Fifteen states allow schools to manage respiratory emergencies among multiple students using a single albuterol inhaler (stock inhaler) paired with a disposable holding chamber.
To evaluate implementation barriers and facilitators, and satisfaction with a stock inhaler program across K-12 schools in Pima County, Arizona.
All public, charter, private, and parochial schools were offered supplies, web-based training, and technical assistance at no cost. The RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework was used to evaluate program implementation. School documentation logs were reviewed, school health personnel were surveyed, and a convenience sample of health personnel were interviewed. Chi-square tests evaluated categorical outcomes and Poisson hurdle regression examined stock inhaler use by school organizational type, grade levels served, and type of school health personnel employed.
Two-hundred-twenty-nine (68%) schools participated reaching 82% of students in the county. One-hundred-fifty-two schools (66%) used a stock inhaler accounting for 1,038 events. The mean number of puffs administered was 2.7 (standard deviation, 1.2) per event and most events (79%) involved students with asthma. While most events (83.9%) resulted in student returning to class, 15.6% resulted in students being sent home. Only 6 events resulted in 9-1-1 calls and 5 of these led to an ambulance transport. School health personnel reported high levels of satisfaction and all schools renewed participation for a second year. Program costs were $156 per school.
With technical assistance, stock inhaler programs can be feasibly implemented by schools in a wide range of settings thereby increasing their capacity to safely manage respiratory emergencies.

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