Policy 1307
James Rumsey Technical Institute recognizes that the opioid epidemic is affecting many West Virginians, including youth and students, which has resulted in a rising number of fatal overdoses. Pursuant to West Virginia Code § 18-5- 8 22d, the Legislature provided that public schools in the state may possess, maintain, and administer, by certain school employees, an opioid antagonist for use in emergency medical care or treatment for an adverse opioid event. Pursuant to the requirements of West Virginia Code § 18-5-22d, the State Board of Education consulted with the State Health Officer to adopt rules and regulations for a county board of education’s possession, maintenance, and administration of opioid antagonists. State Board of Education Policy 2422.7 provides that county boards of education must follow the protocols/standards for dosage set forth by the West Virginia Department of Health and Human Resources. The Department of Health and Human Resources, in consultation with the Bureau for Behavioral Health, Office of Drug Control Policy, and the West Virginia Department of Education, issued the Naloxone Guide for School Nurses, which, among other things, provides a School Naloxone Policy Template and certain appendices that county boards of education may adopt.
Therefore, it is the purpose of this policy to ensure that James Rumsey Technical Institute adopts and complies with the State Board of Education’s opioid antagonist rules and the Naloxone Guide for School Nurses.
- GENERAL:
1.1 The Board adopts and incorporates the Naloxone Guide for School Nurses, as may be modified or amended from time to time by the Department of Health and Human Resources.
1.2 The Superintendent shall adopt practices and procedures designed for school nurses and other qualified individuals to comply with the Naloxone Guide for School Nurses
Adoption Date: 07/28/2023
Authority: W. Va. Code § 18-5-22d; W. Va. State Board of Education Policy 2422.7
OPIOD ANTAGONIST ADMINISTRATIVE PROCEDURES
I. Guidelines: Naloxone HCL (Brand name: Narcan Spray) is a medication indicated for the emergency reversal of a suspected opioid overdose. The cause of death from opioid overdose is respiratory failure. Intranasal Naloxone (Narcan nasal spray) acts by displacing an opioid receptor in the brain leading to a resumption of normal respirations thus potentially preventing death. Naloxone (Narcan nasal spray) acts by displacing an opioid from the opioid receptors in the brain and reverses respiratory depression the cause of overdose deaths.
A. Purpose: To provide training and supervision guidelines for safe administration of stock intranasal Naloxone in the school setting.
B. Equipment:
1. Naloxone spray of appropriate dose/nasal spray for nasal administration delivery.
2. Disposable nonlatex gloves.
3. Disposable manual resuscitator (Ambu Bag, pediatric and adult)
C. Personnel: Certified school RN (school nurse), and/or other licensed health care providers, RNs and LPNs working in the school or designated qualified personnel under the direct or indirect supervision of the certified school nurse.
II. Procedure: ESSENTIAL STEPS KEYPOINTS-PRECAUTIONS
| ESSENTIAL STEPS | KEYPOINTS-PRECAUTIONS |
| A. Counties opting to voluntarily stock naloxone shall maintain and use naloxone nasal spray for emergency care of a suspected overdose. | County shall follow W. Va. Code §18-5-22 (d) and WVBE Policy 2422.7. |
| B. Obtain licensed prescribers order for stock naloxone. | May use standing order provided by the WVDHHR Commissioner and State Health Officer. |
| C. Train designated unlicensed school personnel to administer naloxone and monitor response. | Assess competency utilizing the Skills Performance Checklist. |
| D. Obtain naloxone and ensure proper storage. | Store below 77°F. Do not freeze or expose to excessive heat above 104°F. Protect from light. |
| E. Assess individual for signs and symptoms of suspected opioid overdose. Provide privacy, and safety. | Inability to wake the individual up (does not respond to shouting or sternal rub). Not breathing or not breathing well-look for blue lips or fingertips. If not breathing, there is NO harm in giving Naloxone. |
| F. Call EMS | Use non-latex gloves. Use proper sized ambu bag if administering CPR. |
| G. Administer naloxone spray following manufacturer instructions. | |
| 1. Place the individual flat on their back and open airway (lift chin up). | |
| 2. Open box to remove individually wrapped packages. Peel open package to remove the device. | |
| 3. Place two fingers on top of the device (on each side of the nozzle). | |
| 4. Place nozzle in either nostril until your fingers touch the bottom of the individual’s nose. Point nozzle towards the individual’s ear (away from the middle of the face). | |
| 5. Press the plunger firmly to release the medication. Remove device from nostril after dose is given. | If the individual starts to vomit, turn them onto their side so the vomit does not choke them. |
| 6. If individual is not breathing well after 3 minutes, repeat the dose (in the opposite nostril) with the other device in the box. | |
| 7. If the individual starts to breathe or wake up, put the individual in the recovery position (on his/her side) and move away to put space between you. | Waking up from an overdose can cause some people to get very agitated and confused. |
| H. Monitor and stay with the individual until EMS arrive. | Naloxone will wear off. Continue to monitor. Provide empty naloxone spray device (s) to EMS. |
| I. Document incident on individual treatment record. | Record: 1. Date and time of incident. 2. Description and symptoms of incident. 3. Time and amount of Naloxone administered. 4. Response of Naloxone. 5. Signature of personnel performing procedure. 6. Time EMS notified. 7. Time parent/guardian notified. 9. Time school nurse notified. 10. Time school nurse notified Poison Control. |