Arizona Administrative Code
Title 7 - EDUCATION
Chapter 2 - STATE BOARD OF EDUCATION
Article 8 - COMPLIANCE
Section R7-2-810 - Emergency Administration of Inhalers
Universal Citation: AZ Admin Code R 7-2-810
Current through Register Vol. 30, No. 38, September 20, 2024
A. Applicability. This rule applies to:
1. Any school district or charter school that
voluntarily chooses to stock inhalers pursuant to A.R.S §
15-158.
2. All school districts when required to
stock inhalers pursuant to A.R.S. §
15-158.
B. Definitions. The following definitions are applicable to this rule:
1. "Authorized
Entity" refers to any school district or charter school.
2. "Bronchodilator" means Albuterol or
another short-acting bronchodilator that is approved by the United States Food
and Drug Administration for the treatment of respiratory distress.
3. "Inhaler" means a device that delivers a
bronchodilator to alleviate symptoms of respiratory distress that is
manufactured in the form of a metered-dose inhaler or dry-powder inhaler that
includes a spacer or holding chamber that attaches to the inhaler to improve
the delivery of the bronchodilator.
4. "Personnel" means employees at a school
district or charter school or nurses who are under contract with the school
district or charter school.
5.
"Respiratory distress" includes the perceived or actual presence of coughing,
wheezing or shortness of breath.
6.
"Standing order" means a prescription protocol or instructions issued by the
chief medical officer of a county health department, physicians licensed
pursuant to Title 32, Chapter 13, 14 or 17, or nurse practitioners licensed
pursuant to Title 32, Chapter 15.
C. Annual training on recognition of symptoms of respiratory distress and administration of inhalers:
1. Each school district and charter school
that elects to administer inhalers shall designate at least two personnel at
each school site who shall be required to be trained in the recognition of
respiratory distress symptoms, the procedures to follow when respiratory
distress occurs, and the administration of inhalers, as directed on the
prescription protocol. While each school is required to have two trained
personnel in order to implement the stock inhaler policies, schools may train
as many personnel as they feel necessary.
2. Training in the administration of inhalers
shall be conducted by a nationally recognized organization or professionally
certified medical professionals that are experienced in training laypersons in
emergency health treatment.
3.
Training may be conducted online or in person and at a minimum shall include:
a. How to recognize signs and symptoms of
respiratory distress in accordance with good clinical practice.
b. Standards and procedures for the storage
of inhalers.
c. Standards and
procedures for the administration of an inhaler, as directed on the
prescription protocol.
d. If
necessary, emergency follow-up procedures after the administration of an
inhaler.
4. The
organization that conducts the training shall issue a certificate to each
person who successfully completes the training. The personnel shall submit this
certificate to the school.
5. Annual
training is required for all designated personnel of the school.
6. School districts and charter schools shall
maintain and make available on request a list of school personnel who are
authorized to administer inhalers pursuant to a standing
order.
D. Procedures for annually requesting a standing order and the prescription for the inhaler and holding chamber
1. Each participating school
district or charter school shall obtain a standing order and prescription for
inhalers and spacers or holding chambers pursuant to A.R.S. §
15-158
from the chief medical officer of a county health department, a physician
licensed pursuant to Title 32, Chapter 13, 14 or 17, or a nurse practitioner
pursuant to Title 32, Chapter 15.
2.
Standing orders and prescriptions shall be requested and renewed
annually.
E. Procedures for the administration of inhalers in emergency situations:
1. School districts and charter schools that
elect to administer inhalers shall:
a.
Prescribe and enforce policies and procedures for the emergency administration
of inhalers by designated and trained medical and non-medical
personnel.
b. Designate at least two
personnel at each school to be trained to recognize respiratory distress and
administer inhalers.
c. Require
designated personnel to participate in annual training and provide a
certificate of successful completion to the school.
d. Designate personnel who have completed the
required training to be responsible for the storage, maintenance, control and
general oversight of the inhalers and spacers or holding chambers acquired by
the school.
e. Acquire and stock a
supply of inhalers and spacers or holding chambers pursuant to a standing order
prescription.
f. Store medication in
a secure, temperature appropriate location, unlocked and readily accessible to
designated personnel.
2.
Pursuant to a standing order, school district or charter school personnel who
are trained in the administration of inhalers may administer or assist in the
administration of an inhaler to a pupil or adult whom the personnel believes in
good faith to be exhibiting symptoms of respiratory distress while at school or
a school-sponsored activity.
3.
Procedures adopted by school districts and charter schools shall address at a
minimum, the following requirements:
a.
Determine if symptoms indicate possible respiratory distress or emergency and
determine if the use of an inhaler will properly address the respiratory
distress or emergency.
b. Administer
the correct dose of inhaler medication, as directed by the prescription
protocol, regardless of whether the individual who is believed to be
experiencing respiratory distress has a prescription for an inhaler and spacer
or holding chamber or has been previously diagnosed with a condition requiring
an inhaler.
c. Restrict physical
activity, encourage slow breaths and allow the individual to rest.
d. Assure that trained personnel stay with
the subject who has been administered inhaler medication until it is determined
whether the medication alleviates symptoms.
e. If applicable, instruct office staff to
notify the school nurse if the inhaler is administered by a trained but
non-licensed person.
f. Instruct
school staff to notify the parent or guardian.
g. Call 911 if severe respiratory distress
continues. Advise that inhaler medication was administered and stay with the
person until emergency medical responders arrive.
h. If the individual shows improvement, keep
the individual under supervision until breathing returns to normal, with no
more chest tightness or shortness of breath, and the individual can walk and
talk easily.
i. Allow a student to
return to class if breathing has returned to normal and all symptoms have
resolved.
j. Notify a parent or
guardian once the inhaler has been administered and the student has returned to
class.
k. Document the incident
detailing who administered the inhaler, the approximate time of the incident,
notifications made to the school administration, emergency responders, and
parents/guardians.
l. Retain the
incident data on file at the school pursuant to the general records retention
schedule regarding health records for school districts and charter schools
established by the Arizona State Library, Archives and Public
Records.
m. Order replacement
inhalers, spacers and holding chambers as needed.
4. A school district or charter school may
accept monetary donations for or apply for grants for the purchase of inhalers
and spacers or holding chamber or may accept donations of inhalers and spacers
or holding chambers directly from the product
manufacturers.
F. Immunity from civil liability is prescribed in A.R.S. § 15-158.
Disclaimer: These regulations may not be the most recent version. Arizona may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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