Back to School: The Ultimate Pediatric Call

EMS calls involving pediatric patients are emotionally charged and can generate a high level of stress for the personnel who respond. Apprehension, uneasiness and anxiety are common in calls that involve one or two seriously injured pediatric patients. Can you imagine responding to a scene that may involve ten times as many pediatric patients? This article will discuss problems EMS agencies and school districts face in providing a strong and confident emergency response in the school setting and provide solutions.

Types of EMS Calls in the School Setting

EMS agencies respond to a wide range of calls in the school setting.

The so-called “routine” or “small-scale” calls may involve playground injuries or those sustained in phys. ed., technology or science classes. Medical emergencies may include asthma attacks or other allergic reactions. Trauma may result from physical altercations between students. On a less-common but larger scale, EMS providers may respond to a fire, bomb threat, hazardous-material incident in a chemistry lab, or a biohazard released in the building (such as anthrax or smallpox). Other calls may include shootings, stabbings, gang-related confrontations or physical encounters with disgruntled parents.

Multi-casualty incidents may involve a school bus accident on or off school grounds. This type of call is challenging. Issues regarding jurisdiction, consent, treatment and transport of patients must be addressed. Roles and responsibilities for EMS and the school must be well-defined. Plans must be developed and rehearsed in order to be effective.

Sporting events such as football, basketball, soccer and field or ice hockey can attract numerous spectators. Concerts and dances can also pose a danger when many enthusiastic participants become overzealous in displaying their “fan loyalty.” Bleacher collapse, “mosh pits” or “rushing the stage” can result in people being trampled or crushed. “Crowd surfing” and “stage diving” are also common, yet potentially dangerous practices at concerts that can result in blunt or penetrating trauma.

Accidents can and will occur. Our best defense is to be proactive rather than reactive. EMS agencies and school districts should strive to have a viable plan in place to deal with these situations.

Problems to Address

School districts and EMS agencies do not know what to expect from each other. Fortunately, this problem can be minimized by better communication between the agency and the district. This communication takes work. Some school districts encompass several square miles, which may fall into more than one agency’s jurisdiction. In this case, it may be helpful to have each of the agencies cover athletic events on a rotating basis. In this way, all agencies become familiar with the school setting, faculty and staff; which will help foster cooperation and communication. Other districts may have all their school buildings in a single physical setting and in one agency’s jurisdiction.

The key to establishing and maintaining a line of communication is to have at least one designated liaison between EMS agencies and the school or school district. This responsibility may fall to the principal, school nurse, fire chief or first aid captain. At times, these people are already overloaded with numerous duties. Sometimes they change jobs or leave their positions. The essential continuity in communication can break down. You need to work at keeping it current.

There has to be a district-wide plan to offer a coordinated response in the event of an emergency. The plan must be flexible and adaptive across differing structures, grounds and populations in the school district. The EMS agency should take the initiative in developing this plan with the schools. The lines of communication must be open and dynamic to respond to changing needs. Ongoing assessments have to be made and administrative, faculty and parental concerns need to be addressed. EMS has its own concerns and should also consider what it wants from the school. Are there things school personnel can do while waiting for EMS units to arrive on scene? This part of the plan should be clearly defined.