The purchase, storage and use of adrenaline auto-injector
devices in schools
Schools in the UK can now purchase adrenaline auto-injector
(AAI) devices from their local pharmacy for emergency use on
children at risk of experiencing anaphylaxis (a severe allergic
reaction). See below our handy guide for head teachers, managers
and staff, to clarify the rules and guidance around this. We also
recommend printing and displaying our AAI
What are Adrenaline Auto-Injectors?
Adrenaline auto-injectors (AAIs) are devices to administer
adrenaline to a child experiencing a severe allergic reaction.
EpiPen®, Jext® and Emerade ® are some of the most popular brands of
What is the law on using Adrenaline Auto-Injectors in
A new law called the Human Medicines Regulations 2017 came into
force on 1 October 2017. The new law means a school nurse or first
aider can have swift access to the school’s emergency stock of
spare AAI devices, to give life-saving help to a child with a
Are schools obliged to store spare AAI devices?
No - buying and storing AAIs is an option for each school to
consider. Doing so could bring greater peace of mind to parents of
children with severe allergies.
Rules and guidance for storing AAI devices*
AAI devices should be kept in a safe and suitably central
location where staff have access at all times, out of the reach and
sight of children (e.g. in an office or staff room). They must not
be locked away in a cupboard or room where access is restricted.
Schools should ensure that AAIs are accessible, and not located
more than 5 minutes away from where they may be needed.
In larger schools, it may be prudent to locate an emergency
anaphylaxis kit near the central dining area and another near the
playground. Spare AAI devices should be clearly labelled and kept
separate from any pupil’s own prescribed AAI.
Rules and guidance on the use of AAI devices*
If someone is showing the symptoms of a severe allergic reaction
(anaphylaxis), an ambulance MUST be called immediately - even if
they have already used an AAI device. The school’s AAI can only be
administered to a pupil at risk of anaphylaxis, where both medical
authorisation and written parental consent for use of the spare AAI
has been provided. In the event of a possible severe allergic
reaction in a pupil who does not meet these criteria, emergency
services (999) should be contacted, who will advise whether
administration of the spare emergency AAI is appropriate.
Any AAI(s) held by a school are a spare/back-up device and not a
replacement for a pupil’s own AAI(s). The school’s spare AAI can be
administered to a pupil whose own prescribed AAI cannot be
administered correctly without delay.
AAIs can be used through clothes and should be injected into the
upper outer thigh, in line with manufacturer’s instructions. The
use of adrenaline as an injection into the muscle is safe and can
be life-saving. The adrenaline treats both the symptoms of the
allergic reaction, stops the reaction and the further release of
chemicals causing anaphylaxis. Severe allergic reactions may
require more than one dose of adrenaline, and children can
initially improve but then deteriorate later.
St John Ambulance’s Anaphylaxis First Aid
training is a great way of ensuring staff are informed and
ready to act in the case of an anaphylactic reaction.
Good practice: what should be in an anaphylaxis kit*?
Schools choosing to hold a spare AAI(s) should establish a
policy or protocol for their use in line with ‘Supporting
pupils at school with medical conditions: Statutory guidance for
governing bodies of maintained schools and proprietors’
It is good practice for schools holding spare AAIs to store
these as part of an emergency anaphylaxis kit which should
- • 1 or more AAI(s)
- • Instructions on how to use the adrenaline auto-injector
- • Instructions on storage of the AAI device(s)
- • Manufacturer’s information
- • A checklist of injectors, identified by their batch number
and expiry date with monthly checks recorded
- • A note of the arrangements for replacing the injectors
- • A list of pupils to whom the AAI can be administered
- • An administration record.
Schools should strongly consider keeping the emergency
anaphylaxis kit together with an emergency asthma inhaler kit
(containing a salbutamol inhaler device and spacer), as asthma is a
common symptom during food-induced anaphylaxis.
Department of Health: Guidance on the use of adrenaline
auto-injectors in schools
Human Medicines Regulations 2017