Cardiac arrest, falls, seizures and asthma attacks —schools should be prepared for all of them, according to the American Heart Association. The AHA has issued a statement recommending that schools develop detailed plans for medical emergencies. The statement, which was published in the Jan. 6 issue of Circulation: Journal of the American Heart Association, outlines five key components of an emergency response plan.In a Midwest survey, 18 percent of elementary and high school teachers said they had provided some level of emergency care to more than 20 students every year. Furthermore, 17 percent of teachers said they had responded to a life-threatening emergency at least once during their careers. A New Mexico survey reported that 67 percent of schools need emergency medical services each year.
"Schools should develop and practice a plan before it is needed," said Mary Fran Hazinski, R.N., co-author of the report and a critical care nurse at Vanderbilt University Medical Center in Nashville, Tenn. Hazinski is also a senior volunteer for the AHA. "When a life-threatening emergency occurs, the quality of the response in the first few minutes, before emergency medical service (EMS) personnel arrive, can make the difference between life and death. During the emergency, teachers, staff and students should know what to do and should be prepared to act quickly.
"Schools plan and rehearse responses for emergencies such as tornadoes and fires. We feel they also should practice response to medical emergencies," she added.
The AHA’s statement focuses on cardiac arrest, but the emergency plan that it outlines could be applied to any medical emergency. The plan, which would cost about $3,000 per year per school, has five key elements:
• Effective and efficient communication across the campus. All parts of the school, including outdoor areas, should have links to local emergency medical services.
• A practiced and coordinated response plan. Schools should develop a plan that would be applicable to various common medical emergencies and practice it several times a year. The school nurse, athletics staff and the local EMS personnel could be involved in this plan.
• Risk reduction. Schools should take safety precautions in classrooms and on the playground. If some students or staff have special medical needs, school personnel should be trained to respond to any associated emergencies.
• Training and equipment for first aid and CPR. Teachers, staff and even high school students should be trained in CPR. Staff should be trained to provide basic first aid for medical conditions like sudden cardiac arrest, heatstroke, seizure, diabetes, asthma, burns and broken bones.
• An automated external defibrillator (AED) program for schools that need it. AEDs can deliver shocks that stop abnormal heart rhythms. AED programs have been shown to improve survival in adults who have cardiac arrest outside of a hospital.
"This statement represents an important benchmark in cooperative effort among many national organizations to strengthen the chain of survival in every community, especially the community that cares for and educates our children," said Vinay Nadkarni, M.D., immediate past chair of the American Heart Association’s emergency cardiovascular care committee.
Many organizations endorsed the statement, including: the American Academy of Pediatrics, American College of Emergency Physicians, the American National Red Cross, the National Association of School Nurses, National Association of State EMS Directors, National Association of EMS Physicians, National Association of Emergency Medical Technicians, and the Program for School Preparedness and Planning, National Center for Disaster Preparedness, Columbia University Mailman School of Public Health and The Centers for Disease Control Division of School and Adolescent Health.
You can find the full text of the report at http://www.aap.org/policy/erplanschool04.pdf.
