The Provincial government recently passed new legislation addressing the emergency health needs of students with asthma. Bill 20, Ryan’s Law (Ensuring Asthma Friendly Schools), 2015, received Royal Assent on May 5, 2015, and is now in force.

Ryan’s Law is similar to Sabrina’s Law, which addresses the health needs of students who suffer from anaphylactic allergies. It requires school boards to do the following:

  1. create an asthma policy addressing strategies to reduce student exposure to asthma triggers;
  2. develop a communication plan;
  3. provide training for staff in direct contact with students to be able to recognize the symptoms of asthma and to assist to manage exacerbating factors;
  4. develop individualized asthma plans for students;
  5. ensure that the student’s asthma plans are known to staff at the school;
  6. require at registration, that parents provide information regarding their child’s asthma; and 
  7. maintain an up to date file with information regarding each student’s needs.

One of the most important features of this new legislation is the requirement that a student’s emergency plan ensure that their medication is easily accessible. School principals, when parents provide consent, must permit students to carry their asthma medication with them, perhaps in a fanny pack, which is the way in which most students with anaphylactic allergies carry an EpiPen (epinephrine auto-Injector, for the treatment of anaphylaxis). Students who are 16 years old or older do not require prior parental consent.

Ryan, the namesake of this legislation, was a young student with asthma who had his puffer stored in the school office. Staff members were unable to access his mediation quickly enough to save his life during an asthma attack.

Recommendations

Like anaphylaxis and now asthma, school boards should consider creating individualized student plans for all life threatening conditions in which emergency medication is prescribed for students, such as medication for seizure conditions and glucagon for diabetes. The plan should identify where the medication will be stored and who might access it in an emergency. Students who are sufficiently responsible should be permitted to keep their emergency medication in a fanny-pack. All staff with duties related to the student should be trained to recognize triggers, the signs of distress and the steps to be taken in an emergency, including administering or assisting with the emergency administration of medication. Moreover, school boards should update their information and consents annually, and consider requesting that parents provide more than a single dose of the emergency medication so that the medication can be stored in different locations within the school, particularly in situations where the student will not be carrying it on their person. For those families where provision of more than one dose might be a hardship, school ‘angel’ funds should be utilized.

Individualized student plans should also include measures for avoidance as well as other protocols that must be followed, such as positioning a student in the event of a seizure. The student’s photograph with details of their condition should be posted in a private location, and the individualized plan should be made available to teaching staff with responsibilities for the student, all administrative staff, any occasional teachers replacing the student’s regular teachers, Educational Assistants who might provide assistance to the student, and in the case of students in kindergarten, all Designated Early Childhood Educators.

School boards should consider providing general information sessions regarding these conditions to all staff, as well as students and parents to make them aware of these conditions and any exacerbating factors that might be avoided. Schools might also consider posting information on their school websites and providing reminders about triggers and exacerbating factors in school newsletters.

While the government appears to be addressing students who suffer from life threatening conditions one condition and tragedy at a time, school boards should consider instituting a wholesale, consistent, individualized approach for all students with life threatening conditions.