Highline Public Schools
15675 Ambaum Blvd. SW Burien, WA 98166

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Highline Public Schools
15675 Ambaum Blvd. SW Burien, WA 98166

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I. Students with asthma are authorized, in consultation with the school’s professional registered nurse, to possess and self-administer medication for asthma or anaphylaxis during the school day, during school sponsored events or while traveling to and from school or school sponsored activities. The student shall be authorized to possess and self-administer medication if the following conditions are met.

A. The parent or guardian must submit a written request for the student to self-administer medication(s) for asthma or anaphylaxis on a HPS Medication Authorization form;

B. A health care practitioner has prescribed the medication for use by the student during school hours and the student has received instructions in the correct and responsible way to use the medication(s);

C. The student demonstrates to the health care practitioner and a professional registered nurse at the school the skill necessary to use the medication and to use the device necessary to administer the medication;

D. The health care practitioner provides a written treatment plan for managing the asthma or anaphylaxis episodes of the student and for use of medication during school hours. The written treatment plan should include name and dosage of the medication, frequency with which it may be administered, possible side effects and the circumstances that warrant its use;

E. The parent or guardian must sign a statement acknowledging that the district shall incur no liability as a result of any injury arising from the self-administration of medication by the student and that the parents or guardians shall indemnify and hold harmless the district and its employees or agents against any claims arising out of the self administration of medication by the student.

II. The authorization to self medicate will be valid for the current school year only. The parent or guardian must renew the authorization prior to attending each school year.

III. In the event of an asthma or anaphylaxis emergency, the district shall have the following easily accessible:

A. The student’s written treatment plan;

B. The parent or guardian’s written request that the student self medicate; and

C. The parent or guardian’s signed release of liability form.

IV. Backup medication, if provided by the parent or guardian, will be kept at a location in the school to which the student has immediate access in the event of an asthma or anaphylaxis emergency.The parent/guardian will assure that the backup rescue medication is available to the student outside of school hours and traveling to/from our during school sponsored events.

V. A student’s authorization to possess and self-administer medication for asthma or anaphylaxis may be limited or revoked by the building principal after consultation with the school’s professional registered nurse and the student’s parents or guardian if the student demonstrates an inability to responsibly possess and self-administer such medication.

VI. The school district staff will attempt to manage the school environment to decrease known allergens for students.

Asthma or Anaphylaxis Rescue Procedures

In the event of an asthma or anaphylaxis episode, the school nurse will be immediately contacted. In the absence of the school nurse, the person responsible for school health duties will be contacted.

For asthma, the district will follow the procedures outline in the most recent edition of the AMES: Asthma Management in Educational Settings including:

A. Managing the students’ school environment;

B. Training school personnel in rescue procedures;

C. Accompanying all students exhibiting symptoms;

D. Providing care as designed in the student’s emergency care plan;

E. Calling 911, if appropriate;

F. Notifying the students parent or guardian;

G. Documenting interventions; and

H. Reviewing the student’s emergency care plan and making changes, if necessary.

For anaphylaxis, the district will follow the Guidelines for the Care of Students with Anaphylaxis published by the Office of the Superintendent of Public Instruction.

Highline School District 401
Approved by the Superintendent: June 28, 2006
Approved by the Superintendent: 10.12