A Prospective Study of School Preparedness for Medical and Traumatic Emergencies

摘要

Objective: The purpose of this study was to determine if schools have resources and essential equipment to deal with a medical or traumatic emergency. Methods: This was a prospective survey of all public schools in a local county.Results: 323 schools surveyed with 47.6% response. A nurse was present in 97% of schools. 94% and 96 % of schools had a staff member, other than the nurse, with first aid or CPR training, respectively. Advanced equipment/resources: 22% cervical-spine immobilizer, 29% self-inflating resuscitation device, 51% oxygen, 56% nebulizer, and 73 % had epinephrine pens. 97% had an automatic external defibrillator (AED); in 26% of all schools the AED was available in the field during sports with 56% in high schools. Conclusions: The schools were well equipped with basic emergency supplies and training. The schools were lacking in advanced equipment. A high percentage of schools have an AED with variable location. Introduction The purpose of this study is to determine if schools have essential resources and equipment to deal with a medical or traumatic emergency. There are recommendations from the American Academy of Pediatrics, the American College of Emergency Physicians, the American Heart Association, American National Red Cross, National Association of School Nurses, National Association of State EMS Directors, National Association of EMS Physicians, National Association of Emergency Medical Technicians, Program for School Preparedness and Planning, National Center for Disaster Preparedness, Columbia University Mailman School of Public Health and the National Consensus Group Report regarding resources and equipment necessary for schools in the presence of a school nurse and when non health-related personnel are available. {1,2,3,4,5,6,7,8} Methods Design: This study was a prospective survey that enrolled all public schools in Nassau county, a suburb of New York City. The study was approved by the Institutional Review Board of the participating institution. Setting And Population: This study was conducted in a suburban public school system outside New York City. We included all public schools in Nassau county as published in the Boces directory. Boces is a resource link for school districts in Nassau and Suffolk counties on Long Island . Study Protocol: This was a prospective survey sent to all school administrators of all public schools in Nassau county in September 2004 regarding essential health resources and equipment in the schools. The surveys were completed by the school principal or school nurse. The survey was mailed only once with a stamped return envelope. There were no exclusions. Participants were informed in standardized way about how to complete the survey. To ensure anonymity the top of the survey contained a statement indicating that this was an anonymous survey of the school's preparedness to deal with medical and traumatic emergencies. We also asked the person filling out the survey not to include their name or the school's name on the survey to maintain anonymity. The survey asked for the following information: person filling out the survey (principal or school nurse), if there is a nurse in the school, number of students, and the type of school (i.e., elementary, middle school, high school). There were 2 lists of items as recommended by a National Consensus Group Report {7}, as well as several questions, regarding AED in the schools such as training, where it is kept, and if it brought to the field during sports. Data Analysis: We obtained frequencies on all variables. Descriptive statistics were employed for the majority of data analysis. Results The survey was sent to 323 schools with 154 schools responding (47.6%): Elementary 97 (63%), Middle 18 (12%), High 29 (19%), Middle & High 1 (0.7%), Early Childhood 1(0.7), and missing 8 (5.2%). A school nurse was present in 97% of schools. We obtained the following responses for essential minimum equipment and resources: 87% of schools reported