• j. Completing written documentation of the incident, detailing who administered the injection, the rationale for administering the injection, the approximate time of the injection(s), and notifications made to school administration, emergency responders, the student's parents/guardians, and the doctor or chief medical officer who issued the standing order.
  • k. Ordering replacement dose(s) of auto-injectable epinephrine.
  • l. Reviewing any incident involving emergency administration of epinephrine to determine the adequacy of response.

G. All school districts and charter schools shall report to the Arizona Department of Health Services all incidents of use of auto-injectable epinephrine pursuant to this rule in the format prescribed by the Arizona Department of Health Services.

C. Annual training in the administration of auto-injectable epinephrine.

• 1. Each school district and charter school shall designate at least two school personnel, in addition to any school nurse or athletic trainer, for each school site who shall be required to receive annual training in the proper administration of auto-injectable epinephrine in cases of anaphylactic shock pursuant to standing order.
• 2. Training in the administration of auto-injectable epinephrine shall be conducted in accordance with minimum Standard and curriculum developed by the Arizona Department of Health Services in consultation with the Arizona Department of Education.
• 3. At a minimum, training shall include procedures to follow when responding to anaphylactic shock, including direction regarding summoning appropriate emergency care, and documenting, tracking and reporting of the event.
• 4. Training shall also include Standard and procedures for acquiring a supply of at least two juvenile doses and two adult doses of auto-injectable epinephrine, restocking auto-injectable epinephrine upon use or expiration, and storing all auto-injectable epinephrine at room temperature and in secure, easily accessible locations on school sites.
• 5. Training shall be conducted by a regulated health care professional, whose competencies include the administration of auto-injectable epinephrine, including but not limited to a licensed school nurse, certified emergency medical technician or licensed athletic trainer.

F. Procedures for the administration of auto-injectable epinephrine in emergency situations.

• 1. All school districts and charters schools shall adopt procedures for the emergency administration of auto-injectable epinephrine by designated trained personnel.
• 2. Procedures shall address, at a minimum, the following requirements:
• a. Determining if symptoms indicate possible anaphylactic shock.
• b. Selecting the appropriate dosage of auto-injectable epinephrine to administer pursuant to a standing order.
• c. Injecting epinephrine via auto-injector pursuant to a standing order, noting the time and dose given.
• d. Calling 911 to advise that anaphylactic shock is suspected and epinephrine was administered. e. Keeping the person stable until emergency responders arrive.
• f. Advising school medical personnel and administration of the incident.
• g. Repeating dose pursuant to a standing order when symptoms persist and emergency responders have not arrived.
• h. Providing emergency responders with used epinephrine auto-injector labeled with name, date and time administered.
• i. Assuring that parents/guardians have been notified and advised to promptly alert student's primary care physician of the incident.

39. In consultation with the department of health services, the department of education, medical professionals, school health professionals, school administrators and an organization that represents school nurses in this state, adopt rules that prescribe the following for school districts and charter schools:
    • (a) Annual training in the administration of auto-injectable epinephrine for designated medical and nonmedical school personnel. The annual training prescribed in this subdivision is optional during any fiscal year in which a school does not stock epinephrine auto-injectors at the school during that fiscal year.
    • (b) Annual training for all school site personnel on the recognition of anaphylactic shock symptoms and the procedures to follow when anaphylactic shock occurs, following the national guidelines of the American academy of pediatrics. The annual training prescribed in this subdivision is optional during any fiscal year in which a school does not stock epinephrine auto-injectors at the school during that fiscal year.
    • (c) Procedures for the administration of epinephrine auto-injectors in emergency situations.
    • (d) Procedures for annually requesting a standing order for epinephrine auto-injectors pursuant to § 15-157 from the chief medical officer of the department of health services, the chief medical officer of a county health department, a doctor of medicine licensed pursuant to title 32, chapter 13 or a doctor of osteopathic medicine licensed pursuant to title 32, chapter 17.
    • (e) Procedures for reporting the use of epinephrine auto-injectors to the department of health services.

34. Prescribe and enforce policies and procedures:

    • (a) Allowing pupils who have been diagnosed with anaphylaxis by a health care provider licensed pursuant to title 32, chapter 13, 14, 17 or 25 or by a registered nurse practitioner licensed and certified pursuant to title 32, chapter 15 to carry and self-administer emergency medications, including epinephrine, auto-injectors while at school and at school-sponsored activities. The pupil’s name on the prescription label on the medication container or on the medication device and annual written documentation from the pupil’s parent or guardian to the school that authorizes possession and self-administration is sufficient proof that the pupil is entitled to the possession and self-administration of the medication. The policies shall require a pupil who uses an epinephrine auto-injector while at school and at school-sponsored activities to notify the nurse or the designated school staff person of the use of the medication as soon as practicable. A school district and its employees are immune from civil liability with respect to all decisions made and actions taken that are based on good faith implementation of the requirements of this subdivision, except in cases of wanton or wilful neglect.