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Rebecca King MSN, MEd, RN, NCSN
School Nurse Liaison/504 CoordinatorWVDE-Office of Special Programs
“Saving Lives of Students and Staff:
The New West Virginia Epinephrine Law/Rule
Congratulations to WV School Nurses
West Virginia Status and Stats
Top 5 Medical Diagnoses/Procedures2010/11 School Nurse Needs Assessment
Medical Diagnoses In-School Specialized Health Care Procedures
Asthma Inhalers for Asthma
Behavioral Disorders Emergency Medications
Anaphylactic Reaction Long-Term Medications
Obesity Special Diets per Federal Form
Mental Disorders (Depression, Bipolar, Schizophrenic, Suicidal)
Seizure Management
Close 5th places…..Ear, Nose and Throat/Migraine or Severe Headache/Seizures
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
238 8522147
4213
11491
16145
2010/11 Student Medical Diagnoses
Series1
WHY are increases in Allergies occurring in WV?
• Students• Environment (art material, etc.)• School programs• Etc.
System Response to Severe Allergy
Allergen
MADGE
Immunoglobin E
HypotensionBradycardia
Vasoconstriction of Respiratory System
Epinephrine (adrenaline)
to the RESCUE
Epinephrine/Adrenaline
Harm vs. Help
• Temporary relief due to short half-life of 2-3 minutes for epinephrine.
• Hence a rebound effect and need to call 9-1-1 or possibly administer another dose.
• Restore blood pressure, heart rate and respiratory status
States with Laws allowing Stock Epinephrine in Schools
Objective #1:
Participants will learn about the new W.Va. law and WV State Board of Education Rule on the county option of stock epinephrine for undiagnosed students and staff.
Passage of Epinephrine Law or W.Va. §18-5-22c
Signed by Governor with effective date of July 8, 2013
Status of State Board Medication Administration Policy
• Incorporated into WV State Board of Education Rules by the WV Council of School Nurses through WVBE Policy 2422.8-Medication Administration
• Public comment period ended on November 12, 2013
• Request for approval will be at the December 11-12, 2013 State Board meeting
What does thismean to me?
County Boards have the OPTION of Stock Epinephrine Policy
• County Boards of Education will have OPTION to develop medication policies allowing stock epinephrine.
• Administered under the prescription and standing orders of a MD or DO to students and school personnel who are experiencing signs and symptoms of severe allergic reactions/anaphylactic shock without prior diagnoses.
County Boards have the OPTION of Stock Epinephrine Policy
The training and delegation of administering epinephrine will be done by SCHOOL NURSES with delegation and assignment to other nurses (registered nurses and licensed practical nurses) and designated qualified personnel (teachers at will, aides and secretaries) working in the school system.
Education and Training in Anaphylaxis and Epinephrine
by the School Nurse(s)
Doses and Half LifeDoses:• Epinephrine 0.15 mg for weight of 33 pounds to 66 pounds
• Epinephrine 0.3 mg for weight of 66 pounds or greater
Half Life:The plasma half-life is about 2-3 minutes.
Concerns of Harm?• Benefits definitely outweigh any minimal risk factors.
• Temporary relief due to short half-life of 2-3 minutes for epinephrine.
• Hence a rebound effect and need to call 9-1-1 or possibly administer another dose.
• Restore blood pressure, heart rate and respiratory status
Objective #2:
• Participants will learn about the storage and reporting of epinephrine use in schools.
Storage
Schools shall maintain epinephrine auto-injectors in a SECURE, unlocked, location, which is only accessible to school nurses, health care providers and authorized nonmedical personnel and not by students.
Reporting
West Virginia Poison Center at http://www.wvpoisoncenter.org/Default.aspx.
West Virginia Poison Center
Report each reaction resulting in the administration of epinephrine injections to the West Virginia Poison Center by calling 1-800-222-1222 after emergency medical services have transported the student or staff member to acute care.
Poison Center Reporting Information
The notification should include the name of the student, the student’s age and gender, date and the approximate time the incident occurred, symptoms observed, who administered the injection, the name of the school the student attends,…
Continued…
a contact telephone number, the rational for administering the injection, the response to the epinephrine administration, the dose of epinephrine administered and any other necessary elements to provide a complete report for the individual situation (templates will be provided to schools).
Objective #3:
• Participants will be familiar with EpiPen4Schools Program offered through Mylan Pharmaceutical.
Cost to Schools
EpiPen4Schools Program
• Go to http://www.epipen4schools.com/ and follow the directions.
• Download order application form for FREE EpiPens– You will need a prescription from a
MD or DO (your designated medical consultant)
No more than two 2-Pak Units per school
Next steps…
• After you have completed the steps above, BioRidge Pharma will find a pharmacy near your school that is able to fill the prescription and forward a copy of your valid prescription to the pharmacy. All orders will be shipped directly to your school.
NEW Auvi-Q School Discount Program
How?
Email: [email protected]
OR
Call: (855) 722-8847 for an application
QUESTIONS?
TOGETHER we can save lives!
Rebecca King
WVDE-Coordinator
School Health, Section 504 and
Coordinated School-Public Health
304.558.8830
