Medical emergencies in elementary schools - No school nurse! Nurses please weigh in

[manna, BSN, RN]

I'm seeking some information from any of my fellow nurses - I also cross-posted this in the school nurses forum but figured it'd get more traffic here. I'm a RN in the hospital setting and my kids are in a private school, so I don't have any experience with this type of issue.

A dear friend of mine is a teachers' assistant. The school where she is employed, sadly, has only a part-time school nurse (she is shared with several other counties and was not there at the time of this incident).

Recently, a 9 year old in her classroom suffered a grand mal seizure (my best guess from the way she explained it to me). The child fell out of a chair and they were unsure whether she struck her head on the floor. The child has no history of seizures that the parent/school are aware.

The school did not call EMS, but called the mother (who was an hour away and stated that she would be there in 1-2 hours time). I suppose that the mother gave no directions to call EMS at that time.

The child was kept in the classroom and observed by a teacher. Sadly, only one of the teachers in this school is even trained in CPR! Mother arrived several hours later and picked up the child, but declined to seek medical attention at that time.

Does your school have any policies/procedures for medical emergencies? Is this typical - call the parent/not call EMS? It just seems like a huge liability for the school and health hazard for the kid (with sometimes undereducated parents, sad to say).

Any input/advice/thoughts? Thanks for your help, nurses!

[GingerSue]

this is a good question - where are those policies/procedures found when at a school?

is the child's health as the main concern or is contacting the parent the main concern?

[traumaRUs, MSN, APRN]

We have had similar incidents at schools where my son's have attended. I have never seen any of their schools (and since we are military, they have attended schools in five states and three overseas countries) to have full-time nurses.

The best info I can give is for parents to go to the school immediately when called that something has happened and then seek care too. If you can't go there at the time, then EMS should be contacted.

I worked with a tech in the ER who had a son with severe asthma. One day, they called him to come and get the child because he said he couldn't breathe. He told them to call 911 but the secretary told him that it wasn't that serious, he should come and see for himself. Long story short, the child ended up being intubated for a prolonged period of time. This did not have to happen if the school would have called 911. Very sad.

[MALE*RN*777]

My son attends the same private school the wife and I did and there is not a nurse there either. They do have a policy concerning emergency contacts, permission to send the child to the ER and medication administration. We sign that we give the school permission to seek the necessary medical assistance for emergency without holding them accountable. Now the school should have some no fault insurance for injuries such as when my boy fell off the monkey bars but our insurance covered everything. To make a long story short, its a private school and you should know that no full time/part time nursing staff is available so you are putting your trust in the school staff to call 911.

[moongirl]

I live in a remote rural area. Our public school has no nurse per say, just one and she is shared district wide and the only time I have ever laid eyes on her is when she is called in for a lice check.

More often than not, when I am there volunteering time in my children's classrooms, I end up being the nurse. I have cleaned cuts, scrapes, bleeds

illness, etc.

The way it is ran here, the parents fill out an emergency card with phone numbers and Dr name. Then they number it in order that the school is supposed to call. Assuming that it is non life threatening, the first name on the list would be the first call. Life threatening, EMT's would be called.

Does it actually work like this? I dont know. But I let the office staff know in no uncertain terms that it is not up to THEM to decide if it is a medical emergency, they dont have that kind of training, and if in doubt, call someone. If medical treatment for my child was delayed because they decided to "wait and see" I would have each and everyone of their butts in a sling