Schools seek insight on epipens for emergency use

by | Oct 3, 2019 | Ask Nancy, The Advocate

For October, we heard from schools that serve young kids who may not know if their students have an allergy yet.  

Question:

Can a private school keep epipens on hand in case of an emergency?  

Nancy says:

Having staff trained to deal with an emergency that involves administering an epipen requires schools learn the rules and plan to be prepared.   The DOH website has great information to support schools on this topic.  

In 2016, a law was passed allowing authorized entities to obtain epinephrine auto-injectors. An epinephrine auto-injector is a medical device used to deliver a single dose of epinephrine or adrenaline for the emergency treatment of anaphylaxis. Authorized entities that choose to acquire these devices must have people connected with the entity, such as employees, who have completed an anaphylaxis and epinephrine auto-injector training. These people will be responsible for the storage, maintenance, and general oversight of these products. They may administer or provide an epinephrine auto-injector to people who are experiencing anaphylaxis. An authorized entity is required to report to the Department of Health each incident of use of an obtained epinephrine auto-injector that was provided or administered to a person.

Question:

Where can schools get epipen injectors to store for emergency use situations? 

Nancy says:

A prescription for your authorized entity may be obtained from a health care provider authorized to prescribe epinephrine auto-injectors. The prescription will be filled by a health care provider authorized to dispense medications.

According to RCW 28A.210.383 Epinephrine auto-injectors (EPI pens)—School supply—Use:

(1) School districts and nonpublic schools may maintain at a school in a designated location a supply of epinephrine autoinjectors based on the number of students enrolled in the school.
(2)(a) A licensed health professional with the authority to prescribe epinephrine autoinjectors may prescribe epinephrine autoinjectors in the name of the school district or school to be maintained for use when necessary. Epinephrine prescriptions must be accompanied by a standing order for the administration of school-supplied, undesignated epinephrine autoinjectors for potentially life-threatening allergic reactions.
(b) There are no changes to current prescription or self-administration practices for children with existing epinephrine autoinjector prescriptions or a guided anaphylaxis care plan.
(c) Epinephrine autoinjectors may be obtained from donation sources, but must be accompanied by a prescription.
(3)(a) When a student has a prescription for an epinephrine autoinjector on file, the school nurse or designated trained school personnel may utilize the school district or school supply of epinephrine autoinjectors to respond to an anaphylactic reaction under a standing protocol according to RCW 28A.210.380.
(b) When a student does not have an epinephrine autoinjector or prescription for an epinephrine autoinjector on file, the school nurse may utilize the school district or school supply of epinephrine autoinjectors to respond to an anaphylactic reaction under a standing protocol according to RCW 28A.210.300.
(c) Epinephrine autoinjectors may be used on school property, including the school building, playground, and school bus, as well as during field trips or sanctioned excursions away from school property. The school nurse or designated trained school personnel may carry an appropriate supply of school-owned epinephrine autoinjectors on field trips or excursions.
 
**read additional elements of this rule HERE

Question:

What are the school’s responsibilities for emergency epipen storage and administration?

Nancy says:

Upon proof of a training certification by an employee, an organization may obtain epinephrine auto-injectors, and the organization is responsible for:

  • Storing epinephrine auto-injectors in a location readily accessible in an emergency and in accordance with the instructions for use.
  • Designating employees or agents who have completed the training to be responsible for the storage, maintenance, and general oversight of epinephrine auto-injectors acquired by the authorized entity.
  • Reporting incidents to the Department of Health when epinephrine auto-injectors are used by the authorized entity.  Report an incident here.
Liability for authorized entities

An authorized entity that possesses and makes available epinephrine auto-injectors and its employees, agents, and other trained individuals; is not liable for:

  • Any injuries or related damages that result from the administration or self-administration of an epinephrine auto-injector,
  • The failure to administer an epinephrine auto-injector, or
  • Any other act or omission taken pursuant to this section.

This immunity does not apply to any acts or omissions constituting gross negligence, or willful or wanton misconduct.

This section does not eliminate, limit, or reduce any other immunity or defense that may be addressed under state law, including that provided under RCW 4.24.300.

An entity located in this state is not liable for any injuries or related damages that result from the provision or administration of an epinephrine auto-injector by its employees or agents outside of this state if the entity or its employee or agent:

  • would not have been liable for the injuries or related damages had the provision or administration occurred within this state, or
  • are (is) not liable for the injuries or related damages under the law of the state in which the provision or administration occurred.