Procedures for Medication Emergencies

A life-threatening medical emergency may occur at school or during school sanctioned activities outside of the normal school day. Districts and schools should have school health policies and procedures on how to respond to medication emergencies. A general emergency plan consists of what to do when an emergency occurs. The instructional steps assist the registered nurse working under the auspices of the school or program in professional judgement and accountability of delegation. Additional steps may be required depending on the school or program needs.

The delegatee is able to voice understanding of the following:

1. how to access 911, their community health systems and poison control
2. the emergency protocol in their designated role (if applicable)
3. Understands definition and examples of a life threatening emergency:
   1. Definition: A life threatening or severe emergency includes immediate treatment and mobilization of emergency health services. The most important actions are first aid and transportation to a healthcare facility or emergency room as quickly as possible. Providing immediate basic first aid, CPR and summoning 911 or emergency community health services may mean the difference between life and death. Possible life threatening emergencies may occur minutes or even hours after the medication administration incident. Example signs of a life threatening emergency may include:
   2. Examples:
      1. Acute itching, hives, swelling of face or extremities
      2. Severe swelling of lips, tongue, or mouth, tightness in the throat or hoarseness
      3. Extreme difficulty breathing, shortness of breath, persistent cough, wheezing, breathing stops
      4. Student is unconscious
      5. Dusky color, extremely pale, gray or clammy (damp)
      6. Continuing vomiting or diarrhea
      7. Loss of consciousness, unable to recover
      8. Continuous seizure
4. Understands actions to take in an emergency:
   1. Stay Calm and follow your emergency plan (if applicable)
   2. Observe severity and condition of the individual. Remember specific information for later documentation
   3. Stay with the individual and call for help
   4. Ensure you are wearing correct protective equipment
   5. Provide appropriate life support
   6. Have someone locate AED, if available
   7. Obtain assistance from another person to call 911 for emergency rescue team and Provide all information requested by the dispatcher, the individual’s location, room in building (if applicable), telephone number of the school or device called from, lifesaving services being provided (if applicable) and what is happening
      1. It is important to remember if you are the one making the call to 911, Hang up only with the permission of the dispatcher on the other end of phone line
      2. Implement the individual’s emergency health plan if applicable. For example, administer emergency medication as ordered for a specific student (if applicable).
      3. Contact the following as soon as possible per the district or school protocol: Registered nurse, student’s parent, legal guardian or emergency contact, the hospital emergency room where the individual is being transported if no school personnel can transport with the student to the hospital, and school administration.
      4. Remember, it is ALWAYS better to take a situation seriously; Do not wait and see if the situation is going to turn into a serious one.
      5. The school nurse or designee may accompany the student to the hospital if parents are unavailable and school administration has instructed them to do so, give emergency responders needed information, and send a copy of the student's record with the emergency medical personnel.
      6. Document what happened and as many details as you can about the student’s reaction. You may miss important details if you do not do this right away.