In the past two weeks, four states in the U.S. have passed bills that require schools to stock epinephrine auto-injectors (like the EpiPen) in case students suffering from food or other allergies go into shock.

The states – Nevada, Florida, Tennessee and Oklahoma – are the latest of about 20 which have passed food allergy-related legislation. More states are considering similar measures. The first state to require it was Illinois in 2011, followed by Virginia after children there died from food allergy reactions.

The food allergy organization FARE has backed these state-level pushes for guidelines and epinephrine stocking at schools.

Many pediatricians and doctors recommend that children with severe food allergies carry an EpiPen on their person and that parents inform teachers and school staff so that the pen can be used if the child is unable to do so. The “stock” requirement would give the school a backup or a second dose should the reaction be more severe than expected.

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