Diastat on field trips

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Looking for your thoughts on a recent debate in my district. Thanks for any insight!!

If a student has diastat ordered to be given in case of a seizure lasting >5 minutes, do you send this on a field trip with no nurse?

Specializes in Pediatrics Retired.
That's part of the plan, anyway. You always have to call for something like that.

I've stood, Diastat in hand...911 on the way.

My Seizure Action Plan actually states to call 911 if the Diastat doesn't stop the seizure but there's no way I'd wait. I'd rather tell EMS "never mind."

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Specializes in ICU/community health/school nursing.

In TX diastat may be delegable. I don't think it's delegable but my district makes me train staff on this and on intranasal midazolam. I have written that the training was "discussion only" because we have nothing to use as a model to demo the diastat. And then I let it go.

EMS can dose the med. The med is only given for seizures of 5 minutes' duration or more. It's entirely possible that a non-nurse might have to use this on a field trip, just like it's possible I could get hit by a car in the bus lane tonight. Possible, not probable.

Also - our rules for the bus are that the drivers do not administer but call EMS. So I guess it depends on the adult and his/her willingness to accept delegation.

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I am not a school nurse, but one well-familiar with giving Diastat. I would not delegate this to an untrained person. I either go on the trip, or instruct the chaperones/teachers to call 911. If a kid needs Diastat, they will need some medical follow up anyway.

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Specializes in Pediatrics Retired.
I am not a school nurse, but one well-familiar with giving Diastat. I would not delegate this to an untrained person. I either go on the trip, or instruct the chaperones/teachers to call 911. If a kid needs Diastat, they will need some medical follow up anyway.

If you don't go on the trip are you suggesting to "withhold" the diastat while waiting for EMS?

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I am not a school nurse, but one well-familiar with giving Diastat. I would not delegate this to an untrained person. I either go on the trip, or instruct the chaperones/teachers to call 911. If a kid needs Diastat, they will need some medical follow up anyway.

Our district policy is that if Diastat is used no matter who administers it - nurse or delegated teacher, it is an automatic call to EMS, if parent can arrive at scene quick enough they can make the decision regarding transport otherwise the kid gets transported & parent meets at the hospital.

Now there are always exceptions - I did have a complex medically fragile student in the past with a rare seizure disorder - sometimes would have them a couple of times a day - we had specific written orders from the doctor regarding his seizure action plan - give the diastat if seizing over 5 minutes, put his O2 on and call parents. They would arrive within 30 minutes or so and take him home to monitor - of course if he was in distress or continued to seize we were to call EMS but we never had to.

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If you don't go on the trip are you suggesting to "withhold" the diastat while waiting for EMS?

This is what I was thinking. If a parent sends in diastat, the expectation is that it will be given if needed. If it is not sent on the field trip then it is not available to administer and the school is open to liability- not to mention the risks to the student!

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This is what I was thinking. If a parent sends in diastat, the expectation is that it will be given if needed. If it is not sent on the field trip then it is not available to administer and the school is open to liability- not to mention the risks to the student!

But if it is ordered by a doc and part of the student's plan of care...

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Is it that difficult to hire a sub nurse? I don't get the issue.

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Specializes in Pediatrics Retired.
Is it that difficult to hire a sub nurse? I don't get the issue.

OMG...nurse subs in our district are barely paid above minimum wage. We have one RN sub on our roster and that's just because she's a long time friend to all of us and does it out of the goodness of her heart. On my campus, my "sub" is the office aide since she is right next to my clinic all day and is most familiar with the kids...we get a sub for her when she subs for me.

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OMG...nurse subs in our district are barely paid above minimum wage. We have one RN sub on our roster and that's just because she's a long time friend to all of us and does it out of the goodness of her heart. On my campus, my "sub" is the office aide since she is right next to my clinic all day and is most familiar with the kids...we get a sub for her when she subs for me.

We use an agency. Bettern a lawsuit or a mishandled situation because there wasn't an RN there.

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Is it that difficult to hire a sub nurse? I don't get the issue.

My current district has enough nurses to cover. We have full time internal subs. The last district I worked for, it was next to impossible to get a sub. Same as OD, they paid garbage and several only wanted to work at the elementary schools (I was at a 5th/6th grade building and no one ever wanted to sub there)

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Specializes in Pediatrics Retired.

So based on your "research" across the globe, have you arrived at as consensus for your post?

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