1. “Saving Lives of Students and Staff:
The New West Virginia Epinephrine Law/Rule
Rebecca King MSN, MEd, RN, NCSN
School Nurse Liaison/504 Coordinator WVDE-Office of Special Programs

2. Congratulations to
WV School Nurses

3. West Virginia Status and Stats

4. Top 5 Medical Diagnoses/Procedures
2010/11 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

6. WHY are increases in Allergies occurring in WV?
Students
Environment (art material, etc.)
School programs
Etc.

8. System Response to Severe Allergy
Allergen
MADGE
Immunoglobin E
Hypotension
Bradycardia
Vasoconstriction of Respiratory System
Epinephrine (adrenaline)
to the RESCUE

9. Epinephrine/Adrenaline

10. Harm vs. Help
Temporary relief due to short half-life of 2-3 minutes for epinephrine.
Hence a rebound effect and need to call or possibly administer another dose.
Restore blood pressure, heart rate and respiratory status

11. States with Laws allowing Stock Epinephrine in Schools

12. 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.

13. Passage of Epinephrine Law or W.Va. §18-5-22c
Signed by Governor with effective date of July 8, 2013

14. 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 Medication Administration
Public comment period ended on November 12, 2013
Request for approval will be at the December 11-12, 2013 State Board meeting

15. What does this mean to me?

16. 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.

17. 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.

18. Education and Training in Anaphylaxis and Epinephrine by the School Nurse(s)

19. Doses and Half Life Doses: 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.

20. 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 or possibly administer another dose.
Restore blood pressure, heart rate and respiratory status

21. Objective #2:
Participants will learn about the storage and reporting of epinephrine use in schools.

22. 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.

23. Reporting
West Virginia Poison Center at

24. West Virginia Poison Center
Report each reaction resulting in the administration of epinephrine injections to the West Virginia Poison Center by calling after emergency medical services have transported the student or staff member to acute care.

25. 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,…

26. 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).

27. Objective #3:
Participants will be familiar with EpiPen4Schools Program offered through Mylan Pharmaceutical.

28. Cost to Schools

29. EpiPen4Schools Program
Go to 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)

30. No more than two 2-Pak Units per school

31. 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.

32. NEW Auvi-Q School Discount Program
How?
OR Call: (855) for an application

33. QUESTIONS?

34. TOGETHER we can save lives!

35. Rebecca King WVDE-Coordinator School Health, Section 504 and Coordinated School-Public Health