3419P Procedure - Self-Administration of Asthma and Anaphylaxis Medication

Asthma is an inflammatory disease of the respiratory tract. Anaphylaxis is a life-threatening allergic reaction that may involve systems of the entire body. Anaphylaxis is a medical emergency that requires immediate medical treatment and follow-up care by an allergist/immunologist. 
Students with asthma or anaphylaxis are authorized, in consultation with the school’s professional registered nurse, to possess and self-administer medication for asthma or anaphylaxis during the school day, during school sponsored events, and while traveling to and from school or school sponsored activities. The student will be authorized to possess and self-administer medication if the following conditions are met:
  1. The parent or guardian must submit a written request for the student to self-administer medication for asthma or anaphylaxis;
  2. A health care practitioner has prescribed the medication for use by the student during school hours and the student has received instructions in the correct and responsible way to use the medication;
  3. The student demonstrates to the health care practitioner and a professional registered nurse at the school the skill necessary to use the medication and to use the device necessary to administer the medication;
  4. The health care practitioner provides a written treatment plan for managing the asthma or anaphylaxis episodes of the student and for use of medication during school hours. The written treatment plan should include name and dosage of the medication, frequency with which it may be administered, possible side effects, and the circumstances that warrant its use; and
  5. The parent or guardian must sign a statement acknowledging that the district will incur no liability as a result of any injury arising from the self-administration of medication by the student and that the parents or guardians will indemnify and hold harmless the district and its employees or agents against any claims arising out of the self administration of medication by the student.
  1. The authorization to self medicate will be valid for the current school year only. The parent or guardian must renew the authorization each school year.
  2. In the event of an asthma or anaphylaxis emergency, the district will have the following easily accessible:
    1. The student’s written treatment plan;
    2. The parent or guardian’s written request that the student self medicate; and
    3. The parent or guardian’s signed release of liability form.
  3. Backup medication, if provided by the parent or guardian, will be kept at a location in the school to which the student has immediate access in the event of an asthma or anaphylaxis emergency.
  4. A student’s authorization to possess and self-administer medication for asthma or anaphylaxis may be limited or revoked by the building principal after consultation with the school’s professional registered nurse and the student’s parents or guardian if the student demonstrates an inability to responsibly possess and self-administer such medication.
Asthma or Anaphylaxis Rescue Procedures
In the event of an asthma or anaphylactic episode, the school nurse will be immediately contacted. In the absence of the school nurse, the person responsible for school health duties will be contacted.
For asthma, the district will follow the procedures outlined in the most recent edition of the AMES: Asthma Management in Educational Settings, including:
  1. Managing the student’s school environment;
  2. Training school personnel in rescue procedures;
  3. Accompanying all students exhibiting symptoms;
  4. Providing care as designed in the student’s emergency care plan;
  5. Calling 911, if appropriate;
  6. Notifying the student’s parent or guardian;
  7. Documenting  interventions; and
  8. Reviewing the student’s emergency care plan and making changes, if necessary.
For anaphylaxis, the district will follow the Guidelines for the Care of Students with Anaphylaxis published by the Office of the Superintendent of Public Instruction.
Date: 10/14/08
Revised: 11/13/12