AAP updates guidelines for medical emergencies in schools
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The AAP has updated its guidelines for medical emergencies occurring in schools.
Rani S. Gereige, MD, MPH, FAAP, director of medical education at Nicklaus Children’s Hospital, served as lead author of the original policy statement, published in 2001, and co-authored this update with members of the AAP’s Council on School Health and Committee on Pediatric Emergency Medicine.
“In 2008, the committee published two policies, almost like we retired the [original] policy statement,” Gereige said. Of the two published in 2008, “one was focused on medical emergencies occurring at schools, focusing on the individual student. Another policy statement published around the same time [focused on] general emergency preparedness in schools for natural disasters.”
Since then, Gereige said, much has changed regarding “individual student emergencies” related to guidelines on automated external defibrillators in schools, among other matters.
“If you look at the policy, it's divided into three major sections: the preparedness piece, the response piece, and the mitigation piece,” Gereige said.
Most of the new guidelines, he said, focused on children with special needs or chronic conditions.
“We went a little bit more into the response [guidance] by giving more guidance about specific diseases — allergies, anaphylaxis, asthma; sudden cardiac arrest, which was kind of new” Gereige said. “The other one that was new is substance use and overdose.”
He said the communicable disease guidance was “very short, because we did not want to make it about COVID-19 itself.”
“We realized that throughout the country, different school districts have different resources and different access to certain things,” Gereige said. “So, some schools might have a nurse, but some schools might not have a nurse on site. Some schools might be in a remote rural area and might not be too close to an EMS or a medical center. What we tried to do is give the schools a little bit of preparedness.”
According to an AAP summary of the guidance, “schools need to be prepared to deal with medical, behavioral, and traumatic emergencies that students or staff may experience.”
Up to 25% of childhood injuries occur in school, according to the AAP, making it “prudent for schools to prepare particularly for potential medical emergencies related to chronic conditions, such as seizures, diabetes, allergies/ anaphylaxis, mental illness, substance use, or asthma, through personnel training and emergency action plans,” the updated guidance says.
“Ideally, schools should develop emergency policies with input from the medical community: emergency medical services personnel and community clinicians. These policies need to be flexible enough to accommodate different students’ developmental levels,” the authors wrote.
“Integration of EMS personnel into school emergency planning familiarizes them with the location and type of medical resources available at the school. This collaboration leads to the creation of policies and regulations that appropriately delegate authority, assign roles, distribute shared resources, and establish parameters for health care providers,” they wrote.