California Education Code (EC) Section 49414, as amended by Senate Bill 1266, effective January 1, 2017, requires school districts to provide emergency epinephrine auto-injectors to school nurses or trained personnel who have volunteered, and provides that school nurses or trained personnel who have volunteered may use epinephrine auto-injectors to provide emergency medical aid to persons suffering or reasonably believed to be suffering from an anaphylactic reaction.
Anaphylaxis is a potentially life-threatening hypersensitivity to a substance. The reaction can occur within seconds or minutes of encountering an allergic trigger, including but not limited to an insect sting, food allergy, drug reaction (e.g., antibiotics, aspirin and non-steroidal inflammatory drugs), and exercise.
Provide Epinephrine auto-injector pens at every school:
All schools must stock at least one (1) epinephrine auto-injector pen and one (1) epinephrine auto-injector pen junior at each school. A qualified supervisor of health at a school district, county office of education, or charter school shall obtain from an authorizing physician and surgeon a prescription for each school for epinephrine auto-injectors that, at a minimum, includes, for elementary schools, one regular epinephrine auto-injector and one junior epinephrine auto-injector, and for junior high schools, middle schools, and high schools, if there are no pupils who require a junior epinephrine auto-injector, one regular epinephrine auto-injector.
A qualified supervisor of health at a school district, county office of education, or charter school shall be responsible for stocking the epinephrine auto-injector and restocking it if it is used.
Orders for free stock can be placed on the EpiPen Website. Regularly review expiration dates and submit any requests for replacement.
Storage and Disposal:
Used Epinephrine Auto-Injectors Disposal: Empty Epinephrine Auto-Injectors that have been dispensed in the care of a patient may be disposed of as regular medical waste, that is, placed in a Sharps container or a medical red bag.
Unused EpiPen Disposal: Unused Epinephrine Auto-Injectors that contain only epinephrine salt as the active ingredient may also be disposed of as medical waste.
A school district, county office of education, or charter school shall distribute a notice at least once per school year to all staff that contains; a description of the volunteer request stating that the request is for volunteers to be trained to administer an epinephrine auto-injector to a person if the person is suffering, or reasonably believed to be suffering, from anaphylaxis, as specified, and a description of the training that the volunteer will receive pursuant to California Education Code (EC) Section 49414.
The National Association of School Nurses (NASN) has compiled the checklists, trainings and other resources.
A school district, county office of education, or charter school shall conduct initial training and annual refresher training, pursuant to California Education Code (EC) Section 49414, for all identified volunteers. A free EpiPen training video from Mylan Pharmaceuticals is available on YouTube.
The National Association of School Nurses (NASN) has prepared guidance and template documents including training packets.