JLCE – Emergency Care and First Aid

All School personnel have responsibilities in connection with injuries and emergencies occurring in school and at school-sponsored events, which may be classified as follows:

(1) administering first aid;
(2) summoning school nurse, athletic trainer and/or EMS 911
(3) notifying administration;
(4) notifying parents; and,
(5) filing accident/injury reports.

School personnel must use reasonable judgment in handling injuries and emergencies. Caution should be exercised not to minimize or maximize any injury or illness. All personnel will understand the proper steps to be taken in the event of an injury or emergency, including appropriate activation of EMS and obtaining additional staff assistance when possible. Personnel shall also understand their role as it relates to the District’s Emergency Operations Plan and the site-specific plan for their school.

The Superintendent or their designee(s) will ensure that at least one other person on staff, aside from the school nurse, has current first aid and cardiopulmonary certification (CPR). If the school nurse or licensed practical nurse is not available, the person(s) who have current first aid and CPR certification is authorized to administer first aid and CPR as needed.

The school will obtain at the start of each school year emergency contact information of parents/ guardians for each student and staff member.

The school nurse, or school nurse delegatee may administer medications to students in emergency situations, provided such personnel have all of the training as is required by law. A school nurse shall be permitted to administer oxygen to a pupil in a medical emergency without parental permission or a physician’s order.

If a school nurse or licensed practical nurse is not available to a school for any reason, at least one other person who has a current first aid and cardiopulmonary certification (CPR), including AED training, (automated external defibrillator) will be available (per Ed 306.12). Also required is annual training of the Health Office delegatee and other authorized staff in assisting in the administration of an Epi-pen, a metered dose inhaler, and/or an opioid antagonist. Being available means they must be on school grounds during school hours or present at scheduled school activities so that they can provide emergency care immediately, without prior notification to parents/guardians. However, parents/guardians shall be promptly notified after emergency assistance has been provided.

The school nurse may maintain a supply of asthma related rescue medication and the emergency medication epinephrine. The school nurse may also administer epinephrine to any student in case of a medical emergency, if appropriate. This authorization extends to administering epinephrine without prior notification to parents/guardians.

The school nurse can delegate epinephrine administration to a trained individual of any student who has epinephrine prescribed. The school nurse or other designated personnel may administer or make available to a student for self-administration a bronchodilator, spacer, or nebulizer for use in emergency or other situations as determined by the school nurse provided that:
(a) The school has on file an asthma action plan for the student which shall be filed annually and updated as necessary with the school and includes an order from the student’s health care provider to provide the student with an asthma rescue inhaler, including dosage information and permission for the student to use the school’s stock in the event of an emergency; and
(b) The student’s parent/guardian has provided written permission to the school nurse to administer a bronchodilator, spacer, or nebulizer from the school’s supply.

The school nurse shall notify the student’s parent or legal guardian whenever a bronchodilator, spacer, or nebulizer from the emergency stockpile is administered to a student. The school nurse shall make the notification as soon as practicable in accordance with the contact information on file at the school.

A parent or legal guardian of any child may authorize a school employee, or person employed on behalf of the school in cases where there is no school nurse immediately available, to administer glucagon to a child in case of an emergency, while at school or a school sponsored activity. Glucagon administration training may be provided by a licensed physician, physician assistant, advanced practice registered nurse, or registered nurse, however in no case shall school nurses be required to provide training. The school administration shall allow school employees to voluntarily assist with the emergency administration of glucagon when authorized by a parent or legal guardian. The law currently requires that the state board of education, in conjunction with the American Diabetes Association, and the New Hampshire chapter of American Academy of Pediatrics, shall develop standards and guidelines for the training and supervision of personnel, other than the school nurse, who provide emergency medical assistance to students under this section. Such personnel shall only be authorized to provide such assistance upon successful completion of glucagon administration training. The school nurse, or school employee in cases where there is no school nurse immediately available, may administer glucagon to a child in case of an emergency, while at school or a school sponsored activity in compliance with a diabetes management plan or physician’s order, signed by the student’s health care provider, that prescribes the care and assistance needed by the student including glucagon administration.

Records related to the emergency administration of any medication under this policy shall be made and maintained by the school nurse as provided in Board policy JLCD, District procedures and/or applicable laws and regulations. The school nurse will follow other first aid reporting protocols, as may be determined by other Board policy or administrative directive.

All accidents judged to be other than minor require an accident report to be filled out by the supervising adult and filed with the Principal and SAU Office within 24 hours of the incident per policy EBBB.

The District makes it possible for parents/guardians to subscribe to student accident insurance at low rates. This program is offered each year during September. The District does not provide student accident insurance and the student accident insurance is not a program of the District.

Naloxone/Narcan and Opioid Antagonists:
The Board authorizes the District to obtain, store and administer naloxone/Narcan and/or other opioid antagonists for emergency use in schools.
The school nurse or other properly trained staff member may administer such medication in emergency situations. Opioid antagonists will be available during the regularly scheduled school day. They may be available at other times at the discretion of the Superintendent.
The Superintendent is authorized to procure such medication on behalf of the District.
All such medication will be clearly marked and stored in a secure space in the school nurse’s office or other appropriate location. The school nurse is responsible for storing the medication consistent with the manufacturer’s instructions and Board policy JLCD and District procedures.
Local law enforcement and emergency medical service personnel will be notified if such medication is administered by the District.

Legal References:
RSA 200:40, Emergency Care
RSA 200:40-a, Administration of Oxygen by School Nurse
RSA 200:40-b, Glucagon Injections
RSA 200:44-a, Anaphylaxis Training Required
RSA 200:54, Supply of Bronchodilators, Spacers or Nebulizers
RSA 200:55, Administration of Bronchodilator, Space or Nebulizer
Ed 306.04(a)(21), Emergency Care for Students And School Personnel
Ed 306.12, School Health Services

Category: P

1st Read: September 6, 2022
2nd Read: September 20, 2022
Adopted: September 20, 2022