Episode 1: Emergency Medical Response/
Policies and Procedures
PURPOSE
To establish emergency medical response policies and procedures for the administration of emergency first aid services in the schools, including basic life support, first aid, and emergency treatment. Procedures established in this policy shall be followed during the school day, at school-sponsored activities, and while on a school bus or other school property.
Any and all suggestions in this document should be reviewed by medical and legal counsel for your school and/or district. The provisions of these suggestions are intended to meet student health needs during minor and major injuries or medical emergencies.
Importantly, these model policies and procedures are provided as a starting point and resource for schools developing a Medical Emergency Response Plan. All schools should have their medical response plans reviewed by the district administration and appropriate medical authorities to assure the plan meets their own internal needs and applicable State laws.
GENERAL PROVISIONS
To ensure student safety, SCHOOL has adopted the position that parents and guardians shall administer medications at home whenever possible.
The SCHOOL recognizes that accidents and medical emergencies can and do happen during school campus hours and during school-sponsored events; therefore, SCHOOL has adopted guidelines to prepare staff members to provide first aid and emergency care during these unexpected events.
FIRST AID AND EMERGENCY TREATMENT
First aid shall be provided promptly to students, school staff, and campus visitors.
Any school staff and after-school staff member designated by the principal to render care as part of a Medical Emergency Response Team (Rapid Response and First Responder teams are defined below) shall complete training in basic life support (CPR/ AED) and First Aid provided by the American Heart Association or another nationally recognized training organization. Certification in one or more of the above areas is imperative.
First aid supplies shall be kept in central locations in the schools and athletic offices, where they will remain clean, dry, and available to all personnel.
Since students may have epileptic seizures and/or asthma attacks or other health conditions at school, teachers shall be made aware of appropriate procedures for handling these conditions and for calling for a first responder, or 911 (EMS) and the school’s rapid responders.
Each year, student’s parents or guardians must be requested to update the Student Health Information Form (or other school form name) with the student’s current health condition and any known major health conditions or allergies that may require school personnel to provide emergency care.
RAPID RESPONSE TEAM
At least 20% of employees per building, and in the case of multi-floored buildings, 20% of employees per wing/floor, shall have current certification in cardiopulmonary resuscitation (CPR) / AED and first aid or shall have received training, within the last two years, in emergency first aid and CPR through the American Heart Association or another nationally recognized training organization. Additional staff shall be trained in first aid and CPR so that all persons needing either CPR, rescue breathing, or other life-supporting first aid can be reached within three (3) minutes of the school’s emergency response being activated. At least 20% of employees per building (and in the case of multi-floored buildings, 20% of employees per floor) shall be trained on AED use provided that an Automated External Defibrillator (AED) is maintained in that building. Coaches who may render care to sick or injured students must also receive equivalent training. Volunteers who may render care to sick or injured students must also receive equivalent training.
When an emergency exists, contact 911 (EMS). Members of the school’s rapid response team for the wing/floor/department will respond immediately to the scene as an ambulance is awaited.
CODE BLUE is universal for a Cardiac Medical Emergency. Cardiac Medical Emergencies require IMMEDIATE assessment and activation of 911 (EMS), and immediate dispatch of the school’s rapid response team to begin CPR and use of the AED.
Emergency Injections: epinephrine auto-injectors prescribed for students with identified allergies, another example of a Medical Emergency requiring immediate assessment and activation of 911 (EMS), and immediate dispatch of the school’s rapid responders. These persons are taught by a school nurse (or public health nurse, depending on your state’s guidelines) to administer the injection, following established training guidelines. It is prudent that the school’s Epi-Pen delegates serve on the school’s rapid response team. Only pre-measured doses of epinephrine (Epi-Pen or Epi-Pen Jr.) may be given. The injection will be given immediately after report of exposure to the allergen or at the prescribed student’s request due to onset of allergic reaction. Type of exposure (e.g., ingestion, skin contact, inhaled) as well as specific allergen must be indicated on the licensed medical professional’s order. Persons trained in this procedure must be able to access the student within TWO (2) MINUTES OF ONSET OF SYMPTOMS or notification.
In situations when students are approved by the principal to carry their own epinephrine, the trained persons in addition to the school nurse must be instructed in the administration procedure in the event that the student is unable to self-administer. A second dose, to be used for back up, should be kept in the clinic and/or other approved locations in case the student’s medication is not available. The parent or guardian and licensed medical professional, as indicated, must complete the appropriate authorization form. The school shall contact EMS IMMEDIATELY (if available, send another staff person to dial 911) and the parent or guardian when a student has been given epinephrine.
FIRST RESPONDER TEAMS
In cases where it’s not a Medical Emergency (potential life or death) situation, the first responder team will assess the situation to determine if a call to 911 is necessary.
If a call to 911 is deemed necessary, the school’s rapid response team must be summoned.
Inhalers & Self-Administration
With a diagnosis of asthma, and orders from a licensed medical professional, a student may be permitted by the principal to carry and use an inhaler for asthmatic conditions (as long as state guidelines allow).
At least three school employees shall be taught to assist in the administration of the inhaler.
A second inhaler, to be used as a back-up, may be kept in the clinic or other school-approved location accessible by the student with appropriate staff supervision as required.
FIELD TRIPS
For field trips that are considered an extension of the school’s program, arrangements for management of injury and medical emergencies shall be provided in accordance with the procedures described in this policy.
Ideally, one or more members of the school’s first responder and rapid response teams will travel along with a licensed school nurse for the field trip (preferably one member per field trip bus/vehicle).
It is recommended that one staff member per bus is trained in first aid and age-appropriate CPR, including adult CPR. That person shall also be trained to use an AED, provided that an AED accompanies the students and staff on the bus/ field trip.
First aid supplies shall be available on all school buses and vans during field trips.