Districts encouraged to carry epinephrine, naloxone in schools

A sign of the changing times, schools now have the legal clearance to administer naloxone and epinephrine, as concerns over opioid use have grown and schools are seeing increased numbers of those with allergies.

“It is not required by KDE,” said Ed McKinney, director of pupil personnel for the district during a board of education meeting July 24. “KDE has been very encouraging of districts to accept (policy changes).

“I know our board has had issues in the past with liability and how that would be administered. The Narcan is less of an issue because medical professionals will tell you if you administer Narcan to someone you suspect is having an opioid overdose, there is no negative consequence if they are not.”

Administering epinephrine is a slightly different case, he said.

“It does have some consequences that need to be considered,” McKinney said. But, explained that there are more and more cases each year of students and adults with allergies.

“Whether we diagnose them better or there are truly more allergies, I don’t know,” he said.

Trainings are required before either can be administered, according to statute.

Kentucky Revised Statute 158.836 gives schools the right to keep epinephrine on the premises, and use that, in the case of a student having anaphylaxis or for a student who has asthma. The statute gives the students permission to carry the medication if they are at risk and stipulates that any school employee who will administer the medication much be trained.

The statute also alleviates the employee of liability if they use the medicine “in good faith” on a student believed to be having an allergic or anaphylactic reaction.

KRS 217.186 authorizes schools to keep and administer naloxone if the boards so choose, along with certain other agencies. It also stipulates the board, in collaboration with their local health department and health providers, should develop protocols for administering the medication.

The Boyle County Schools implemented their policies last August, allowing naloxone to be kept in middle and high schools, as well as keeping epinephrine auto-injectors stocked in.

“The same people are trained to use both,” said Pam Tamme, district health coordinator for the Boyle County Schools. 

There are a few designated to provide the service at each school, and they receive yearly training, she said. They also can provide help for students having issues with diabetes and those suffering from seizures.

“There are a minimum of two people trained at each school,” Tamme said.

They wanted to train more than that, in case of an emergency.

Epinephrine auto-injectors are not new to the district, she said. They’ve been in the school for a few years now.

“You don’t know when someone’s going to have their first allergic reaction,” Tamme said.

McKinney talked to the board about how important adding the policy could be for a student, especially regarding epinephrine.

“It’s something that’s out there that could prevent a tragedy. If you know it’s out there, it’s hard to not have that available,” he said. “The risk — with Epi pens — with someone who’s not having an allergic reaction, I don’t think outweigh the benefit of having them on hand.”

The districts that enact the two policies can choose which schools carry naloxone, but that there should be at least two doses in separate places in the school. Districts are are encouraged to keep two epinephrine doses of adult and child at every school in the district.

Keith Look, superintendent of the Danville Schools, said one of those locations would likely be the cafeteria and they would encourage staff to be trained in using the epinephrine.

“That’s the most likely place for an allergic reaction,” he said.

They also told the board they plan to train enough people in each building that it would be “unlikely” that there would ever be an occasion where a trained staff member couldn’t be found.

“We don’t want to train anyone who is not comfortable,” McKinney said. “We would love to have as many as we can — the more the merrier.”

The Danville board held a first reading on the policies at the July 24 meeting, but asked McKinney to do a little more research in where epinephrine and naloxone had to be available — whether they had to be at any school event, such a football game. McKinney said he believed they were only to be kept at the schools, not at the fields or on field trips. He also pointed out that any child with a doctor’s prescription to carry epinephrine would likely have that with them on said trips.

SO YOU KNOW

To learn more about the Kentucky Department of Education’s policies regarding naloxone and epinephrine, visit bit.ly/2tQdztT.

To learn more about KRS 217.186, visit bit.ly/2v5b8n0; or KRS 158.836, visit bit.ly/2h8WiWO.