Smithfield School District Naloxone (Narcan) Policy
The purpose of this policy is to establish guidelines and procedures governing the utilization of Naloxone administered by members of the Smithfield School Department.
Per RIGL § 16-21-35 (2015-S 0154A, 2015-H 5047A), it is the policy of the Smithfield School Department that it shall provide and maintain opioid antagonists on-site at the public middle school and high school facility, at a minimum. To treat a case of suspected opioid overdose in a school setting, any trained certified school nurse teacher or other trained staff may administer an opioid antagonist, during an emergency, to any student or staff suspected of having an opioid-related drug overdose whether or not there is a previous history of opioid abuse.
No certified school nurse teacher or other trained staff shall be liable for civil damages which may result from acts or omissions relating to the use of the opioid antagonist which may constitute ordinary negligence; nor shall the school personnel be subject to criminal prosecution which may result from acts or omissions in the good faith administration of an opioid antagonist. This immunity does not apply to acts or omissions constituting gross negligence or willful or wanton conduct. No certified school nurse teacher shall be subject to penalty or disciplinary action for refusing to be trained in the administration of an opioid antagonist.
Certified school nurse teachers and other staff, such as administrators and counselors, may be trained in the use of naloxone by the Rhode Island Department of Health (RI DOH), the Medical Reserve Corp (MRC), or a designee. School departments are encouraged to send other staff to be trained, including administrators, coaches, guidance counselors, etc.
PROCUREMENT OF NALOXONE
The superintendent, principal, certified school nurse teacher, or designee will be responsible for the procurement of naloxone. The school physician shall prepare standing orders.
The Rhode Island Department of Health (RI DOH) recommends that school provide intranasal naloxone. At minimum, each school should have the following supplies:
Naloxone will be clearly marked and stored in an accessible place at the discretion of the certified school nurse teacher. The certified school nurse teacher will ensure that all other relevant staff are aware of the naloxone storage location. Naloxone is to be stored in accordance with manufacturer’s instructions to avoid extreme cold, heat, and direct sunlight.
Inspection of the naloxone shall be conducted regularly by the school nurse teacher, who shall check the expiration date found on either the box or the vial and check the condition of the mucosal atomization devices (considered sterile for approximately 4-5 years).
USE OF NALOXONE
In case of a suspected opioid overdose, certified school nurse teachers or other trained staff shall follow the protocols outlined in the naloxone training and the instructions in the naloxone kit:
- Call 911
- Administer rescue breathing
- Prepare and administer naloxone
- Alert the administrator/school crisis response team
- Continue rescue breathing
- Give another dose of naloxone after 3 minutes if no response or minimal breathing or responsiveness
- Naloxone wears off in 30-90 minutes which necessitates definitive medical care
- Comfort the person - withdrawal can be unpleasant
- Encourage survivors to seek treatment
After administration of naloxone, the certified school nurse teacher, or other staff, will follow the Smithfield School Department reporting protocols. The certified school nurse teacher or other staff will:
- Ensure that the overdose victim was transported to the emergency department
- Notify parent/guardian if victim is a minor
- Notify appropriate support staff
- Provide substance abuse prevention resources to the overdose victim and family as appropriate upon return to school.