Frequently Asked Questions

Any entity or organization where allergens capable of causing anaphylaxis may be present, such as restaurants, recreation camps, youth sports leagues, amusement parks, colleges, universities, and sports arenas.

An epinephrine autoinjector is a medical device used to deliver a single dose of epinephrine or adrenaline for the emergency treatment of anaphylaxis.

Anaphylaxis or anaphylactic shock is a serious allergic reaction with rapid onset. It may cause death. Common causes include insect bites or stings, foods, plants, chemicals or medications. Symptoms include:

• Skin reactions, including hives and itching and flushed or pale skin

• Low blood pressure (hypotension)

• Constriction of your airways and a swollen tongue or throat, which can cause wheezing and trouble breathing

• A weak and rapid pulse

• Nausea, vomiting or diarrhea

• Dizziness or fainting

A prescription for your authorized entity may be obtained from a health care provider authorized to prescribe epinephrine autoinjectors. The prescription will be filled by a health care provider authorized to dispense medications.

In addition to traditional authorized prescribers (Medical Doctors, Osteopathic Physicians, Physician Assistants, etc.), some pharmacies may employ pharmacists with a Collaborative Drug Therapy Agreement (CDTA) to prescribe epinephrine autoinjectors. Under WAC 246-863-100, pharmacists may have the ability to prescribe epinephrine autoinjectors and other medications when an authorized practitioner gives them his or her prescriptive authority through a written guideline or protocol. The Washington State Department of Health does not track which pharmacies employ pharmacists with a CDTA. You may contact the pharmacies in your area to see if they have a pharmacist on staff with a Collaborative Drug Therapy Agreement to prescribe epinephrine autoinjections.

Upon proof of a training certification by an employee, an organization may obtain epinephrine autoinjectors, and the organization is responsible for:

• Storing epinephrine autoinjectors in a location readily accessible in an emergency and in accordance with the instructions for use.
• Designating employees or agents who have completed the training to be responsible for the storage, maintenance, and general oversight of epinephrine autoinjectors acquired by the authorized entity.
• Reporting incidents to the Department of Health when epinephrine autoinjectors are used by the authorized entity.

An authorized entity is required to report to the Department of Health each incident of use of an obtained epinephrine autoinjector that was provided or administered to a person.

Report an incident here.

The law allows authorized entities to obtain epinephrine autoinjectors if there is a potential for a person on the entity's premises or receiving services from the entity to encounter allergens that would trigger an allergic reaction leading to anaphylaxis. Authorized entities that choose to acquire epinephrine autoinjectors must have people connected with the entity, such as employees, who have completed an anaphylaxis and epinephrine autoinjector training. A certification will be proof of completing the training. This affects prescribers and dispensers in the following ways:

• Prescribers: In most cases medications are prescribed to a specific person with a known allergy. Under this law the prescription will be in the name of the entity, business, or organization. The prescriber may request proof of a current epinephrine autoinjector and anaphylaxis training certificate held by an employee or representative of the authorized entity.
• Dispensers: The law allows a pharmacist to dispense prescriptions for epinephrine autoinjectors to an entity rather than an individual patient.

Epinephrine autoinjectors need to be disposed of according to safe and best practices, and according to your local guidelines and programs.

For more information about the disposal of autoinjectors, please refer to the U.S. Food and Drug Administration's (FDA) information about Safely Using Sharps (Needles and Syringes) at Home, at Work and on Travel.

Information for prescribers

An authorized health care provider who prescribes epinephrine autoinjectors to an authorized entity is not liable for any injuries or related damages that result from the administration or self-administration of an epinephrine autoinjector.

Liability for authorized entities

An authorized entity that possesses and makes available epinephrine autoinjectors and its employees, agents, and other trained individuals; is not liable for:

o Any injuries or related damages that result from the administration or self-administration of an epinephrine autoinjector,

o The failure to administer an epinephrine autoinjector, or

o Any other act or omission taken pursuant to this section.

This immunity does not apply to any acts or omissions constituting gross negligence, or willful or wanton misconduct.

This section does not eliminate, limit, or reduce any other immunity or defense that may be addressed under state law, including that provided under RCW 4.24.300.

An entity located in this state is not liable for any injuries or related damages that result from the provision or administration of an epinephrine autoinjector by its employees or agents outside of this state if the entity or its employee or agent:

o would not have been liable for the injuries or related damages had the provision or administration occurred within this state, or

o are (is) not liable for the injuries or related damages under the law of the state in which the provision or administration occurred.