Adrenal insufficiency occurs when the adrenal glands do not produce enough hormones. These hormones include cortisol, sometimes called a “stress hormone,” which is essential for life.

Adrenal crisis is a sudden, severe worsening of symptoms associated with adrenal insufficiency.
Symptoms include severe pain in the lower back, abdomen or legs, vomiting, diarrhea, dehydration, low
blood pressure or a loss of consciousness.

An employee who has successfully completed educational training in the treatment of adrenal
insufficiency as described in subsection (d) of Tennessee Code Annotated §49-50-1603 may receive from
the parent or legal guardian of a student a medication that treats adrenal insufficiency and that is
prescribed by a healthcare professional who has appropriate prescriptive privileges and is licensed under Title 63, as well as the necessary paraphernalia for administration. The employee may possess the
medication and administer the medication to the student for whom the medication is prescribed if the
student is suffering an adrenal crisis in an emergency situation when a licensed healthcare professional is not immediately available, provided the parent or legal guardian of the student has provided written
permission. Written permission should be kept on file in the student’s record.

Education training on the treatment of adrenal insufficiency, as required by state law, shall be conducted
under the supervision of a physician or nurse practitioner. The training may be conducted by a registered nurse.

Training:

1. School personnel trainee must successfully complete an adrenal insufficiency training recognizing the signs and symptoms of an adrenal crisis responding with student-specific interventions.
2. General information about adrenal insufficiency and the dangers associated with adrenal
   insufficiency.
3. Review the medication order and confirm parent/legal guardian permission.
4. School personnel trainee will be able to describe the types of medications available for treating
   adrenal insufficiency and an adrenal crisis.
5. School personnel trainee must be able to properly administer the medication used to treat an
   adrenal crisis to include drug preparation, documentation and follow-up care.
6. School personnel trainee will notify or delegate notification of EMS/911, parents/legal guardian
   and school nurse anytime adrenal crisis medication is administered.

An employee administering the medication or performing health care procedures related to the
administration of medication that treats adrenal insufficiency and a board of education authorizing the
administration of medications or the performance of health care procedures related to adrenal
insufficiency shall not be liable in any court of law for injury resulting from the administration of such
medication or the performance of any related health care procedure if administered or performed in
accordance with this section.

Legal Reference:

1. T.C.A. § 49-50-1603.

Approved as to Legal Form
By Knox County Law Director 1/2/2024
/Gary T. Dupler/Deputy Law Director