Need Help: Emergency Response Program

[MMiz]

I'm now teaching in a more rural environment that is attempting to establish an emergency response program. I'd love to make this program work, but unfortunately my knowledge on the subject is limited, and there aren't any programs in our area (we hope to be the first).

Background Information:
I teach at a middle school in a suburban/rural area. It is a working class community with two middle schools and a single high school across the street.

Staff:
Currently we have one school nurse for the district who is on call, each school has a school resource officer (city police officer), and an emergency response team. The team is nothing more than one teacher per hallway who is trained in CPR/First Aid.

Training/Equipment:
Maybe 10 teachers in the school are trained in CPR/First Aid. There are two Teachers/EMTs, and they've been encouraged to act within their scope of practice. Every teacher is provided a plastic lunch bag with bandaids and a pair of latex gloves.

Future/HELP!
Where do we go from here? All I see is 100 problems and things not working, yet I'd like to create a roadmap as to developing a program that works and is practical. I see major problems with communication, training, and equipment, but it's hard to march into a new school and start a program (though I have full support).

Anyone have any experience with this?

 

[rescuecpt]

How is an emergency communicated amongst the response team? to the principal? to 911?

What is the procedure in place now if something happens? Give us some more details, and maybe we can make suggestions on how to improve what's already in place.

 

[MMiz]

Right now the system is a disaster.

The phone system in the school is an intercom. If an issue arises, we pick up our telephones, dial an extension, and start talking. We hope someone on the other end is there. If not, then we're SOL.

Right now if a staff member witnesses an emergency, they pick up the nearest phone, dial 0, and then notify the office. The office then announces one of several codes over the PA system.

In the case of a medical emergency, a Code X: Room X is declared, and then we respond to the location. Currently our first aid supplies consist of bandaids, gloves, and more "stuff" in the nurses office.

The school's administration and police officer are supposed to carry Nextels, but I don't see if happening.

What I'd like to see:
1. Communications - I'd like each member of the leadership team, school secretary, and ERT members to have a communication device. I'm not a huge fan of Nextels because of limited availability, and lack of open communication. I've seen Nextels with portable radio backups available in the office, and that seems like an ideal solution.

2. Training: There are no policies if x happens. Whether it be a medical emergency, terror threat, etc, we have no training beyond what is written on a flip chart. Half the teachers don't even have those. In Michigan both in my school experience, and the other schools I've taught in, staff and students trained for all types of drills. I don't see that happening here. In Michigan every teacher needed to be trained in AHA CPR/First Aid/AED. There are maybe 5-10 teachers trained in it at my school.

3. Supplies: I'd like to see medical supplies, radios, MCI supplies, bull horns, reflective vests, etc. available for these type of situations. In Michigan the school needed to have two sets of these supplies packed in boxes in two separate locations of the school. Here they don't have anything. In fact I don't even believe we have student records should we need to evacuate. I'd like on-site O2, a trauma kit/first responder bag, etc.

Most importantly, I'd like to know how to approach this. I don't want to step on toes, but the school is looking for people to take a leadership position on these activities, and I'd like to get the ball rolling.

I may suck at managing my time, and I have far too many responsibilities as it is, but this is something that I just feel wrong about. Unfortunately I feel as though no one else, besides another EMT in the school, feels the same way.

 

[Ridryder911]

I would keep it simple as much as possible. How is the local EMS in that area ? If they are active and provide quick response, then I would not be developing an in-depth program. Keeping up CEU's supplies and materials is not only expensive, as well not needed in most cases. Simple supplies of a few bandages, and maybe a SAM splint or something similar is about all is needed until EMS arrives. I definitely would not get oxygen (remember this is medication and does require a physician prescription to purchase and administer) again, increasing potential litigation and risks.

Improving communication and properly reporting and emergency is one of the most essential areas. Basic first-aid at the simplistic means for all staff should be encouraged, and then develop a response team of those with additional training. Not all staff want or can handle emergencies, and there is enough for everyone to do.

I wish you the best of luck...

R/r 911

 

[MMiz]

Rid,

I think your post sums up much of the school's and staff's sentiment. Right now we're being pounded with one program/initiative after another, and I think in order for this to work, we need a small team of dedicated responders, as the school is creating.

I agree with the KISS method (Keep It Simple Stupid), but also realize that we are relatively unprepared should a disaster happen.

I think my first reaction is to focus on what to buy/have in order to respond to the emergency, but I think it's safe to say that the preparation/training is by far the biggest element.

EMS is 5-20 minutes away. We have a Level II trauma center about another 20-30 minutes away via ambulance. Most traumas fly.

What would we do in a school shooting? Where would the kids go? How would parents be contacted? How would we account for them? How would we access student records if the computers went down? How would we transport them to the staging location? Where would ambulances stage? and on.. and on.. and on.

I'm not so sure what is wrong with O2. We have two EMTs on scene, one who works for the responding EMS agency. We also have a nurse on call. Heck, the AHA even teaches O2 administration, even though they haven't yet decided whether to make it part of the core classes.

I guess part of me was hoping that there was some sort of template I could use as a guide.

 

[Jon]

O2 is now showing up as "public access O2" same as "Public Access AED."

If you want to have O2, what about talking with the local EMS agency? Could they provide an oxygen tank as a "loaner"... you'd just swap it out with them when it got empty?

At the least you should have spme basic bandadging and resusitation supplies (BVM, CPR Board). Can EMT-B's use Epi-Pens?

As for communications - how big is the school? Why not use MURS radios (colored dot channels) or GMRS radios... heck, why not use the cheap FRS radios.. they should work OK. At <$30 a piece, you could give one to everone involved in the ERT.

As for records:
My school nurse had a big, heavy duty "code cart" that held all her records and all the meds... she took this with her during any building evacuation. We also had a bullhorn or 2 around the school office.

As for the equipment and backup student records... is there someone in the office who could be responsible for this? Bringing the ERT gear for you, or taking the records to the evacuation CP?

Oh, yeah... the school should be NIMS-Compliant (not joking)... There should be a designated Command Post (and a backup site) for the principal and support staff to report to... that way the local response agencies know where to meet the "guy in charge." (My school's was the flagpole out front... 50+ feet from building)

Good luck!

 

[MMiz]

Jon,

Our school should be a lot of things... but yeah. This may sound stupid, but I'd forever be in your debt (when you have a chance) if you could email or post the "things" or protocols you remember from school.

I graudated high school in 2001, so I remember a lot of what we did, but I'd always like additional feedback.

Thanks!

 

[oldschoolmedic]

You are asking the wrong people for help in this case. You need to coordinate this through your local responders police, fire, and EMS to see what they need from you.

Fire - have they done a preplan on a large commercial structure like your school, or actually done one for your school? Ask them where they want students to gather in the eventuality of a fire, or hazmat situation. From there designate a rally point and practice evacuating the school (fire drill ) once a quarter at the minimum. None of your staff should respond to either of these situations as your primary responsibility will be the childrens safety.

Police - have they utilized the availability of DHS grants to upgrade their response to terrorist situations? What do they need from your staff in the eventuality of a hostage or shooter in school situation? Ask them. Again, no staff member should respond in these situations.

EMS - Find out what their policy is on a incident at your school. Do they have more than one unit available to handle something? What do they expect from your staff? For them I would recommend establishing a central location where they would go to receive an injured/sick student or staff member. Have someone designated to meet the crew and lead them into the patient, possibly give a quick oral report of the situation.

Internal communication sounds like your biggest problem. You will have to find a better way to address how a situation is announced. A simple way is an alphanumeric pager with all call technology. The pager goes off and there is the message detailing the needed response from staff. Cheap radios are just that, cheap, and would have to be kept on all day in class. No teacher is going to do that. Nextels are fine as is WT coverage, but costly. VHF/UHF will require FCC licensure depending on your broadcast power, 800 radios will cost you in membership/user fees. You have to remember this idea will have to be sold to the school board who are elected officials that will pinch a penny until Lincoln screams.

A far as medical supplies in house, get an AED. No doubt about it, they save lives. It's a big expense, but if you look online and do some research you will find many places will help with the expenses, some businesses will even buy them outright for you. Get a BVM, or at the very least, pocket masks. Keep enough bandaging in house to handle a significant wound, and post it in strategic locations. Ladder or SAM splints are easy to use and can be inexpensive to keep on hand. Think about your school, does it teach wood/plastic/metal shop, does it teach home ec? These are places where a laceration, fracture, or burn could be very severe. Next up make it a requirement for ALL STAFF to learn CPR, remind them they will probably not have to do it on a child, more than likely it will be on another staff member, kind of an incentive there. The AHA or ARC teaches first aid, get them in there over a school break and have them teach a class or three. They love to help places be proactive instead of reactive. Involve your school nurse. As a licensed provider she has more flexibility in what she can and cannot do. That could be your out for getting oxygen on campus. We always had O2 in the nurses office where I went to school. The nurse should have a copy of a students health record available to be sent with them in the eventuality of an emergency. It could be as simple as emergency contact numbers, meds, allergies, and hx. That would be sufficient to get the ball rolling at the ED.

You are trying to tackle a commitee sized problem on your own. Ask for some help or delegate to the other EMT on site. Good luck with your project. I hope it is never needed.