(b) Any pupil, who is required to take during the school day a medication prescribed by a licensed physician, advanced registered nurse practitioner, licensed physician's assistant or dentist, shall have a school nurse either assist the student to take the medication or administer the medication.

(c) This duty may also be undertaken by a RN or LPN under the direction of the school nurse.

(d) The school nurse may delegate the administration of medications, if appropriate to others pursuant to RSA 326-BNurse Practice Act and Nur 404.

(e) Asthma inhalers and epinephrine auto injectors may be possessed by a student and self-administered in accordance with RSA 200:42 through RSA 200:47.

(f) If the school nurse is not available the building principal or designee may assist students in taking required medications by:

• (1) Making such medications available to the student as needed;

• (2) Observing the student as he/she takes or does not take his/her medication; and

• (3) Recording whether the student did or did not take his/her medication.

A pupil may possess and use a metered dose inhaler or a dry powder inhaler to alleviate asthmatic symptoms, or before exercise to prevent the onset of asthmatic symptoms, if the following conditions are satisfied:

I. The pupil has the written approval of the pupil's physician and, if the pupil is a minor, the written approval of the parent or guardian. The school shall obtain the following information from the pupil's physician:

• (a) The pupil's name.

• (b) The name and signature of the licensed prescriber and business and emergency numbers.

• (c) The name, route, and dosage of medication.

• (d) The frequency and time of medication administration or assistance.

• (e) The date of the order.

• (f) A diagnosis and any other medical conditions requiring medications, if not a violation of confidentiality or if notcontrary to the request of the parent or guardian to keep confidential.

• (g) Specific recommendations for administration.

• (h) Any special side effects, contraindications, and adverse reactions to be observed.

• (i) At least one emergency telephone number for contacting the parent or guardian.

• (j) The name of each required medication.

II. The school principal or, if a school nurse is assigned to the pupil's school building, the school nurse shall receive copies of the written approvals required by paragraph I.

III. The pupil's parent or guardian shall submit written verification from the physician confirming that the pupil has the knowledge and skills to safely possess and use an asthma inhaler in a school setting.

IV. If the conditions provided in this section are satisfied, the pupil may possess and use the inhaler at school or at any school sponsored activity, event, or program.

V. In this section, “physician” includes any physician or health practitioner with the authority to write prescriptions.

I. A school nurse and designated unlicensed assistive personnel may administer or make available to self-administer a bronchodilator, spacer, or nebulizer to a student who has been diagnosed with asthma for use in emergency or other situations as determined by the school nurse provided that:

• (a) The school has on file an asthma action plan for the student which shall be filed annually and updated as necessary with the school and includes an order from the student’s health care provider to provide the student with an asthma rescue inhaler, including dosage information and permission for the student to use the school’s stock in the event of an emergency; and

• (b) The student’s parent/guardian has provided written permission to the school nurse to administer a bronchodilator, spacer, or nebulizer from the school’s supply.

II. The school nurse shall notify the student’s parent or legal guardian whenever a bronchodilator, spacer, or nebulizer from the emergency stockpile is administered to a student. The school nurse shall make the notification as soon as practicable in accordance with the contact information on file at the school.