1. Illinois EMSC1 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

2. Illinois EMSC2 Your Role in Emergency Planning As a school nurse you have an instrumental role in developing a comprehensive management plan for school emergencies.

3. Illinois EMSC3 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. Illinois EMSC4 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. Illinois EMSC5 Your Responsibilities in Communicating with Others Parents and caregivers Primary health provider School administrator, teachers and staff

6. Illinois EMSC6 SPECIAL CONSIDERATIONS Cultural Diversity Children with Special Health Care Needs

7. Illinois EMSC7 SPECIAL CONSIDERATIONS AGE AND DEVELOPMENTAL LEVEL OF STUDENTS LACK OF HEALTH CARE ACCESS RESPONSE OF LOCAL EMS

8. Illinois EMSC8 PLANNING FOR EMERGENCIES Assess your existing emergency plan

9. Illinois EMSC9 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 ?

10. Illinois EMSC10 ASSESSING COMMUNITY RESPONSE EMS Coordinator EMS dispatch Response time Level of responders EMS protocols Local law enforcement

11. Illinois EMSC11 COMMUNITY RESPONSE Hospital Emergency Department –Variables in decision –Transport times –Trauma center –Pediatric center

12. Illinois EMSC12 Emergency Responders Emergency Department Nurse/Physician Bystanders/Good Samaritan Medical First Responder Emergency Medical Technician EMT-B EMT-I EMT-P

13. Illinois EMSC13 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

14. Illinois EMSC14 School Communications System Notifying EMS Notifying school staff Notifying parent/guardian Public Information dissemination Providing informational updates

15. Illinois EMSC15 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

16. Illinois EMSC16 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

17. Illinois EMSC17 Transport Options Based on condition of student Available options –EMS ground transport –EMS air transport –Parent/guardian –Other responsible adult –School staff

18. Illinois EMSC18 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

19. Illinois EMSC19 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

20. Illinois EMSC20 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

21. Illinois EMSC21 Follow-Up Activities Complete incident reports Conduct follow-up review Evaluate outcome Collect data

22. Illinois EMSC22 Special Situations Refusal of care –Parent/guardian –Student –Other Religious objections DNR Automated External Defibrillators

23. Illinois EMSC23 Crisis Management Natural disasters Manmade disasters Terrorist attacks Violent incidents

24. Illinois EMSC24 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

25. Illinois EMSC25 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

26. Illinois EMSC26 Communication During a Crisis Warning Codes Code Red Code Yellow Code Blue Code White Code Green

27. Illinois EMSC27 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

28. Illinois EMSC28 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.

29. Illinois EMSC29 ANY QUESTIONS??