As used in this part:

1. (1) “Adrenal crisis” means a sudden, severe worsening of symptoms associated with adrenal insufficiency that can lead to:

   1. (A) Circulatory collapse;
   2. (B) Heart and organ failure;
   3. (C) Brain damage; and
   4. (D) Death;

2. (2)

   1. (A) “Adrenal insufficiency” means a chronic medical condition in which the adrenal glands do not produce enough of the necessary hormones to respond to stressors such as illness and injury.

   2. (B) The hormones involved help maintain and regulate key functions of the body such as:

      1. (i) Blood pressure;
      2. (ii) Metabolism;
      3. (iii) The immune system; and
      4. (iv) How the body responds to stress;
3. (3) “Diabetes” means a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both;
4. (4) “Emergency dose medication” means, for purposes of adrenal crisis, intramuscular hydrocortisone sodium succinate;
5. (5) “Emergency situation” means a circumstance in which students with low blood glucose cannot be treated with a glucose-containing substance by mouth because the student has an altered mental status, is having a seizure, or has high blood glucose, requiring emergency administration of insulin to prevent complications;

6. (6)

   1. (A) “Glucagon” means a hormone prescribed by a licensed healthcare practitioner that stimulates the release of glucose in the blood.
   2. (B) Glucagon is dispensed as a “Glucagon Emergency Kit” or a “Glucagon Emergency Kit for Low Blood Sugar”;

7. (7)

   1. (A) “Insulin” means a hormone that regulates the metabolism of glucose and other nutrients.
   2. (B) It generally is given by injection or through a subcutaneous insulin delivery system.
   3. (C) It is prescribed by a licensed healthcare practitioner;

8. (8) “Licensed healthcare practitioner” includes, but is not limited to:

   1. (A) Medical doctors;
   2. (B) Doctors of osteopathy;
   3. (C) Advanced practice registered nurses with prescriptive authority;
   4. (D) Registered nurse practitioners; and
   5. (E) Physician assistants who work under physician-approved protocols;

9. (9)

   1. (A) “Licensed school nurse employed by a school district” means those nurses employed by an Arkansas public school district or open-enrollment public charter school who hold the following licenses or certificate:

      1. (i) Registered nurse;
      2. (ii) Advanced practice registered nurse; or
      3. (iii) Diabetes nurse educator.

   2. (B)

      1. (i) This definition does not include licensed practical nurses (LPNs).
      2. (ii) LPNs may assist in the provision of training under this part.

      3. (iii) However, training under this part must be performed by:

         1. (a) (a) Registered nurses;
         2. (b) (b) Advanced practice registered nurses; or
      4. (c) (c) Diabetes nurse educators;
10. (10) “Nonscheduled dose of insulin” means an additional or corrective dose of insulin to treat hyperglycemia or to cover a rise in blood glucose levels;

11. (11) “Other healthcare professional” includes the following:

    1. (A) Registered nurse;
    2. (B) Advanced practice registered nurse;
    3. (C) Diabetes nurse educator;
    4. (D) Medical doctor;
    5. (E) Registered nurse practitioner;
    6. (F) Doctor of osteopathy;
    7. (G) Physician assistant;
    8. (H) Pharmacist; and
    9. (I) Certified diabetes educator;
12. (12) “Scheduled dose of insulin” means a dose of insulin administered at regular times during the school day;
13. (13) “Stress dose medication” means, for purposes of adrenal insufficiency, oral hydrocortisone; and

14. (14) “Trained volunteer school personnel” means licensed or classified personnel employed by an Arkansas public school district or open-enrollment public charter school who volunteer and successfully complete training for the administration of:

    1. (A) Insulin, glucagon, or both to students diagnosed with diabetes; and
    2. (B) An emergency dose medication to a public school student who is diagnosed with an adrenal insufficiency using the appropriate delivery equipment when a public school nurse is unavailable.

Codification Notes: This section as promulgated prior to codification into the Code of Arkansas Rules provided as follows: “History: Amended: June 15, 2024”