Emergency Use of Naloxone (Narcan) and Epinephrine Auto-Injectors
Policy 6-103
Scope:
The District is authorized to obtain, maintain, and administer stock naloxone hydrochloride (Narcan) and epinephrine auto-injectors for use in emergency situations. The District shall maintain these emergency medications in the main office at each school site, in a secure but readily accessible location known to trained personnel.
The Superintendent or designee shall ensure that designated staff receive training consistent with state law and that emergency medications are stored, maintained, and administered in accordance with applicable legal requirements.
Definitions:
1. Naloxone Hydrochloride (“naloxone”) / Narcan: An opioid antagonist used to reverse the effects of an opioid overdose.
2. Epinephrine Auto-Injector: A device used to treat anaphylaxis.
3. Designated Personnel: School employees who have volunteered and been trained to administer emergency medications under Education Code requirements.
Administrative Regulations
1. Naloxone (Narcan) Program
Authorization
The District may obtain and maintain stock naloxone for school nurses or volunteer trained personnel to use in responding to a suspected opioid overdose.
Designated Personnel and Training
The District must distribute notice once per school year to all staff that includes the following:
a. A description of the volunteer request which is for volunteers to be trained to administer naloxone or other opioid antagonist;
b. A description of the training the volunteer will receive; and
c. A statement that no benefit will be granted or withheld based on an employee’s offer to volunteer. A statement that there will be no retaliation against any employee for rescinding their offer to volunteer.
Any employee who voluntarily agrees to be trained may administer naloxone in accordance with applicable training.
The Education Code does not require a minimum number of trained personnel.
Training must be provided by the school nurse or other qualified person designated by an authorizing physician and surgeon. The training must be based on the standards developed by the Superintendent of Public Instruction (“SPI”).
Training shall include:
a. Recognition of symptoms of opioid overdoes.
b. Standards and procedures for storage and restocking.
c. Emergency administration of naloxone or other opioid antagonist.
d. Emergency follow-up procedures including calling 911 and contacting the pupil’s parent/guardian.
e. Recommendation on the necessity of instruction and certification in cardiopulmonary resuscitation.
f. Written materials covering this information. Each school site must retain these written materials for reference.
Training must be completed before a volunteer may administer naloxone.
Storage
Naloxone shall be stored in the main office at each school site in a secure, temperature-appropriate, and readily accessible location.
Emergency Response Procedures
When an opioid overdose is suspected, staff shall immediately contact 911.
Trained personnel may administer naloxone following approved training protocols.
a. Volunteers may only administer naloxone by nasal spray or auto-injector, whichever they are most comfortable with.
The individual shall be monitored until emergency medical services arrive.
The site administrator and the Superintendent or designee shall be notified.
For students, parents/guardians shall be notified as soon as practicable.
Disposal and Replacement
Used or expired naloxone shall be disposed of in accordance with medical waste regulations.
Disposal shall be documented including date, method, and lot information.
Replacement medication shall be ordered promptly, but not later than two weeks after it is used.
Naloxone must be restocked prior to its expiration.
Student Use
Pursuant to Education Code § 49414.6, the District will not prohibit students in middle schools, junior high schools, high schools, or adult schools from carrying a federally approved opioid antagonist for over the counter use for the emergency treatment of persons suffering or reasonably believed to be suffering from an opioid overdoes while on a school site or participating in school activities.
Pursuant to Education Code § 49414.35, the District will not prohibit a student 12 years or older from carrying or administering Naloxone or another opioid antagonist for purposes of providing emergency treatment to persons suffering or are reasonably believed to be suffering from an opioid overdoes while on a school site or participating in school activities.
2. Emergency Epinephrine Auto-Injector Program
Authorization
The District shall obtain and maintain stock epinephrine auto-injectors for school nurses or other employees who have volunteered and have received the required training to use during anaphylactic emergencies.
Notice and Staffing
The District must distribute notice once per school year to all staff that includes the following:
a. A description of the volunteer request which is for volunteers to be trained to administer epinephrine;
b. A description of the training the volunteer will receive; and
c. The location of the epinephrine at each school site.
The District shall make reasonable efforts to ensure trained volunteers are available during school-sponsored events, extracurricular activities, and off-campus programs.
Training Requirements
Training must be provided by the school nurse or other qualified person designated by an authorizing physician and surgeon. The training must be based on the standards developed by the Superintendent of Public Instruction (“SPI”).
Training shall include:
a. Recognition of anaphylaxis.
b. Standards and procedures for storage and restocking epinephrine.
c. Emergency administration of epinephrine.
d. Instruction on determining which epinephrine auto-injector to use.
e. Emergency contact procedures.
f. Recommendations on the necessity of instruction and certification in cardiopulmonary resuscitation.
g. Written materials covering this information. Each school site must retain these written materials for reference and make them accessible such as through positing them at the location of the epinephrine auto-injectors.
h. Annual recertification is required.
Storage
Epinephrine auto-injectors shall be stored in the main office at each school site in a secure, clearly labeled, and accessible location.
Emergency Response Procedures
When anaphylaxis is suspected, staff shall immediately contact 911.
A school nurse or trained volunteers may administer epinephrine consistent with their training.
The individual shall be monitored until emergency medical services arrive.
The site administrator and Superintendent or designee shall be notified.
Parents/guardians shall be notified for student incidents.
Disposal and Replacement
Used or expired auto-injectors shall be disposed of as medical waste in accordance with local and state regulations.
Disposal shall be documented including date, device, and method.
Replacement devices shall be restocked promptly, but not later than two weeks after it is used.
Replacement devices shall be restocked before their expiration date.
Student Use
In order for a student to carry and self-administer a prescription epinephrine delivery system the District will comply with the requirements of Education Code § 49423 and all other applicable law.
3. Liability Protections
District employees, and to the extent applicable students, who administer naloxone or epinephrine auto-injectors in good faith and in accordance with training and this policy are afforded liability protection under Education Code §§ 49407, 49414, 49414.3, and 49414.35.
4. Program Oversight
The Superintendent or designee shall:
Ensure compliance with applicable laws;
Maintain training records;
Monitor and replace medication inventories; and
A qualified supervisor of health must obtain a prescription for each school site for epinephrine auto-injectors from an authorizing physician and surgeon that include the appropriate doses for the ages and weights of the pupils at the school site.
A qualified supervisor of health must obtain a prescription for each school site for naloxone hydrochloride from an authorizing physician and surgeon.
Oversee reporting and documentation requirements.