Guidance Regarding Epinephrine Auto Injectors

On June 13, 2019 Public Act 19-19, An Act Concerning Epinephrine Auto Injectors, was signed into law. This Public Act makes epinephrine auto injections accessible to businesses and other institutions that have the appropriately trained staff.

This document provides guidance to those who wish to obtain epinephrine auto injectors, including information about what medical protocols must be followed.

Authorized Entities and Prescribing Practitioners

Any for-profit or nonprofit entity or organization that employs at least one person with the appropriate training is considered an “Authorized Entity” in the State of Connecticut and may purchase epinephrine cartridge injectors from a wholesaler (including a pharmacy if it has a wholesale distributor license).

Before an establishment purchases an epinephrine auto injector, a medical protocol must be established with a practitioner licensed to prescribe in the State of Connecticut.

The medical protocol must include (at minimum):

• Any training required, in addition to the training required in Public Act 19-19;
• Storage and maintenance of epinephrine cartridge injectors;
• Records to be maintained; and
• Procedures for handling emergency medical situation involving anaphylactic allergic reactions.

A copy of the medical protocol shall be maintained at the place of business.

The medical protocol shall be reviewed annually by the person(s) with training and the prescribing practitioner.

Person with Training

The person(s) with training must have completed a course, approved by a prescribing practitioner, in first aid that includes training regarding recognizing the signs and symptoms of anaphylaxis, administering epinephrine, and following emergency protocol. 

The training course may be offered by the American Red Cross, American Heart Association, the National Ski Patrol, the Department of Public Health or any director of health that certifies the training or by a licensed physician, physician assistant, advanced practice registered nurse or emergency medical services personnel.

A record of training must be maintained by trainer and trainee and readily available. A certificate issued by the training entity (listed above) or a written statement of acknowledgment of training signed by a licensed physician, physician assistant, advanced practice registered nurse or emergency medical services personnel are both sufficient forms of documentation.

A person with training may administer an epinephrine cartridge injector to a person they believe is experiencing anaphylaxis, or provide an epinephrine cartridge injector for immediate administration to an individual, parent, guardian or caregiver for someone believed to be experiencing an anaphylactic reaction. After administering or providing an epinephrine cartridge injector to a person, the person with training or any other employee or agent of the authorized entity must:

• Promptly notify local emergency medical services; and
•  Report the use of the epinephrine cartridge injector to the prescribing practitioner within 30 days.

Wholesalers

Wholesalers are now permitted to provide epinephrine cartridge injectors to authorized entities that have a medical protocol with a prescribing practitioner as outlined in this document. Prior to providing an epinephrine cartridge injector to an authorized entity, the wholesaler is required to validate that the authorized entity has a protocol with a prescribing practitioner.

Immunity

Any authorized entity that has acquired and maintains a supply of epinephrine cartridge injectors, and employs someone trained in the use of epinephrine cartridge injectors, shall not be liable for civil damages or subject to criminal prosecution for any individual’s injuries that result from acts or omissions which may constitute ordinary negligence when the person with training provides or administers epinephrine to an individual who they believe is experiencing anaphylaxis during the course of such person’s employment.