Can we have EpiPens on School Campuses?

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EpiPens in California school districts are governed in Education Code Section 49414.  The short answer is yes.   You can make them available to trained personnel.  This has become a large issue with the California Nurse’s Association and the K.C. Settlement.  I would suggest checking with your general counsel prior to implementing this program.

Ed. Code Section
49414. (a) A school district or county office of education may provide emergency epinephrine auto-injectors to trained personnel, and trained personnel may utilize those epinephrine auto-injectors to provide emergency medical aid to persons suffering from an anaphylactic reaction. Any school district or county office of education choosing to exercise the authority provided under this subdivision shall not receive state funds specifically for the purposes of this subdivision. (b) For purposes of this section, the following terms have the following meaning: (1) “Anaphylaxis” means a potentially life-threatening hypersensitivity to a substance. (A) Symptoms of anaphylaxis may include shortness of breath, wheezing, difficulty breathing, difficulty talking or swallowing, hives, itching, swelling, shock, or asthma. (B) Causes of anaphylaxis may include, but are not limited to, an insect sting, food allergy, drug reaction, and exercise. (2) “Epinephrine auto-injector” means a disposable drug delivery system with a spring-activated concealed needle that is designed for emergency administration of epinephrine to provide rapid, convenient first aid for persons suffering a potentially fatal reaction to anaphylaxis. (c) Each public and private elementary and secondary school in the state may voluntarily determine whether or not to make emergency epinephrine auto-injectors and trained personnel available at its school. In making this determination, a school shall evaluate the emergency medical response time to the school and determine whether initiating emergency medical services is an acceptable alternative to epinephrine auto-injectors and trained personnel. Any school choosing to exercise the authority provided under this subdivision shall not receive state funds specifically for the purposes of this subdivision. (d) Each public and private elementary and secondary school in the state may designate one or more school personnel on a voluntary basis to receive initial and annual refresher training, based on the standards developed pursuant to subdivision (e), regarding the storage and emergency use of an epinephrine auto-injector from the school nurse or other qualified person designated by the school district physician, the medical director of the local health department, or the local emergency medical services director. Any school choosing to exercise the authority provided under this subdivision shall not receive state funds specifically for the purposes of this subdivision. (e) (1) The Superintendent of Public Instruction shall establish minimum standards of training for the administration of epinephrine auto-injectors that satisfy the requirements in paragraph (2). For purposes of this subdivision, the Superintendent of Public Instruction shall consult with organizations and providers with expertise in administering epinephrine auto-injectors and administering medication in a school environment, including, but not limited to, the State Department of Health Services, the Emergency Medical Services Authority, the American Academy of Allergy, Asthma, and Immunology, the California School Nurses Organization, the California Medical Association, the American Academy of Pediatrics, and others. (2) Training established pursuant to this subdivision shall include all of the following: (A) Techniques for recognizing symptoms of anaphylaxis. (B) Standards and procedures for the storage and emergency use of epinephrine auto-injectors. (C) Emergency follow-up procedures, including calling the emergency 911 phone number and contacting, if possible, the pupil’s parent and physician. (D) Instruction and certification in cardiopulmonary resuscitation. (E) Written materials covering the information required under this subdivision. (3) A school shall retain for reference the written materials prepared under subparagraph (E) of paragraph (2). (f) A school nurse, or if the school does not have a school nurse, a person who has received training pursuant to subdivision (d), may do the following: (1) Obtain from the school district physician, the medical director of the local health department, or the local emergency medical services director a prescription for epinephrine auto-injectors. (2) Immediately administer an epinephrine auto-injector to a person exhibiting potentially life-threatening symptoms of anaphylaxis at school or a school activity when a physician is not immediately available. (g) A person who has received training as set forth in subdivision (d) or a school nurse shall initiate emergency medical services or other appropriate medical follow up in accordance with the training materials retained pursuant to paragraph (3) of subdivision (e). (h) Any school district or county office of education electing to utilize epinephrine auto-injectors for emergency medical aid shall create a plan to address all of the following issues: (1) Designation of the individual or individuals who will provide the training pursuant to subdivision (d). (2) Designation of the school district physician, the medical director of the local health department, or the local emergency medical services director that the school district or county office of education will consult for the prescription for epinephrine auto-injectors pursuant to paragraph (1) of subdivision (f). (3) Documentation as to which individual, the school nurse or other trained person pursuant to subdivision (f), in the school district or county office of education will obtain the prescription from the physician and the medication from a pharmacist. (4) Documentation as to where the medication is stored and how the medication will be made readily available in case of an emergency.

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