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Special Needs Transporters Seek Answers to Tough Questions on Administering Prescription Drugs to Students
By Ryan Gray
specifically on the emergency drug Diastat, and much-needed medical guidance appears to be on the way. Also known as Diazepam, Diastat is essentially Valium in a gel
A
preparation that is administered rectally to stop cluster seizures in people with epilepsy. It decreases brain electricity generation to prevent degradation to a serious, long-standing seizure that may require admittance to intensive care and the use of anesthesia. “Diastat helps kids attend school who would never have
been able to 10, 15 years ago,” said Dr. Marilyn Bull, professor of pediatrics at Indiana University, during a general session at the Transporting Students with Disabilities & Preschoolers 21st National Conference & Exhibition in Orlando, Fla., on March 13. Bull added that doctors must carefully consider when it is
appropriate to prescribe Diastat. “It varies from child to child,” said Bull, who is also the District
V chair of the Indiana Chapter of the American Academy of Pe- diatrics and a member of AAP’s Section on Neurology. “Only a registered physician knows when that will be.” But in doing so, a panel of experts joined Dr. Bull to discuss
major concerns about allowing this drug and others to be admin- istered on the yellow bus, one of which is student privacy. Sue Shutrump, the supervisor of occupational and physical thera-
py at the Trumbull County (Ohio) Educational Services Center, said Diastat used to be administered as a “drug of last resort” to school- aged students after about 10 minutes of seizure activity. Tis allowed student transporters to plan routes to pass near emergency facilities or modify routes to reduce the student’s time on the bus. Tis also allowed for medical assistance on the bus, which meant that the IEP team along with the parent and/or caregiver could plan for the drug being administered only at school or at home. But more recently, many doctors nationwide have been pre-
scribing the drug to be administered 1 to 2 minutes after seizures. “Tis has greatly impacted the team’s decision making while
greatly limiting options, which do not include administering on the bus,” Shutrump told School Transportation News in January. Shutrump is also the chair of NAPT’s Special Needs Commit-
tee, which ramped up its discussion on Diastat last year when a bill was introduced and later passed in California that requires school districts to train other personnel to administer Diastat and other medications when a school nurse is not present. Te California School Nurses Organization fought the passage of SB
24 School Transportation News Magazine May 2012
161, arguing that Diastat and other emergency seizure-calming drugs should not be administered in a school setting, especially when a licensed medical expert is not available. Some states have regulations — and many others don’t — that
permit school nurses to delegate the administration of medica- tions to non-medical personnel, a category that includes school bus drivers and aides. In these situations, school nurses often lead the team in making transportation decisions and ultimately provide the training to drivers and attendants, along with school staff, if Diastat is determined to be necessary on the bus. “However, most school districts do not have a full-time nurse,”
Shutrump added, “and an increasing number do not even have a nurse on staff.” Nancy Kessler is the special needs transportation coordina-
tor at Katy ISD near Houston, which does not require a licensed medical professional to administer Diastat. Tis means the job falls on school bus drivers, aides and paraprofessionals on the bus. In Katy, she said, the operator drives while the paraprofes- sional and aid disrobe the student. Ten, while the aid looks after the other students, the paraprofessional administers the drug. Tis can lead to awkward moments for everyone on the bus, in- cluding the other students. She said the district’s policy is to always call EMS when the
drug must be administered, and the local police department is also aware of which buses are equipped with Diastat. Te dis- trict’s attorneys, the executive director of special needs and the director of health services are also involved in the entire process.
dministering medicines to students with disabilities on board the school bus is nothing new for most drivers, aides and paraprofessionals. But a growing concern centers
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