Health, Medicine & Reunification in School Disasters

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1 Health, Medicine & Reunification in School Disasters National Center for Disaster Medicine and Public Health October 11, hrs

2 Disclaimer The views expressed in this presentation are solely those of the presenter and do not reflect the views of Boston University School of Medicine.

3 NCDMPH Disclaimer The views expressed in this presentation are solely those of the presenter and do not reflect the views of the National Center for Disaster Medicine and Public Health, the Uniformed Services University of the Health Science, and the US Department of Defense

4 Objectives Discuss health emergencies that are prevalent in schools today. Advocate the need for drills as a component of a comprehensive school emergency management programs. Discuss how family reunification in school disasters should be a priority for all school emergency plans.

5 Intro/Conceptual Framework What is a crisis for schools? Sudden, unexpected, overwhelming incident Can range in scope & intensity Range of events that require potential evacuation Fires Power failure Contagions (lice, flu, stomach bugs) Bomb threats Gas leak Student and/or staff deaths Active Shooter / Acts of Violence

6 School Emergency Planning Team Representatives from: Fire, Police, EMS School Admin, Staff & RN Community at large Meet in non-school location if possible. Team should be middlemanagement personnel and not Dept. Heads

7 School Health Emergency Needs CPR / AED Training Building Emergency Response Teams (BERT) Medical Emergency Response Plans School Nurse integration to Emergency Management Meetings and Evacuation Drills Family Reunification Psychological First Aid

8 Schools & Healthcare Healthcare Areas of Concern for Sandwich (MA) Public Schools 2013 Medical Issues for Children with Autism Room set up for housing evacuated special population students. Transportation of special populations HIPAA issues as it pertains to special populations. Emergency responder interaction with special populations. Communication issues with special populations. Psychological support for special population students and family members in times of crisis.

9 Health Services Policy and Procedures Head Lice Procedure Concussion Policy No Food in the Classroom Policy Wellness Policy Accident/Injury Reporting Procedure Procedure for Field Trips

10 Sandwich (MA) Public Schools Health Services Policy and Procedures will drive the drill and exercise schedule for the district. List was derived from Massachusetts Department of Public Health and Department of Education collaboration.

11 BERT BERT Information Building Emergency Response Teams Made up of faculty and staff who have additional training provided by Police, Fire, EMS. Respond to emergencies in house to assist School RN and athletic staff. Are issued radios, BERT Vests and meet once a month to discuss response scenarios and practice radio nomenclature. BERT in Action

12 Common BERT Organization School Principal BERT Leader Emergency Support Transportation Staff Support

13 CPR/AED Trainings for Schools In collaboration with the Sandwich Fire Department, district staff are offered Heartsaver AED Training on an annual basis Any BERT Team member who is interested in becoming certified in this American Heart Association (AHA) training course will be given a class during school hours if possible.

14 AED Policy and Procedure Each school building has at least 1 Automated External Defibrillator (AED) school staff need to be aware of the location of the building AED AED equipment including battery and pads - are routinely checked and maintained by school personnel/school nurse School staff who are trained in CPR and in the use of the AED are members of the building s medical response team

15 Michael s Law (MA) Plans shall be developed in consultation with the school nurse, school athletic team physicians, coaches, trainers and the local emergency medical services agency, as appropriate. Schools shall practice the response sequence at the beginning of each school year and periodically throughout the year and evaluate and modify the plan as needed. Plans shall be submitted once every 3 years to the department of elementary and secondary education on or before September 1, beginning in the school year. Plans shall be updated in the case of new construction or physical changes to the school campus. Included in each initial and subsequent filing of a medical emergency response plan, each school district shall report on the availability of automated external defibrillators in each school within the district, including, the total amount available in each school, the location of each within the school, whether or not the device is in a fixed location or is portable, those personnel or volunteers who are trained in its use, those personnel with access to the device during regular school hours and after and the total estimated amount of automated external defibrillators necessary to ensure campus-wide access during school hours, afterschool activities and public events.

16 Medical Emergency Response Plan In response to Michael s Law, the Sandwich Public Schools (SPS) has developed an Medical Emergency Response Plan in consultation with members of the school community, including the School Nurse Leader, School Physician Consultant and local EMS Responders SPS Medical Emergency Response Plan was submitted to the Department of Elementary and Secondary Education (DESE) per state mandate in September, 2012 The purpose of this plan is twofold: to reduce the incidence of life-threatening emergencies to promote efficient responses to such emergencies

17 Medical Emergency Response Plans Individualized emergency plans for those students or staff in wheelchairs or unable to ambulate. Plans put together with affected member, school RN and Administration with FD input. Currently there are a handful of students in the district that fall under this criteria. Numbers change in part to athletic seasons (football etc..) School District BERT members and Public Safety partners work together during drills to tighten up these assistance procedures including stair chair evacuation practice. Fire Department provides in-service training to teaching staff on how to evacuate students or staff with functional needs.

18 School RN/EM Crosswalk Need to have knowledge of Incident Command System. Need to have mental health triage training (PSYSTART) and Psychological 1 st Aid. Need to have input in all (4) phases of Emergency Management plans. Mitigation Prevention Response Recovery

19 Good Practices School District Nurse Manager Carilyn Rains (Sandwich, MA) coordinates (3) meetings a year with all School Nurses, Police SRO and Fire Department personnel. Discussion about emergency procedures, student illness trends and evacuations should be discussed with staff, students and parents. Practice re-unification procedures during dismissal each day strengthens reunification if real disaster happens.

20 Mock Code Drills As part of your Medical Emergency Response Plan In partnership with Fire, Police, & EMS In collaboration with Athletic Department and provides practical exam for Coaches in dealing with medical emergencies. The scope of the mock code drills will be expanded into the district s school buildings during the school day

21 School Evacuation Consider special populations when writing and implementing school evacuation procedures Realized Spinnaker Program, and Camp Excel with separate staff and transportation, are housed in Sandwich Schools and have special populations. Autism, and 1 to 1 medical interventions. Agreement made with Sandwich Council on Aging to use Human Services Building as Special Populations Evacuation site. Town RN on site, Plenty of room and ADA compliant.

22 Cape Cod Collaborative Exercise CCC exercise has been yearly event every June since Fire Department practices response to functional needs populations and is used as a teachable moment for emergency response. Not all triage is SMART when dealing with special populations. Students are medically compromised and also have autistic students on all spectrums.

23 Family Reunification Most critical element for schools during and after a disaster. Chaotic and uncontrolled with chances for several mistakes. Schools need to have comprehensive emergency family reunification protocol that is understood by parents, faculty and students PRIOR to any disaster.

24 Family Reunification Work with the Parent Teachers Association (PTA) in promoting and disseminating family reunification plan. Encourage individual families to adopt their own family reunification plan based on elements of the school district plan. Practice and exercise school evacuations each year and include family reunification.

25 Action Items for Schools Go to EMR for student records with mobile IPADS or Tablets that can be brought outside and used outside of the building. Enable these devices with 4G LTE in case internet is not available. Town of Sandwich (MA) receives insurance liability discounts for practicing school emergency plans each year including mock cardiac arrest and school evacuations. District has saved roughly $22,000 since 2008 by this participation which goes back into safety and health procedures.

26 Resources Good Resources for schools and emergency management. NIH report on School Emergency Management NCDMPH Tracking & Reunification of Children in Disasters: A Lesson & Reference for Health Professionals online training course. Local Police, Fire & EMS can be a huge resource and they are vested in the system. Online Sources: px

27 Contact Information John J. Burke, M.S., EMT-I Associate Director / Instructor Boston University School of Medicine s Health Care Emergency Management Program

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