Medical Protocol for a School Emergency
Medical emergencies that arise during school hours require the trained and knowledgeable response of school personnel. Medical emergencies can be caused by by accidents or by injuries sustained on the playground or during athletic practices. Some result from underlying medical conditions such as food allergies or asthma. In some cases, the cause of the medical crisis is not immediately apparent. Whatever the cause, a documented and practiced plan of response is needed to help ensure the welfare and safety of children during school hours.
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Rational for Protocol
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Students spend 28 percent of their waking hours in school during the months school is in session. According to statistics from the American Academy of Pediatrics in the article "Medical Emergencies Occurring at School," 18 million of the 72.3 million U.S. students under 18 have special healthcare needs or suffer from a chronic illness. Results of a national survey reported in the October 2008 issue of "Pediatrics" suggests that some schools are unprepared to deal with a medical emergency. Sixty-eight percent of the 573 nurse respondents reported treating a life-threatening emergency that required EMS response. The great majority (86 percent) of nurses reported that their schools have a medical emergency protocol in place. Thirty-five percent of nurses reported that their schools had not tested the protocol by way of drills.
School Nurses
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School nurses play a vital role in the response to medical emergencies. The emergency protocol ought to include the requirement that school nurses be trained in emergency care procedures. These procedures include first aid, how to use metered-dose inhalers and nebulizers, basic life support, treatments for anaphylactic reactions, broken limbs and other common medical emergencies. The school nurse must be trained to recognize and provide first-responder treatment for health conditions such as diabetes, asthma and hemophilia.
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Staff
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The American Academy of Pediatrics policy, "Guidelines for Emergency Medical Care in Schools," recommends designated staff members be trained as part of the emergency response protocol. In schools where a nurse is not always available on-site, two or more staff members should be trained to handle medical emergencies. Schools must have a list of staff members trained and authorized to deal with medical emergencies and distribute the list to all school personnel. A good list includes the names, location and contact information of the trained individuals.
Sports Personnel
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School sports are a popular, but often dangerous, activity. Injuries during practice and training may occur outside of regular school hours. For example, football practice is often scheduled before or after school. Training for the coach and his staff are critical to handling sports-related injuries. The American Academy of Pediatrics recommends that the entire coaching staff, including athletic trainers, receive additional training in medical emergency response procedures. Areas of extra training include airway management, rescue breathing and cervical spine immobilization.
Emergency Equipment
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School preparedness is a major part of the medical protocol. This preparedness includes having the right equipment available. An emergency response manual outlining first aid procedures must be given to all personnel likely to deal with a medical emergency. Emergency kits should be placed in secure locations. Staff members must be advised on the location of the kits as well as how to access and use them. Assigning a designated person the task of monitoring and updating the supplies in the kits is vital. Include Autoinject epinephrine in the kit to treat anaphylaxis. The medication should only be administered by a nurse or other trained professional knowledgeable in the signs and symptoms of anaphylaxis. Heart defibrillators ought to be available to the coaching and other trained staff.
Notification Procedures
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A Medical Protocol for Emergencies includes a plan to notify parents or other emergency contact persons listed on the students enrollment form. Training the employee responsible for notifying emergency contacts prior to the school year is essential. Student files contain documentation of known illnesses, present medications and allergies. Following the incident, the emergency, the response to the emergency and the outcome must be documented and placed in the student's file. School policy may dictate forwarding information regarding the incident to other officials.
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References
Resources
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