Emergency Procedures

An emergency at a school site often precipitates the need for emergency transport of the student to a hospital or other acute medical treatment facility. How does one determine if the injury is severe enough to require transport?

Normally, the decision to transport is made by EMS personnel after they have arrived at the scene, assessed the incident, and, as appropriate, consulted with other medical personnel. As such, the subjective judgment of the school nurse or principal to call 911 is not determinative with respect to emergency transport, and emergency calls should be made such that they always err on the side of caution.

1. Disasters require the response of numerous agencies and organizations and multiple levels of government simultaneously.
2. Disasters disrupt the normal autonomy and freedom of action of individuals, organizations, and governmental entities. A new, temporary social order may be put in place during a disaster.
3. Different performance and treatment standards apply during disasters. Speed of response and individualized care given to treating the injured is superseded by a need to triage victims to better allocate resources.
4. Normal procedures, privacy and property rights, and public/private distinctions may be suspended during disasters. Mobilization supersedes due process for the common good.

A student may be transported without parental permission in an emergency arising from an illness or injury to said student.

Education Code Section 35350 provides that “No governing board of a school district shall require any student or pupil to be transported for any purpose or for any reason without the written permission of the parent or guardian. This section shall not apply to the transportation of a student in an emergency arising from illness or injury to the student or pupil.”

Except when a written objection to medical treatment (other than first aid) has been previously filed by a parent or guardian, a District is not liable for reasonable medical treatment, even without parental consent when the parent cannot be reached, when a student is ill or injured during regular school hours.

Education Code Section 49407 provides that “Notwithstanding any provision of any law, no school district, officer of any school district, school principal, physician, or hospital treating any child enrolled in any school in any district shall be held liable for the reasonable treatment without the consent of a parent or guardian of the child when the child is ill or injured during regular school hours, requires reasonable medical treatment, and the parent or guardian cannot be reached, unless the parent or guardian has previously filed with the school district a written objection to any medical treatment other than first aid.”

Good Samaritans are not liable when rendering emergency care at the scene of an emergency in good faith.

Business and Professions Code Section 1799.102 provide s that “No person who in good faith, and not for compensation renders emergency care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission. The scene of emergency shall not include emergency departments and other places where medical care is usually offered.”

• If injured child is in immediate danger, the school administrator, nurse or designee will discuss the details with the parent/guardian.
• School administrator, nurse or designee will call 911.
• Principal will notify District Office.
• School nurse or Health Technician will make copies of the student’s emergency card: EMT, nurse, principal or designee.
• If the parent/guardian has transportation, the parent/guardian will follow the ambulance to the hospital.
• The principal or designee will follow the ambulance to the hospital and wait for the parent to arrive. The principal or designee will bring a copy of the student’s STUDENT EMERGENCY/ MEDICAL INFORMATION CARD.
• The school nurse will follow up with a phone call later in the day or the next morning.
• Nurse/aide will write an incident report.
• Administrator will call home in the evening. If the administrator is not available, a counselor will call.
• Coaches and teachers should remember to take the students’ STUDENT EMERGENCY/ MEDICAL INFORMATION CARDS with them on all outings.
• Coaches and after-school activity proctors will be notified of these procedures. All media inquires will be directed to the District Communications Director.

If injured child is in immediate danger, the school administrator, nurse or designee will attempt to notify the parent/guardian of the situation.

• If injured child is in immediate danger, the school administrator, nurse or designee will attempt to notify the parent/guardian of the situation.
• School administrator, nurse or designee will call 911.
• Principal will notify District Administration.
• School nurse will make 3 copies of the student’s STUDENT EMERGENCY/ MEDICAL INFORMATION CARD: EMT, school nurse, principal or designee.
• If the child needs to proceed to the hospital, transported by ambulance, the school nurse will communicate the destination (hospital) of the injured child to the parent.
• If the parent/guardian is not available or prefers to meet the ambulance at the hospital, the principal or designee will follow the ambulance to the hospital and wait for the parent to arrive. The principal or designee will bring a copy of the student’s emergency card.
• If the parent/guardian is not able to get to the hospital or is unavailable, the school representative will communicate with the nurse to ensure that a listed person on the emergency card has been contacted.
• The school nurse will notify District Administration on the day the incident takes place.
• The school nurse will do a follow-up communication to the parent on the day of the incident.
• The school nurse will communicate results of the follow-up communication to the principal in writing.
• All media inquires will be directed to the District Communications Director.
• Administrator will call home in the evening. If the administrator is not available, a counselor will call.
• Coaches and other school staff should remember to take a copy of the student’s STUDENT EMERGENCY/ MEDICAL INFORMATION CARD with them when taking students off premises to events and activities.
• Coaches and after-school activity proctors will be notified of these procedures.

By following some basic guidelines, disease transmission when providing first aid can be largely prevented:

Following these guidelines decreases the risk of getting or transmitting diseases. Remember always to give first aid in ways that protect you and the victim from disease transmission. The American Red Cross recommends the use of a breathing barrier when performing CPR or rescue breaths if you have concerned about making direct contact with a victim.

• Avoid contact with bodily fluids, such as blood and other potentially infectious materials (OPIM), when possible
• Place barriers, such as disposable gloves or a clean dry cloth, between the victim’s bodily fluids and yourself
• Cover any cuts, scrapes, and openings in your skin by wearing protective clothing, such as disposable gloves
• Use breathing barriers, if available, when breathing for a person
• Wash your hands with soap and water immediately before and after giving care, even if you wear gloves
• Do not eat, drink, or touch your mouth, nose, or eyes when giving first aid
• Do not touch objects that may be soiled with blood, mucus, or other bodily substances

A medical emergency (emergency) is a condition that involves the immediate onset of symptoms, including pain, severe enough to lead a prudent layperson with an average knowledge of health and medicine to reasonably believe that immediate medical attention is needed to avoid a serious impairment of bodily functions or serious dysfunction of a bodily organ or part because there is a serious threat to the health of the individual or a fetus. Emergency conditions include suspected heart attack or stroke, sudden or extreme difficulty breathing, sudden loss of consciousness, severe bleeding, severe abdominal pain, and injuries to one or both eyes. When an emergency occurs, proceed as follows:

• Assess the situation. Be sure the situation is safe for you to approach. The following dangers will require caution:
  • live electrical wires
  • gas leaks
  • building damage
  • fire or smoke
  • traffic, and/or
  • violence
• A responsible adult should stay with the student and render first aid until the person designated to handle emergencies arrives. If the student is transported, a responsible adult should stay with the injured student.
• Call for help to the person designated to handle emergencies. In the most convenient method available, contact this person who will take charge of the emergency, render any further first aid needed and call for additional resources as required. If the emergency is life-threatening, call 911 or your local emergency number. The responsible school authority or a designated employee should then notify the parent or legal guardian of the emergency as soon as possible to determine the appropriate course of action.
• DO NOT give medications unless there has been prior approval by the parent or guardian. Follow school district medication policy.
• DO NOT move a severely injured or ill student or staff unless absolutely necessary for immediate safety. If moving is necessary, follow guidelines for “NECK AND BACK INJURIES.”
• DO NOT send an injured or sick child home unless there has been prior contact with and approval by the parent or guardian. Under no circumstances should a sick or injured student be sent home without the knowledge and permission of the parent or legal guardian.
• If the parent or legal guardian cannot be reached, notify a parent or legal guardian substitute and call either the physician or the hospital designated on the STUDENT EMERGENCY/ MEDICAL INFORMATION CARD, so they will know to expect the injured student. If necessary, arrange for transportation of the injured student by Emergency Medical Services (EMS).
• Complete a report for all incidents requiring above procedures as required by TUSD policy. Document as required by your TUSD and notify site and District administrators.

For individuals with special needs, conditions are more hostile and difficult to deal with during an emergency. Recognizing this, pre-planning for medical emergencies requires additional considerations. To accomplish this, District teachers and staff responsible for emergency medical care and other emergency programs must:

• Involve the student with special needs, their parents, staff, and teachers in identifying the communication and transportation needs, accommodations, support systems, equipment, services, and supplies that they will need during an emergency,
• Identify medical needs and make appropriate plans,
• Determine transportation needs for students, and
• Include local responders in such planning.

The Individuals with Disabilities Education Act of 1975 (amended 1997) (IDEA) requires that planning for the educational success of these students is done on an individual case-by-case basis through the development of an Individual Education Program (IEP). Students with special needs who are self-sufficient under normal circumstances may have to rely on others in an emergency. They may require additional assistance during and after an incident in functional areas, including, but not limited to: communication, transportation, supervision, medical care and reestablishing independence. While not explicitly stated, a component of the IEP for related services must consider the particular needs of the child to ensure his or her safety during an emergency. 504 Plans may further address issues relevant to emergencies such as “do-not-attempt-resuscitation orders” (DNR orders6).