Student Illness

Procedures shall be established by the administration to ensure that proper attention is given to any student who becomes ill during the course of a school day.

Accidents Involving Students

Emergency procedures shall be established by the administration to ensure proper attention for any student injured at school. Accidents involving students during the school day shall be documented either electronically or on paper records and retained according to the District retention schedule.

Emergency Treatment Forms

Each year, students and parents shall complete and sign a form that provides emergency information and authorizes school officials to obtain emergency medical treatment, as provided by law.

Administering Medication

No employee shall give any student prescription medication, nonprescription medications, herbal substances, anabolic steroids, or dietary supplements of any type, except as provided below.


Employees authorized by the Superintendent or designee may administer to students:

Provided by Parent

Prescription medication in accordance with legal requirements. [See FFAC(LEGAL)] A medication request form signed by a physician or other health-care professional with authority to write prescriptions shall be required.

Nonprescription medication, upon a parent's written request, when properly labeled and in the original container. Nonprescription medications shall be administered according to the package directions unless a note from a doctor or other health-care professional accompanies the medication request.

Herbal substances or dietary supplements as prescribed by the physician, provided by the parent, and only if required by the individualized education program (IEP) or Section 504 plan of a student with disabilities. Reliable information must be given by the physician or other health-care professional with authority to write prescriptions which includes the safe use of the product including toxicity, drug interactions, and adverse effects.

Provided by District

Prescription and nonprescription medications provided on an emergency basis by the District and consistent with:

Protocols established by the District's medical advisor who must be licensed to practice medicine in the state of Texas; and

Parental consent given on the electronic or paper emergency treatment form.

Student Self-Medication

Students may be allowed to self-administer prescription asthma and/or injectable anaphylaxis medication while on school property or at a school-related event or activity if the following conditions exist:

Written permission from the physician allowing the student to self-medicate is on file in the nurse's office.

The nurse has counseled the parent on the school's inability to monitor the student's health condition during the school day while he or she is self-medicating.

The student complies with all campus safety policies.


Except as permitted by Education Code 38.016, an employee shall not:

Recommend to a student or a parent that the student use a psychotropic drug;

Suggest a particular diagnosis; or

Exclude the student from a class or a school-related activity because of the parent's refusal to consent to psychiatric evaluation or examination or treatment of the student.

Do Not Attempt Resuscitation Requests

All school nurses and health services staff must comply with District procedures and federal, state, and local regulations in providing health services to children with Do Not Attempt Resuscitation (DNAR) requests. See References (a), (b), and (c), below.


For the purposes of this policy, the following definitions apply:

Medically Fragile Children

Medically fragile children are children with serious, long-standing, progressive illnesses that are often life-threatening.

DNAR Request

A DNAR request is a written directive from a physician signed by the parent or guardian of a medically fragile child requesting that medical treatment be withheld. A DNAR does not rescind any obligation to provide quality medical care; it is part of the management plan. A DNAR does not apply to a first aid procedure that is considered necessary to provide comfort or care.

Designated Hospital

A designated hospital is the hospital selected by the parent or guardian to be used in case of an emergency. The designated hospital must be indicated on the DNAR request.

Emergency First Aid

Emergency first aid is emergency care or treatment given to an ill or injured person before regular medical aid can be obtained.


The school nurse or RN team leader shall be responsible for coordinating a DNAR request from a parent or physician. The requirements are as follows:


The school nurse, RN team leader, the child's physician or medical team, parents or guardians, and administrators shall meet to discuss the DNAR request, the procedures to follow in an emergency, the specific disease entity, and the potential signs and symptoms of deterioration before the child begins to attend school.

Agreement to Pick Up Ill Child

The student's parent or guardian shall agree in writing that any time the school nurse, principal, or principal's designee feels that the child is too ill to be in class, the family will be immediately available to pick up the child.

Emergency (EMS) Notification

The school nurse or RN team leader shall notify the nearest EMS team to inform them of the parents' DNAR request and designated hospital.

Placement of DNAR Request

A copy of the DNAR request with the name of the designated hospital shall be kept in the classroom, on the child's bed or wheelchair, or in another convenient place where it can be easily located at all times. The original request shall be kept on file in the nurse's office.

Parent Notification of an Emergency

The parent or guardian shall be notified immediately by the school nurse, principal, or designee when an emergency occurs.

Revocation of a DNAR Request

A parent or guardian wanting to revoke a DNAR request must provide a signed, written, revocation request to the school nurse. The DNAR can be revoked at any time.

EMS Notification of Revocation

If a DNAR request is revoked, the school nurse or RN Team Leader will inform the EMS team previously notified of the change.


If a medically fragile child becomes extremely ill at school, the following procedures should be followed:

The school nurse or designated personnel shall provide the child with basic emergency first aid;

The school nurse, principal, or designee shall notify the parents or guardians;

The school nurse, principal, or designee shall call EMS (911);

The school nurse or designee shall supply the EMS team, upon its arrival at the school , with a copy of the DNAR letter including the name of the designated hospital;

The EMS team shall determine what action is necessary;

The child shall be transported to the designated facility; and

Emotional support shall be made available to the family and other members of the child's class.

Maintenance Responsibility

The assistant superintendent, instructional support services, shall be responsible for maintenance of this policy.


(a) Texas Health and Safety Code 672.018

(b) Texas Health and Safety Code 674.001 et. seq.

(c) Texas Natural Death Act 672.002 (6)

Round Rock ISD


LDU 2020.01

DATE ISSUED: 1/28/2020