Illinois EMSC 1

Your Role in Emergency Planning Objectives

Upon completion of this lecture, you will be better able to:•Assess your school emergency response time•Analyze your school emergency preparedness•Plan appropriate responses for student illness or injury•Describe at least 7 variables to consider when planning for emergency care•Discuss the components involved in crisis management•Describe at least 4 factors that help to identify students at risk for violent behavior

Illinois EMSC 2

Your Role in Emergency Planning

As a school nurse you have an instrumental role in

developing a comprehensive

management plan for school emergencies.

Illinois EMSC 3

Your Responsibilities in Emergency Planning

• Evaluate first aid and emergency care delivery

• Identify potential problems in school environment

• Work with the school medical advisor

• Coordinate first aid and CPR training for staff

• Develop emergency plans for students with known health problems

Illinois EMSC 4

Your Responsibilities in Delivering Immediate Care

• Initiate appropriate interventions when students are ill or injured

• Manage emergency care at the scene

• Counsel students and staff

Illinois EMSC 5

Your Responsibilities in Communicating with

Others• Parents and

caregivers• Primary health

provider• School

administrator, teachers and staff

Illinois EMSC 6

SPECIAL CONSIDERATIONS

• Cultural Diversity

• Children with Special Health Care Needs

            

            

Illinois EMSC 7

SPECIAL CONSIDERATIONS

• AGE AND DEVELOPMENTAL LEVEL OF STUDENTS

• LACK OF HEALTH CARE ACCESS

• RESPONSE OF LOCAL EMS

Illinois EMSC 8

PLANNING FOR EMERGENCIES

Assess your existing

emergency plan

Illinois EMSC 9

Assessing the Emergency Care Plan

• WHO could require care ?

• WHAT could be the illness or injury ?

• WHERE could it happen ?

• WHEN could it occur ?• HOW should you

respond ?

Illinois EMSC 10

ASSESSING COMMUNITY RESPONSE

• EMS Coordinator• EMS dispatch• Response time• Level of

responders• EMS protocols• Local law

enforcement

Illinois EMSC 11

COMMUNITY RESPONSE

• Hospital• Emergency

Department– Variables in

decision– Transport times– Trauma center– Pediatric center

Illinois EMSC 12

Emergency Responders

• Emergency Department Nurse/Physician

• Bystanders/Good Samaritan• Medical First Responder• Emergency Medical

Technician• EMT-B• EMT-I• EMT-P

Illinois EMSC 13

IS YOUR SCHOOL FULLY PREPARED?

• Written policies/standing orders

• Standing orders reviewed and signed by MD annually

• Transport policies clearly defined

• Personnel educated• Duties outlined• Safety procedures

developed• Adequate equipment and

supplies– Investigate sources for securing

funds for supplies

Illinois EMSC 14

School Communications System

• Notifying EMS• Notifying school staff• Notifying

parent/guardian• Public Information

dissemination• Providing

informational updates

Illinois EMSC 15

School Personnel

• All school employees assigned to respond and provide care in an emergency should:– Be knowledgeable of Universal Precautions– Be offered the Hepatitis B vaccine– Have personal protective equipment (PPE)

available– Report all exposures– Follow-up with a medical evaluation

following an incident

Illinois EMSC 16

Triage• EMERGENT

• Students requiring emergent care are those with an illness or injury requiring immediate medical attention

• URGENT• Students requiring medical

intervention within two hours

• NON-URGENT• Students may or may not require

referral for routine medical care

Illinois EMSC 17

Transport Options

• Based on condition of student• Available options

– EMS ground transport– EMS air transport– Parent/guardian– Other responsible adult– School staff

Illinois EMSC 18

Telephone Triage

• Rely on a sense of hearing• Develop an ability to interpret auditory

cues• Learn to work with other senses• Ask questions• Rely on the caller for key information• Develop one’s intuition• Understand the loss of power and control• Use verbal communication effectively

Illinois EMSC 19

Telephone Triage Pitfalls to Avoid

When giving advice over the phone, avoid the following pitfalls -

• Failure to correctly evaluate the nature or urgency of the situation

• Failure to speak directly with the student

• Failure to document the call

Illinois EMSC 20

Documentation

• Comprehensive and consistent• Ease and efficiency • Record for continuity of care• Record of nursing care for legal

protection• Standard format facilitates

acceptance• Data collection valuable in

planning

Illinois EMSC 21

Follow-Up Activities

• Complete incident reports

• Conduct follow-up review

• Evaluate outcome

• Collect data

Illinois EMSC 22

Special Situations

• Refusal of care– Parent/guardian– Student– Other

• Religious objections• DNR• Automated External

Defibrillators

Illinois EMSC 23

Crisis Management

• Natural disasters

• Manmade disasters

• Terrorist attacks

• Violent incidents

Illinois EMSC 24

Your Role and Responsibility in Crisis Management

• Recognize patterns of illness• Maintain a high index of suspicion• Assess potential emergency risks to the school

population• Assess adequacy of emergency preparedness training

and drills• Prepare to function on front lines during adverse

events• Plan for the health care needs of special needs

students during a disaster• Coordinate both short-term and long-term recovery

phases after a traumatic event• Become involved in local emergency planning

Illinois EMSC 25

Children and Terrorism Special Considerations

• Short stature puts them closer to ground where aerosolized biological, chemical and radiologic agents settle

• Thinner skin• Greater surface-to-mass

ratio• Smaller circulating volume

than an adult• Developmental level• Psychological needs• At risk for dehydration and

hypothermia

Illinois EMSC 26

Communication During a Crisis

Warning Codes

• Code Red• Code Yellow• Code Blue• Code White• Code Green

Illinois EMSC 27

Coping with Violence

Youth violence– A critical public health problem– Need for violence prevention

programs– Identify students at risk for violent

behavior– Implement appropriate interventions

Illinois EMSC 28

Summary

• School nurses play a key role in providing emergency care and managing student illness and injury in the school environment.

• Collaborate with others to develop an emergency plan and crisis management plan.

• Remain attune to current standards of practice and local/state regulations.

Illinois EMSC 29

ANY QUESTIONS??