Washington State’s revised standing order now allows schools to maintain and administer stock epinephrine—including auto-injectors and intranasal options—for individuals 4 years and older experiencing anaphylaxis on school property, buses, field trips, and during off-site activities.
Key points of this updated order:
- Pharmacists may dispense epinephrine to school nurses or designated representatives.
- School nurses and trained staff may administer stock epinephrine to students with a prescription on file.
- Only school nurses may administer stock epinephrine to individuals without a prescription, based on observed symptoms and professional judgment.
While this is a critical step toward broader emergency readiness, a significant gap remains: if a student without a prescription experiences a first-time reaction and no nurse is present, staff may not legally administer epinephrine—even in a life-threatening situation. In such cases, calling 911 remains the only option. This seems to conflict with Good Samaritan Law and common expectation to help in an emergency situation. This new rule is putting school staff in a difficult position both legally and humanely.
School leaders are urged to review and update internal policies, ensure staff training, and align practices with the revised order.
