Epinephrine

Pursuant to Education Law Article 19, ONLY an RN, or an LPN under the direction of an RN, may administer patient-specific and non-patient-specific Neffy® "nasal epinephrine" in the school setting. This includes during district transportation and at school-sponsored events.

Pursuant to Education Law Article 19 §921 and §921-a, appropriately trained unlicensed personnel may only administer epinephrine auto-injectors. This would include a student with a patient-specific order, or for schools choosing to train unlicensed personnel to administer emergency stock epinephrine auto-injectors to students or staff on-site.

 NYSED Guidelines and Resources 

Guidelines for Managing Allergies and Anaphylaxis in Schools (NYSED 4/2024)
This guidance provides school districts with the information to establish an anaphylaxis policy, setting forth guidelines and procedures to be followed for both the prevention of anaphylaxis and to be used during a medical emergency resulting from anaphylaxis. 

NOTE: Pursuant to Education Law §921-a, both public and non-public schools may choose to provide and maintain epinephrine auto-injectors on-site and permit volunteer school personnel to be trained to administer epinephrine via auto-injector on-site to a student or staff member in an instructional facility per Commissioner's regulation §136.6 who appears to be in anaphylaxis, regardless of history of severe allergic reaction.

Schools choosing to train unlicensed personnel to administer emergency stock epinephrine auto-injectors are required to provide all teachers with written informational materials on using epinephrine auto-injectors created and approved by the Commissioner of Health.

The NYSDOH materials are not available yet. In the interim, schools are encouraged to use each epinephrine manufacturer's website to access the required information on the use and type of stock epinephrine auto-injector they have on site.

The Food Allergy Research & Education (FARE) webpage lists the current epinephrine devices, product information, and product use.

Options Chart for Administration of Epinephrine in Schools (NYSCSH 12/2024)
This chart was updated to include the requirements in the NYSED guidance document shown above. Prior to administering epinephrine in the school setting, district boards of education and school governing bodies must develop and approve policies consistent with the laws and regulations of New York State.

Allergy and Anaphylaxis Training for School Personnel (e-Learning Page)
Schools choosing to train unlicensed personnel to administer emergency epinephrine to any student or staff member on-site must use the NYSDOH/NYSED approved training. The approved training and resources are located on the e-Learning page under Website Courses.

See NYSCSH Sample Resources to Assist with Implementation

Manufacturer Resources

Epinephrine Auto-Injectors Products, Training and Administration Options For School Personnel
Food Allergy Research & Education (FARE) offers product information about currently available epinephrine auto-injectors.

EpiPen4Schools® Program
Viatris offers four free EpiPen® (epinephrine injection, USP) or EpiPen Jr® (epinephrine injection, USP) Auto-Injectors upon qualification, which includes having a valid prescription, to public and private kindergarten, elementary, middle, and high schools in the US. Schools may receive the authorized generic versions of EpiPen and EpiPen Jr.   

Note: The New York State Education Department (NYSED) and NYS Center for School Health (NYSCSH) do not endorse individual vendors, products, or services. Links to vendors, products, or services by trade name, trademark, or manufacturer are provided for educational purposes only.

Epinephrine Auto-Injectors Disposal

Epinephrine Auto-Injector Disposal
The FDA does not consider the epinephrine salts in epinephrine auto-injectors hazardous waste. Therefore, they should be disposed of in the same manner as other sharps.

See Also:

Page Updated 12/23/24