Answer:  It has become a standard of practice in New York State for school nurses to develop an Emergency Care Plan for students with a potentially life threatening condition.  A good benchmark is to develop a plan for students with an order for Epinephrine, Glucagon and Diastat, although there may be other students who would benefit from a plan for emergency care.  School nurses must use their nursing judgement as well as follow the guidance of their district Medical Director to make that determination.

Question: What are the four categories of emergencies and is there a resource regarding emergencies in the school setting?

Answer: The four categories of emergencies are:

1. Life-threatening or potentially disabling (EMERGENT). These types of

emergencies can cause death or disability within minutes, and therefore

require immediate intervention, medical care, and usually hospitalization:

• Airway and breathing difficulties

• Cardiac Arrest

• Chest pain and acute dyspnea and/or cyanosis

2. Serious, or potentially life-threatening or disabling (URGENT) These may

soon result in a life-threatening situation or may produce permanent damage,

they must be treated as soon as possible.

• Chest pain associated with URI

• Burns

• Major multiple fractures

3. Non life threatening. (NON-URGENT) These are identified as any injury

or illness that may affect the general health of a person, for example: fever,

stomachache, headache, seizures, broken bones, cuts etc. The person should

be evaluated as soon as parents can be notified or within a few hours at

maximum.

• Chronic backache

• Moderate headache

• Minor fractures or other injuries of a minor nature

4. Expectant: Injury so severe, individual is not expected to live (i.e., massive

brain trauma, severe burns).

A full resource guide to emergencies is available under "E" in our A - Z Index under "Emergency Planning and Preparedness" and is highlighted as this week's SN Tool of the Week at: http://www.schoolhealthservicesny.com/tool_kit.cfm

Question: What equipment is appropriate to have available for an emergency response?  Is there a state mandate about the equipment that a nurse should have available?

Answer:  There is not a state mandate regarding the equipment that a nurse and/or Health Office should have available for emergency responses in the school setting.  The nurse and school health staff should follow the guidance from their district Medical Director and district Counsel.  We do have a listing of one example of an Emergency Backpack that was instituted in a district to assist nurses in caring for students in an emergent situation found at:

Emergency First Aid Backpack Example

Question:  When an ambulance is called to a school, what are the responsibilities of the school nurse in reporting to the Emergency Medical Services personnel?

Answer:  While there is no official state guidance on this matter, it could be considered best practice to compile information related to the emergent event, along with nursing assessment, medical history and parent notification information.

We have posted a sample School Nurse Emergency Care Flow Sheet in our SN Tool Kit for your use.  We would recommend completing the form during an emergent event (with assistance if needed) and retaining a copy for the school Health Office.