Your Role in Emergency Planning Objectives

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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

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Your Role in Emergency Planning

• As a school nurse you have an instrumental role
  in developing a comprehensive management plan for
  school emergencies.

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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

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

5
Your Responsibilities in Communicating with Others

• Parents and caregivers
• Primary health provider
• School administrator, teachers and staff

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SPECIAL CONSIDERATIONS

• Cultural Diversity
• Children with Special Health Care Needs

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SPECIAL CONSIDERATIONS

• AGE AND DEVELOPMENTAL LEVEL OF STUDENTS
• LACK OF HEALTH CARE ACCESS
• RESPONSE OF LOCAL EMS

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PLANNING FOR EMERGENCIES

• Assess your existing emergency plan

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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 ?

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ASSESSING COMMUNITY RESPONSE

• EMS Coordinator
• EMS dispatch
• Response time
• Level of responders
• EMS protocols
• Local law enforcement

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COMMUNITY RESPONSE

• Hospital
• Emergency Department
• Variables in decision
• Transport times
• Trauma center
• Pediatric center

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Emergency Responders

• Emergency Department Nurse/Physician
• Bystanders/Good Samaritan
• Medical First Responder
• Emergency Medical Technician
• EMT-B
• EMT-I
• EMT-P

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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

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School Communications System

• Notifying EMS
• Notifying school staff
• Notifying parent/guardian
• Public Information dissemination
• Providing informational updates

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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

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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

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Transport Options

• Based on condition of student
• Available options
• EMS ground transport
• EMS air transport
• Parent/guardian
• Other responsible adult
• School staff

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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 ones intuition
• Understand the loss of power and control
• Use verbal communication effectively

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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

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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

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Follow-Up Activities

• Complete incident reports
• Conduct follow-up review
• Evaluate outcome
• Collect data

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Special Situations

• Refusal of care
• Parent/guardian
• Student
• Other
• Religious objections
• DNR
• Automated External Defibrillators

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Crisis Management

• Natural disasters
• Manmade disasters
• Terrorist attacks
• Violent incidents

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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

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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

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Communication During a Crisis

• Warning Codes
• Code Red
• Code Yellow
• Code Blue
• Code White
• Code Green

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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

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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.

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ANY QUESTIONS??