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Lampasas Independent School District

Lampasas Independent School District

unassigned epinephrine

unassigned epinephrine

This protocol is to be used in the care of children and / or adults who present with signs and symptoms of a severe allergic reaction while on an LISD campus. Anaphylaxis is a life-threatening allergic reaction that may involve multiple body systems. This is a medical emergency that requires immediate intervention and treatment.


  • Food allergies (examples may include milk, eggs, peanuts, tree nuts, shellfish, wheat, soy)
  • Insect stings (examples may include bees, hornets, yellow jackets, wasps, fire ants)
  • Latex allergies
  • Medication
  • Exercise

Food allergies are the leading cause of anaphylaxis in children. Children who have asthma and food allergies are at greater risk for anaphylaxis and may often react more quickly, requiring aggressive and prompt treatment.

Symptoms of anaphylaxis may include any or several of the following:
  • Skin: hives; rash; flushing; itching/tingling/swelling of lips, mouth, tongue, throat; nasal congestion or itchiness, runny nose, sneezing; itchy, teary, puffy eyes; sweating
  • Respiratory: chest tightness; shortness of breath; wheezing; shallow respirations; difficulty swallowing; hoarseness; coughing; choking
  • Gastrointestinal: nausea, vomiting, abdominal cramps, diarrhea
  • Cardiovascular: dizziness; fainting; loss of consciousness; flushed or pale skin; cyanosis; low blood pressure; weak, thready pulse; shock
  • Mental: change in level of consciousness; sense of impending doom; crying; anxiety


Epinephrine is the emergency drug of choice for an anaphylactic reaction and must be given immediately. There should be no delay in the administration of epinephrine.
  • Administer epinephrine based on individual's weight:
    • Epinephrine auto-injector (0.15mg IM dose of epinephrine from epinephrine injection 1:2000 USP) for children weighing < 55 pounds.
    • Epinephrine auto-injector (0.3mg IM dose of epinephrine from epinephrine injection 1:1000 USP) for children weighing > 55 pounds.
  • Call EMS (911) and report anaphylactic episode. EMS transport is required after administration of an epinephrine injection.
  • Place individual on back with legs elevated. If individual begins to vomit, turn to their side.
  • Notify parents / guardians / alternate adults.
  • Place AED close to the individual.
  • Monitor pulse, breathing, level of consciousness, and progression of symptoms while waiting for EMS arrival. Prepare individual for EMS transport.
  • Notify Director of School Health Services immediately following administration of epinephrine. 
Unassigned Opioid Antagonist (Narcan)

Unassigned Opioid Antagonist (Narcan)


The purpose of this policy is to establish guidelines and procedures governing the utilizations of the opioid antagonist Narcan administered by trained staff of Lampasas ISD.


All Lampasas ISD campuses will stock opioid antagonists (Narcan), for emergency use to assist a student, staff member, or visitor suspected of experiencing an opioid overdose. 


For purposes of this policy, these terms shall be defined as follows:
  • Drug overdose – an acute medical condition, including, but not limited to, severe physical illness, coma, mania, hysteria, or death, which is the result of consumption or use of one or more controlled substances causing an adverse reaction. An individual’s condition may be deemed to be a drug overdose if a prudent person, possessing an average knowledge of medicine and health, would reasonably believe that the condition is in fact a drug overdose and requires immediate medical attention.
  • Narcan – a medication that can reverse an overdose caused by an opioid drug. As a narcotic antagonist, Narcan displaces opiates from receptor sites in the brain and reverses respiratory depression that usually is the cause of overdose deaths.
  • Opioid – illegal drugs such as heroin, as well as prescription medications used to treat pain, such as morphine, codeine, methadone, oxycodone, hydrocodone, fentanyl, hydromorphone, and buprenorphine.


Before any Department of School Health employee, school nurse, or SRO may administer Narcan under this policy, the employee must successfully complete a training program about recognizing opioid-related overdoses, administering Narcan, and promptly seeking medical attention for drug overdoses. A list of LISD employees who successfully complete such training shall be maintained, updated, and kept in the school nurse’s office.

Physician Standing Order:

The school district’s Superintendent or designee shall obtain a standing medical order from a health care provider who is licensed in Texas and whose scope of practice includes the prescribing of medication and writing the prescription for the school corporation. 
The standing order shall authorize the school district to obtain, store, and administer Narcan in compliance with this policy to ensure the safety and well-being of an individual experiencing a drug overdose. The original standing order shall be maintained in the Director of School Health’s office, and copies of the standing order shall be kept in the nurse’s offices of each campus.


LISD campuses will store the emergency medication in a safe location to which only school employees have access.
Narcan will be clearly marked and stored in accordance with manufacturer’s instructions to avoid extreme cold, heat, and direct sunlight.
Narcan shall be made readily accessible to those employees who have completed the required training to administer it in the event of a suspected drug overdose. All properly trained employees shall be made aware of exactly where Narcan is being stored within the school.

Administration of Narcan:

In case of a suspected opioid overdose, the school nurse or other trained staff should follow the protocols outlined in the Narcan training:
  • Call for medical help immediately (dial 911).
  • Assess breathing and perform rescue breathing if needed.
  • Prepare and administer the Narcan as instructed in training.
  • Continue rescue breathing (or CPR if needed) as instructed in training.
  • Administer a second dose of Narcan in 3 minutes if there is no response or minimal breathing or responsiveness.
  • Place in the recovery position as instructed in training.
  • Stay with the individual until emergency medical help arrives.
  • Cooperate with EMS personnel responding to the incident.
  • Notify the building administrator or designee of the incident.


The school nurse or trained employee will:
  • Ensure that the overdose victim is transported to the emergency department, even if symptoms are better.
  • Contact parent / guardian.
  • Complete a Report of Narcan Administration and submit to the Texas Department of State Health Services within 10 days of the use of stock Narcan.
  • Provide substance abuse prevention resources for the overdose victim and family, as appropriate.


The school corporation shall indemnify and hold harmless any employee who administers emergency medications in good faith to another individual experiencing a suspected drug overdose, if all these conditions apply:
  • The employee did not act with the intent to harm or with reckless indifference to a substantial risk or harm in administering emergency medication to that individual.
  • The employee successfully completed the training contemplated by this policy.
  • The employee promptly sought additional medical assistance before or immediately after administering the emergency medication.
  • The employee is administering the emergency medication pursuant to this policy.