Epinephrine Auto-Injector Use by Children's Camps

Fact Sheet - April 2013

  • This Fact Sheet is also available in Portable Document Format (PDF, 100KB, 3pg.)

Article 30, section 3000-C of the Public Health Law authorizes specially trained staff, in children's day and overnight camps that participate in an epinephrine auto-injector program, to use an auto-injector device in life-threatening emergencies . Children's camps are strongly encouraged to establish an epinephrine auto-injector program. For people experiencing life-threatening allergic reactions (also known as anaphylaxis), the availability of an auto-injector is a matter of life and death.

More than 2 million Americans suffer from anaphylaxis. The main causes are insect stings or ingesting food or medication to which an individual is allergic. The allergic individual's best chance of survival is an immediate injection of the medication epinephrine to counteract the body's allergic response.

What is an auto-injector?

An auto–injector is an easy–to–use, pencil–like needle that injects a premeasured dose of epinephrine into someone having an anaphylactic reaction. The law applies to auto–injectors not syringes.

Who can administer an auto–injector?

  • a camper, if he/she has proof of his/her own prescription;
  • a licensed health care practitioner;
  • children's camp employees designated by the camp director and the camp's emergency health care provider and who have passed a training course approved by the New York State Department of Health on the use of the auto–injector.

What steps must a children's camp take to become involved in the program?

  • identify a physician or hospital to serve as the camp's emergency health care provider;
  • develop, sign and implement an agreement between the camp and the emergency health care provider; this must include written practice protocols and policies for use of the auto–injector;
  • include the agreement as part of the written plan that the camp submits to the local health department;
  • have appropriate staff trained as outlined in the agreement, and maintain a record of those trained with training dates, training refresher dates and curriculum followed; verification must be submitted to the local health department;
  • give written notice to the local Emergency Medical Service System dispatch center that an auto–injector will be available on site (verbal and written notice to the local ambulance service is also suggested);
  • file a completed and signed Notice of Intent to Provide Epinephrine Auto–Injector (DOH–4188) with the local Regional Medical Services Council (REMSCO) and attach a copy of the agreement with the health care provider.
  • notify and file a new agreement with REMSCO when there is a change in the agreement and/or the emergency health care provider.

Note: After the initial submission of the notice of intent and agreement to REMSCO, it is not necessary to re–file each season unless there is a change in the agreement or health care provider.

What must the practice protocols and policies include?

The practice protocols and policies must include:

  • the curriculum used to train authorized individuals; the curriculum must be approved by the Commissioner of Health;
  • designation of who will conduct the training of the authorized individuals; this will be determined by the emergency health care provider;
  • designation of staff to be trained to use, acquire and dispose of the auto–injector;
  • a procedure for completing and documenting training each year or more frequently if recommended by the emergency health care provider;
  • a protocol for use of the auto–injector for both pediatric and adult cases;
  • a plan of action when an auto–injector is used, including notification of EMS, mandatory reporting to the local Department of Health and the camp emergency health care provider, and disposal of the auto–injector in accordance with OSHA regulation 29 CFR 1910.1030;
  • a procedure for obtaining, storing and accounting for the drug (it is the responsibility of the emergency health care provider to purchase and distribute the auto–injectors to the individual camps).

If there is a life–threatening emergency and an auto–injector is administered, what else must be done?

  • call the local Emergency Medical Service System as quickly as possible to obtain further medical attention and to transport the individual to the hospital;
  • report the incident to the camp health director and enter it in the camp medical log;
  • report the incident to the emergency health care provider listed in the collaborating agreement;
  • report the incident to the local health department within 24 hours;
  • immediately after use the auto–injector will be placed back in the packaging tube and the cap replaced;
  • whenever possible the auto–injector will accompany the individual to the hospital.

What is included in an approved training course?

  • an overview of the common causes of allergic emergencies;
  • how to identify the signs and symptoms of a severe allergic reaction;
  • how to quickly access the Emergency Medical Service System;
  • instructions for use of an auto–injector;
  • safe storage, handling and disposal practices for the auto–injector;
  • the steps for providing ongoing care of the patient until emergency medical personnel arrive;
  • the state regulations that allow an individual to possess and use an auto–injector in a life–threatening situation;
  • a system for identifying those who carry their own auto–injector.

What will the local health department look for during the annual on–site inspection?

  • implementation of the camp's written plan, including the proper storage, accountability, documentation, use and disposal of the epinephrine auto–injector per the agreement with the camp's emergency health care provider;
  • a system for identifying those with severe allergies who carry their own auto–injector;
  • documentation in the camp medical log and other incident reports to document when an auto–injector was used;
  • a copy of the camp agreement with the emergency health care provider;
  • a list of camp employees who have been trained to administer the auto–injector and proof of completion of an approved training course by those employees;
  • the auto injectors on camp property all possess a current manufacturer's expiration date.

More Information

For additional information on this law and for a list of training courses approved by the New York State Department of Health, contact:

Bureau of Community Environmental
Health & Food Protection
Bureau of Emergency
Medical Service
Children’s Camp Program Operations Unit
(518) 402-7600 (518) 402-0996, extension 2