Be Elijah’s Echo: NYC Preschools Will Stock Epinephrine Auto Injectors

Elijah's Echo. Elijah Silvera was a precious preschooler with a milk allergy who died after eating a grilled cheese sandwich.
Be Elijah's Echo and share his story to save lives. Photo credit: Silvera family

Elijah’s Echo. Elijah Silvera was a precious preschooler with a milk allergy who died after eating a grilled cheese sandwich. Echo, defined as a sound or series of sounds caused by the reflection of sound waves from a surface back to the listener.

Be Elijah’s Echo. We are Elijah’s Echo when we share Elijah’s story to advocate for food allergy awareness in order to save lives. New York City Board of Health is the latest effect of Elijah’s Echo and recent updates to their health code will save lives. The city will require their preschools to stock epinephrine and implement additional food allergy and anaphylaxis training. I spoke with Thomas Silvera, Elijah’s father, and Evan Edwards, co-inventor of Auvi-Q, Kaleo VP regarding their thoughts.

Disclosure: This is an unsponsored post, I want to share an important story and calls to action with you. Please consult with your medical care team if you have any medical questions or concerns.
Elijah's Echo. Elijah Silvera was a precious preschooler with a milk allergy who died after eating a grilled cheese sandwich.
Be Elijah’s Echo and share his story to save lives. Photo credit: Silvera family

NYC Health Code Update Will Require Stock Epi and Training

On June 5, 2018 New York City Board of Health amends the city’s health code for their preschool programs to stock and maintain epinephrine autoinjectors (EAI), to train teachers to administer them in an anaphylactic emergency, and to provide emergency care. Additionally Kaleo will donate 7,500 Auvi-Q epinephrine autoinjectors to their nearly 3,000 sites. The child care teachers will receive training this summer and the EAI will be distributed to the sites in the fall.

Elijah’s Story

Thomas Silvera, Elijah’s father, and I chatted recently about what happened to his son in November 2017 and his thoughts about the updated health code. Thomas is a kind and gracious man and he expresses himself articulately and passionately despite his family’s tragic loss. He is Elijah’s echo when he continues to advocate, shares his son’s story with legislators and all of us so in order to save lives.

Thomas told me, “Dina (Elijah’s mom), received a call to go to the school immediately because Elijah had some asthma symptoms. She arrived at the child care center to give him his asthma medications and asked if Elijah had eatened anything he shouldn’t have and was told no. Dina noticed Elijah’s breathing getting worse and decided to rushed him to the hospital, where he later passed away.”

NYC responded to Elijah’s death with some very decisive actions.

NYC shut down the preschool during an investigation which confirmed that a staff member gave Elijah a grilled cheese sandwich even though he had a documented milk allergy.

A few days later, a city official announced that all sites must call 911 if a child is having a medical emergency because the school called Elijah’s mom rather than 911.

Finally, on June 5, 2018 NYC Board of Health amended their health code to require all approved sites to maintain two epinephrine auto-injectors on location, to include training to administer the medication, and to call 911 when students have a medical emergency.

These new rules will have all staff trained in preventing and responding to emergencies related to food allergies. Each site will have at least two unexpired epinephrine auto-injectors available to staff have at least one staff member on site whenever children are present who is trained

  • to recognize the signs and symptoms of severe allergic reactions, including anaphylaxis,
  • to know that there are recommended epinephrine dosage for adults and children,
  • to administer an epinephrine auto-injector and
  • to initiate required follow-up procedures (calling 911, notifying a child’s parent or guardian, and reporting the incident to the Health Department)
  • to store and maintain epinephrine auto-injectors and to dispose of them properly after use.

Beyond Training: Prevent, Recognize, and Respond

Kaléo, the company which manufactures AUVI-Q epinephrine auto-injectors, will donate 7,500 devices to the nearly 3,000 NYC operated child care sites. I spoke with Evan Edwards, Kaléo’s VP Innovation, Development, & Industrialization & Co-Founder, who told me,

“We’re happy to donate Kaléo’s AUVI-Q epinephrine autoinjectors to city-regulated child care sites in New York City. The most important next step for the sites is educating everyone to recognize the signs of anaphylaxis in order to protect the most vulnerable. The AUVI-Q was designed to be easy to use in case of anaphylaxis at daycare and schools. We thank Thomas Silvera and his family for their bravery in their family’s tragedy, which is a testament and legacy in Elijah’s memory.”

Despite their family’s tremendous loss, Thomas and Dina want to be Elijah’s Echo so that his story is not forgotten. Thomas told me

“My concern with the new amendment is now this is required for all day care centers in NYC. Who will follow up with these facilities to make sure that they’re abiding by these new implementation? I have stressed training is the key component to making sure that these educators are protecting these children. I also want to know how are these day care centers going to keep these children who suffer with severe food allergies safe when playing and eating.”

Congratulations to NYC Board of Health officials for taking important steps necessary to protect their students with food allergies. Training preschool teachers and staff about food allergies and anaphylaxis will save lives, because we know that food allergic reactions are life threatening.

Being able to recognize the signs and symptoms of an allergic reaction and to respond with administration of epinephrine and calling 911 in case of anaphylaxis are essential to saving lives. Our hearts cannot bear another tragic loss.

Be Elijah’s Echo: Keep The Conversation Going

It’s far better to be mindful to prevent reactions. Whether we have a preschooler in NYC, or college bound teens in California, or somewhere in between, I hope these suggestions will continue this conversation and amplify the need for food allergy awareness and preparedness in preschools and beyond to keep children safe.

  • Start with the basics.
    • Work with your allergist to update your emergency care plan and refill your epinephrine autoinjector prescription this summer for back to school.
    • Be sure you understand when and how to use epi and practice with an epi trainer.
    • Do not be deterred by costs or shortages. Keep in mind that Kaléo has an Affordability program and their AUVI-Q is in stock for back to school orders.
    • Take the time to learn what you need to know about food allergies and be compassionate toward others in the community, as their needs may be different (more or less severe) but still the same if they carry epi.
  • Advocate for your child or children.
    • Collaborate with your child’s school and teachers to create a section 504 plan for food allergies.
    • Include the basics such as known allergies, emergency care plan, necessary specific accommodations.
    • Talk about how will the staff remember students’ allergens and prevent accidental ingestion or cross contact.
    • Discuss where will EAI be stored in an unlocked but safe location.
    • Encourage inclusion so that foods, activities, and special events are safe for everyone.
    • Understand the school’s food allergy protocols already in place and add any modifications your allergist recommends.
    • Consider yourself a food allergy parent ambassador, build a strong reputation of being a collaborator and always take the opportunity express appreciation for anyone who is mindful to keep your child safe, happy, and included.
  • Advocate in your community.
    • Find creative ways to share about food allergies. Read children’s food allergy books to your child’s class or scouting troop or pack, host an event, etc..
    • Your story is impactful. Choose a powerful and concise story to share with your family, friends, community, legislators, and/or media.
    • Advocate for your local preschools to adopt a food allergy/anaphylaxis policy like NYC. They are leading the way as they expect to serve 62,000 preschoolers.
    • If your state “allows” stock epi but your district doesn’t stock epi, encourage your local school district to adopt a stock epi policy. The additional training and food allergy awareness are invaluable to keep our food allergic kids safe as well as children experiencing an allergic reaction for the first time.

We can all be Elijah’s Echo when we talk about food allergies. Remember Elijah’s story, share our own, encourage greater food allergy awareness, and create changes in our community. Connect with Elijah’s Echo on Facebook.

Many thanks to Thomas and Dina Silvera and Evan Edwards for talking with me so that I can share this important update with you. Please be Elijah’s echo by sharing this article and talking about it. Every echo matters. <3

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About Sharon Wong 277 Articles
Welcome to Nut Free Wok, a blog about Allergy Aware Asian Fare. I hope that you will find my food allergy mom experiences helpful and enjoyable to read as I write about recipes, cooking techniques, Asian ingredients, and food allergy related awareness and advocacy issues. My professional experiences include education, teaching, and a little bit of science and computers. Thank you for visiting! ~Sharon Wong, M.Ed.

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