School Bus Driver Training

Unit IStudent Emergencies

ObjectivesAt the end of this session school bus

operators will be able to:Describe their role in providing first aid

emergency situations on the busDemonstrate good assessment skills in

setting priorities when managing a medical emergency on the bus

Describe required contents of the first aid kit and body fluid clean up kit

Student EmergenciesWHAT IS CONTAINED IN THIS UNIT ARE

ONLY GENERAL GUIDELINES. YOU MUST FOLLOW YOUR LOCAL SCHOOL DISTRICT PROCEDURES AND GUIDELINES REGARDING RECEIVING FIRST AID TRAINING AND ADMINISTERING FIRST AID ON YOUR SCHOOL BUS.

Student EmergenciesFIRST AID AND EMERGENCY CARE ARE

ONLY TEMPORARY STEPS TAKEN UNTIL MORE ADVANCED TREATMENT CAN BE OBTAINED, EITHER AT THE SCENE OF AN INCIDENT OR AT A HOSPITAL

Procedural Overview Control hazards at the sceneEvaluate injuries or illnessesEnlist the help of othersContact emergency medical servicesMaintain control of the situation

Medical Liability Anyone who gives first aid should be

concerned about liabilityPA Good Samaritan Act protects well

intentioned acts and omissions from civil liability for those with first aid training

There are several first aid courses that would meet this requirement

Pennsylvania Department of Health EMS Information Bulletin #051

First Aid ProceduresSetting priorities: What to do first?Hazard control

Existing or imminent smoke or fire conditionHazardous materialsUnsafe siteDistractions

Obtaining emergency medical assistanceUse a cell phoneGive specific instructions:

Exact location or precise directions Exact nature of problem Number of people injured Description of vehicles involved

Reporting

Report ALL Incidents to your Supervisor

Using Responsible HelpersAdult bystanders are bestKnow your passengersONLY IN EXTREME EMERGENCIES

SHOULD OLDER RESPONSIBLE STUDENTS BE SENT FOR HELPFollow local policy and proceduresDo NOT send elementary school studentsIf policy allows sending students, send two

together

Assessing Injuries or IllnessesPrioritize injuries if more than oneAlways follow local procedures on performing

first aid treatmentBe organized and do one thing at a time

Treatment ProceduresWHAT IS CONTAINED IN THE FOLLOWING SLIDES ARE ONLY GENERAL GUIDELINES. YOU MUST FOLLOW YOUR LOCAL SCHOOL DISTRICT PROCEDURES AND GUIDELINES REGARDING RECEIVING FIRST AID TRAINING AND ADMINISTERING FIRST AID ON YOUR SCHOOL BUS.

SeizuresDon’t panic, let it run its courseIf not already done, lay the student downProtect student from injury as much as

possible.Move any objectsCushion head

Monitor airwayDo NOT put anything in the mouthDo NOT restrainAfterwards, always call dispatcher

FracturesSigns and symptoms

Pain at sitePain on movementSwellingDiscolorationMisaligned bones

Care and treatmentCall dispatcher and 911Prevent movement

Allergic Reaction: Bites and Bee Stings

Signs and symptomsPuncture marksAnxietyPale, cool skin with progressive onset of sweatingRapid, weak pulseRapid, shallow breathing or breathing difficulties Difficulty swallowing and speakingBlurred visionAbdominal painNausea and/or vomitingHeadacheIntense pain at site of biteLocalized redness and swelling

Allergic Reaction: Bites and Bee Stings

Care and treatmentApply direct pressure over bitten area Find out if the student has any allergies to

stings or bites Use cold compress, if available, to reduce

swelling

Allergic Reaction: Anaphylactic Shock

Can be life threateningFollow district policyKnow and use appropriate emergency

numbers: CALL FOR HELP Enforce “No Food on Bus”Follow local policies and procedures for

EpiPen/epinephine use

Allergic Reaction: Anaphylactic Shock

Signs and symptomsItching Red, raised, blotchy skin (hives) Wheezing Confusion Weakness Pale color Unconsciousness Unable to speak more than one or two words Sitting straight up or with hands on knees Gasping for breath Pursing lips to breathe Using neck muscles to take breaths

Allergic Reaction: Anaphylactic Shock

Care and treatmentCall your dispatcher and report the situationCall 911 immediatelyIf you district procedures and guidelines allow,

you are qualified, and you have received training, administer epinephrine

AsthmaCan be life threateningFOLLOW LOCAL PROCEDURES AND GUIDELINESSigns and symptoms

Pale, cool, clammy skinShortness of breathWheezingAnxiety, exhaustion, rapid or weak pulseCollapse

Care and treatmentCall dispatcher and reportSit student uprightBe calm and reassuringAssist using inhaler

Bites from Other StudentsClean bites with antiseptic wipeCover with band aidReport incident

External BleedingTypes of wounds

IncisionLacerationAbrasionPunctureAmputation

Care and treatmentGet help

Call dispatcher Call EMS for serious wounds

Use universal precautionsApply pressure using sterile bandageRaise and support above the heart

Internal BleedingSigns and symptoms

Visible internal bleedingBlood coughed by student (bleeding in lungs or

stomach)Pale, cool, clammy skinThirstRapid, weak pulseRapid, shallow breathing Guarding of the abdomen, in fetal positionPain or discomfortNausea and/or vomitingSwelling

Internal BleedingCare and treatment

Get expert medical helpIf possible, position student on backElevate legsGive nothing by mouth

ChokingDo NOT slap them on the backBest not to do anything if person is coughing

forcefully and not turning bluish colorSigns and symptoms

Difficulty or absence of breathingInability to speak or coughDistress – grabbing the throat, collapseSomeone who cannot answer by speaking and

can only nod the head has a complete airway obstruction and needs emergency help.

ChokingCare and treatment

Check mouth and clear any obstructionsStand behind the student and wrap your arms around

the their waistMake a fist with one handPlace the thumb side of the fist against the student’s

abdomen in the midline and slightly above the navel Grasp the fist with the other hand and press the fist

into the student’s abdomen with a quick upward thrust Each new abdominal thrust should be a separate and

distinct movementRepeat thrusts until student expels the obstruction

DehydrationBe careful of this during afternoon routes in

warm weatherSigns and symptoms

Pale, cool, clammy skinRapid breathingProfuse and prolonged sweatingThirstLoss of skin elasticity Sunken eyes

Care and treatmentGive cool water, if available

DiabetesImbalance of sugar in bloodYou (driver) are not expected to manage

student diabetes by checking blood glucose levels or administering medication

Recognize signs and symptomsKnow what to doBe especially aware at the end of the day

DiabetesSigns and symptoms

Hot, dry skin Smell of acetone (nail polish remover) on the breath Drowsiness or change in mood Unconsciousness, progressing to coma Profuse sweating Grayish skin colorHungerConfused or aggressive behavior Rapid pulse May appear drunkMay have seizures

DiabetesCare and treatment

DO NOT give insulin injectionsGive sweet drink, if availableBe familiar with Quick Reference Emergency

Plan if availableBe aware of where students keep suppliesProvide input to school health team when

requestedCommunicate with parents and school nurseRespect student confidentiality

Heat StrokeBe particularly aware on afternoon runs in hot weatherMore dangerous than sunstrokeSigns and symptoms

Flushed, hot, dry skin The student has stopped sweating Rapid pulse, gradually weakening Irrational or aggressive behavior Staggering or fatigue Visual disturbances, headache, vomiting Collapse and seizure

 Care and treatment Cool the student as much as possible Give fluids and water if the person is conscious

HyperventilationSigns and symptoms

Rapid respirations and pulseShortness of breath Pressure, tightness or pain across the chest AnxietyBlurred visionTingling in fingers and toesHand and finger spasmsFainting

Hyperventilation Care and treatment

ReassuranceRemove the cause of anxiety, if possibleIf the student has fainted, lay student down

with legs elevated.

Nose BleedsKeep trunk of body higher than heartTilt head forward Compress nostril for 5-10 minutes

Report All Incidents As with all of the above emergencies,

FOLLOW LOCAL PROCEDURESReport EVERYTHING to proper authoritiesWork with your Supervisor and parents to

inform substitute drivers on medical issues – keep confidentiality in mind!

Watch for after-affects from a crash

First Aid KitInspectReplace items as usedPlacement

Clearly markedMounted in accordance with manufacturer’s

instructionsRemovableEasily accessible

Body Fluid Clean Up KitInspectReplace items as usedPlacement

Clearly markedMounted in accordance with manufacturer’s

instructionsRemovableEasily accessible

Cleaning Body Fluid SpillsAlways wear disposable glovesSmall spills can be cleaned with paper towels

or tissuesClean with disinfecting solutionRemove gloves and place into plastic bag

with waste and other cleaning materialsWash hands

Soap Running water for at least 30 seconds

If possible, carry hand sanitizer, extra gloves, and band aids