EMS Response to School Incidents
|Bureau of EMS Policy Statement|
|Policy Statement #||99-11|
|Subject||Re: EMS Response To |
EMS Response to School Incidents and Bus Accidents
The purpose of this policy statement is to furnish information to EMS providers and agencies concerning responses to schools and the management of school bus accidents.
The potential number of patients, the frequent presence of uninjured children who do not require hospitalization, the jurisdiction of the school district and the responsibilities of EMS providers often raise conflicting issues of jurisdiction, consent, treatment, and transportation. The roles and responsibilities of the school district and the EMS agency must be identified in advance of any incident, by jointly developing operations plans so that a common understanding of their respective expectations and responsibilities are well defined.
Several citations in Education Law place responsibility for student health and safety on the local school board/district1:
- State Education Law §912 places responsibility on the school board for the health and welfare of all children including the administration of emergency care programs for all ill or injured pupils.
- Formal Opinion of Counsel No. 213(1967) the State Education Department cites several authorities for schools to provide health and safety and pupil transportation for children in their jurisdiction.
- In Decision 10,587(1981) the State Education Commissioner found that the responsibility for pupil safety shifts from the parent at the point of pick up by the school bus.
These citations clearly identify the roles and jurisdiction for a school's health services and administrative employees and it's agent provider of transportation. These responsibilities include student health and safety and pupil guardianship. The exact nature of the responsibility is left to local district policy, procedure and practice.
No specific statute clearly defines responsibility in the case of a school bus crash. As in most other prehospital situations more than one agency has a role and jurisdiction. In the case of a school bus accident the school district, law enforcement and EMS each have specific and unique roles. As in many field situations the use of well established plans and a unified incident command structure provides the means to define whom is in charge of the incident.
Emergency Planning with Schools
Utilizing long established practice of pre planning for responses to known situations, EMS agencies need to establish the necessary dialog with school administrators and health services personnel to develop, implement, periodically drill, and review response plans to school incidents including bus accidents.
The State Education Department in guidelines2 provided to local school districts identifies a requirement3 to develop comprehensive emergency plans for all contingencies. It specifies that all community resources be identified and policies and action plans be developed and coordinated with local emergency services. Additionally, the emergency procedure guidelines require training in the response to catastrophic emergencies and conducting periodic instruction in disaster, fire and bus drills.
- EMS agencies need to communicate with the administrators of all school districts in their response areas and develop, implement and/or review specific emergency response plans to school emergencies, including bus crashes. It is helpful if this planning is done in a coordinated environment, which would include law enforcement, fire, and the local office of emergency service/management.
- The authority, jurisdiction and responsibilities of the school and each response agency must be included in the plan.
- Assessment and triage protocols need to take into account the behavior of children in such incidents. The protocols also must recognize that passengers may be injured, act as if they are injured or may not be injured at all. The objective for EMS providers is to render appropriate care and/or transportation for passengers who require emergency medical care and/or transportation.
Any student presenting injury or a sign or symptom suggesting injury should be properly assessed, triaged and transported in accordance with state and local treatment protocols.
Any student presenting with no complaint or injury can be released to school health services personnel or administrator on the scene for further evaluation and transportation. Once the student has been released to the school district, its personnel assume responsibility for the student and any further assessment, treatment or transportation to a hospital as needed.
All persons on the bus need to be identified and recorded as being involved in the crash. Treatments provided and passenger disposition may be documented via log, triage tag or PCR if treated and/or transported. A copy of all documentation should be made available to the school upon request. Schools and EMS agencies should develop a tracking system for use in such situations.
School bus crashes are difficult and emotional incidents for all involved.Each one is different and a well-developed and rehearsed plan conducted using a unified incident command management system will facilitate the most effective outcome for the patients, schools, EMS services and other responsible local authorities.
1will be referred to as schools
2Emergency procedures in the School Setting, State Education Department, 1993.
3State Education Commissioner's Regulations § 155.13
John J. Clair
Associate Director — Operations
Edward G. Wronski