Virginia students have been permitted to carry and self-administer inhaled asthma medications in schools since 2000. When Virginia passed the law allowing them to do so, it also passed a law that stating that any school principal or employee who supervised a student’s use of an asthma inhaler would be shielded from civil liability (meaning that they will be protected from lawsuits) as long as the employee acted in good faith, was not grossly negligent, and did not engage in willful and wanton misconduct.
Virginia started allowing students with anaphylaxis to carry auto-injectable epinephrine in schools five years later, in 2005.
Before long, legislators realized that there was a gap in the statute because, although Virginia allowed students to self-administer epinephrine, it did not allow school employees to administer epinephrine to students in the event of a medical emergency. Nor did it shield school employees who administered epinephrine to students from civil liability, which legislators feared might prevent them from providing life-saving medical treatment to students in need.
As a result, in 2012, the General Assembly passed legislation allowing school nurses and employees1 to administer epinephrine to students provided that:
- a physician had prescribed the epinephrine to the student
- the employee had been trained how to administer epinephrine
- the employee was not grossly negligent.
The following year, in 2013, the General Assembly declared that every school should have epinephrine on-site and at least one person at the school who has been trained how to administer epinephrine to any student believed to be having an anaphylactic reaction. Two years later, in 2015, the General Assembly extended these requirements to schools for students with disabilities as well.
As with asthma medications, school nurses and employees who administer epinephrine to students will not be subjected to civil liability unless they are grossly negligent.2 This is consistent with Virginia’s Good Samaritan Law, which states that anyone who administers epinephrine in an emergency to an individual that they believe is suffering (or is about to suffer) a life-threatening anaphylactic reaction cannot be held liable for civil damages arising from their negligence.
Today, Virginia law allows students to carry and self-administer these medications during the school day, at school-sponsored activities, or while on a school bus or other school property, provided that:
- The parent has given written consent for their child to do so.
- The student’s treating physician or licensed nurse practitioner provides written notice that
- identifies the student
- states that the student has a diagnosis of asthma or anaphylaxis, or both, and has approval to self-administer the medications
- specifies the name and dosage of the medication, the frequency with which it is to be administered, and the circumstances which might warrant their use (such as before exercising or engaging in physical activity to prevent the onset of asthma symptoms or to alleviate asthma symptoms after the onset of an asthma episode)
- attests that the student is able to safely and effectively self-administer the medications.
- The student has an individualized health care plan (IHC) that outlines emergency procedures for any life-threatening conditions.
- The school consults with the student’s parent before imposing any limitations or restrictions upon, or revoking, their child’s ability to possess and self-administer the medications.
The number of school children who need access to auto-injectable epinephrine is on the rise. Fortunately, in Virginia, legislators have enacted legislation in an effort to keep pace with the rising need.
Footnotes
- The following year, in 2013, the legislature added local government and health department employees to the list of individuals allowed to administer epinephrine to students having an allergic reaction. Va. Code Ann. § 22.1-274.2 (2013).
- Va. Code Ann. § 8.01-274.2 (2019)
