Guidelines for Urgent Care in School

Abstract

Minor injuries and illnesses can occur in children during the course of the school day. They are usually well handled by the nurse in consultation with the school medical advisor; true medical emergencies are quite rare. Many school systems, however, have part-time school medical advisors and nurses who cover more than one school building and may not be readily available. Therefore, the burden of emergency recognition and management may fall on teachers, principals, or other personnel in the local school. Inappropriate and delayed care may result in increased morbidity or possible death. Finally, consideration must be given to the question of malpractice or assault charges being filed by the families of inappropriately treated children. In order to solve this problem, it is important for school administrators in consultation with the school medical advisor and nursing service to formulate a guide for emergency care. The Committee on School Health of the American Academy of Pediatrics suggests the following: 1. Every school district should have an identified, qualified administrator with decision-making status. 2. An emergency care manual and standing orders for first aid should be written and made available to nurses, athletic staff, and faculty volunteers. A sample manual1 is available from the Connecticut State Department of Health (540 Nortontown Rd, Guilford, CT 06437 [$ 8.50]). 3. The school nurse in each building should be the key person to carry out the program as she or he is most familiar with the student's health problems. All nurses should be trained in a program of emergency care developed by physicians, emergency medical technicians, and/or other nurses with special training in emergency care.