Brockton Public Schools

School Committee Policy

ADMINISTRATION OF EPINEPHRINE REGULATIONS - JLCD-R

A school or school district may register with the Department for the limited purpose of permitting properly trained school personnel to administer epinephrine by auto injector in a life-threatening situation, when a school nurse is not immediately available, provided that the following conditions are met:

1. The School Committee or, in the case of a private school, the chief administrative officer, approves policies developed by the school nurse governing administration of epinephrine by auto injector, and renews approval every two years.
2. The School Committee or chief administrative officer provides an assurance to the Department that sufficient school nurses are available to provide proper oversight of the program, and provides such back-up documentation as required by the Department.
3. In consultation with the school physician, the school nurse manages and has final decision-making authority about the program and selects the persons authorized to administer epinephrine by auto injector.

4. The school personnel authorized to administer epinephrine by auto injector are trained by a physician or school nurse, and tested for competency, in accordance with the standards and a curriculum established by the Department.

   1. The school nurse shall document the training and testing of competency.
   2. The school nurse shall provide a training review and informational update at least twice a year.

   3. The training, at a minimum, shall include:

      1. Proper use of the device
      2. The importance of consulting and following the medication administration plan
      3. Recognition of the symptoms of a severe allergic reaction
      4. Requirements for proper storage and security, notification of appropriate persons following administration, and record keeping
   4. The school shall maintain and make available upon request by parents or staff a list of those school personnel authorized and trained to administer epinephrine by auto injector in an emergency, when the school nurse is not immediately available.

5. Epinephrine shall be administered only in accordance with a medication administration plan satisfying the applicable requirements of 105 CMR 210.005(E) and 210.009 (A) (6), updated every year, which includes the following:

   1. A diagnosis by a physician that the child is at high risk of a life threatening allergic reaction, and a medication order containing indications for administration of epinephrine.
   2. Written authorization by a parent or guardian.
   3. home and emergency number for the parents, as well as the name(s) and phone number(s) of any other person(s) to be notified if the parents are unavailable.
   4. Identification of places where the epinephrine is to be stored, following consideration of the need for storage at places where the student may be most at risk. The epinephrine may be stored at more than one location or carried by the student when appropriate.
   5. Consideration of the ways and places epinephrine can be stored so as to limit access to appropriate persons, which shall not require the epinephrine to be under lock and key.
   6. A list of the school personnel who would administer the epinephrine to the student in a life-threatening situation.
   7. A plan for risk reduction for the student, including a plan for teaching self-management, where appropriate.
6. When epinephrine is administered, there shall be an immediate notification of the local emergency medical services system (generally 911), followed by notification of the school nurse, student's parents or, if the parents are not available, any other designated person(s), and the student's physician.

7. There shall be procedures, in accordance with any standards established by the Department, for:

   1. Developing the medication administration plan.
   2. Properly storing medication, including limited access to persons authorized to administer the medication and returning unused or outdated medication to a parent or guardian whenever possible;
   3. Recording receipt and return of medication by the school nurse.
   4. Documenting the date and time of administration.
   5. Notifying appropriate parties of administration.
   6. Reporting medication errors in accordance with 105 CMR 210.005 (F) (5)
   7. Reviewing any incident involving administration of epinephrine to determine the adequacy of the response and to consider ways of reducing risks for the particular student and the student body in general.
   8. Planning and working with the emergency medical system to ensure the fastest possible response.
8. The Department of Public Health is permitted to inspect any record related to the administration of epinephrine without prior notice, to ensure compliance with 105 CMR 210.100.