with allergy.