School Bus Driver Training
Unit I
Student Emergencies
Objectives
 At the end of this session school bus operators will
be able to:
 Describe their role in providing first aid emergency
situations on the bus
 Demonstrate good assessment skills in setting
priorities when managing a medical emergency on
the bus
 Describe required contents of the first aid kit and
body fluid clean up kit
Student Emergencies
 WHAT IS CONTAINED IN THIS UNIT ARE ONLY
GENERAL GUIDELINES. YOU MUST FOLLOW YOUR
LOCAL SCHOOL DISTRICT PROCEDURES AND
GUIDELINES REGARDING RECEIVING FIRST AID
TRAINING AND ADMINISTERING FIRST AID ON
YOUR SCHOOL BUS.
Student Emergencies
 FIRST AID AND EMERGENCY CARE ARE ONLY
TEMPORARY STEPS TAKEN UNTIL MORE
ADVANCED TREATMENT CAN BE OBTAINED,
EITHER AT THE SCENE OF AN INCIDENT OR AT A
HOSPITAL
Procedural Overview
 Control hazards at the scene
 Evaluate injuries or illnesses
 Enlist the help of others
 Contact emergency medical services
 Maintain control of the situation
Medical Liability
 Anyone who gives first aid should be concerned about
liability
 PA Good Samaritan Act protects well intentioned acts
and omissions from civil liability for those with first
aid training
 There are several first aid courses that would meet this
requirement
 Pennsylvania Department of Health EMS Information
Bulletin #051
First Aid Procedures
 Setting priorities: What to do first?
 Hazard control
 Existing or imminent smoke or fire condition
 Hazardous materials
 Unsafe site
 Distractions
 Obtaining emergency medical assistance
 Use a cell phone
 Give specific instructions:




Exact location or precise directions
Exact nature of problem
Number of people injured
Description of vehicles involved
Reporting
Report ALL Incidents to your Supervisor
Using Responsible Helpers
 Adult bystanders are best
 Know your passengers
 ONLY IN EXTREME EMERGENCIES SHOULD
OLDER RESPONSIBLE STUDENTS BE SENT FOR
HELP
 Follow local policy and procedures
 Do NOT send elementary school students
 If policy allows sending students, send two together
Assessing Injuries or Illnesses
 Prioritize injuries if more than one
 Always follow local procedures on performing first aid
treatment
 Be organized and do one thing at a time
Treatment Procedures
WHAT IS CONTAINED IN THE FOLLOWING
SLIDES ARE ONLY GENERAL GUIDELINES.
YOU MUST FOLLOW YOUR LOCAL SCHOOL
DISTRICT PROCEDURES AND GUIDELINES
REGARDING RECEIVING FIRST AID TRAINING
AND ADMINISTERING FIRST AID ON YOUR
SCHOOL BUS.
Seizures
 Don’t panic, let it run its course
 If not already done, lay the student down
 Protect student from injury as much as possible.
 Move any objects
 Cushion head
 Monitor airway
 Do NOT put anything in the mouth
 Do NOT restrain
 Afterwards, always call dispatcher
Fractures
 Signs and symptoms
 Pain at site
 Pain on movement
 Swelling
 Discoloration
 Misaligned bones
 Care and treatment
 Call dispatcher and 911
 Prevent movement
Allergic Reaction:
Bites and Bee Stings
 Signs and symptoms
 Puncture marks
 Anxiety
 Pale, cool skin with progressive onset of sweating
 Rapid, weak pulse
 Rapid, shallow breathing or breathing difficulties
 Difficulty swallowing and speaking
 Blurred vision
 Abdominal pain
 Nausea and/or vomiting
 Headache
 Intense pain at site of bite
 Localized redness and swelling
Allergic Reaction:
Bites and Bee Stings
 Care and treatment
 Apply direct pressure over bitten area
 Find out if the student has any allergies to stings or bites
 Use cold compress, if available, to reduce swelling
Allergic Reaction:
Anaphylactic Shock
 Can be life threatening
 Follow district policy
 Know and use appropriate emergency numbers: CALL
FOR HELP
 Enforce “No Food on Bus”
 Follow local policies and procedures for
EpiPen/epinephine use
Allergic Reaction:
Anaphylactic Shock
 Signs and symptoms
 Itching
 Red, raised, blotchy skin (hives)
 Wheezing
 Confusion
 Weakness
 Pale color
 Unconsciousness
 Unable to speak more than one or two words
 Sitting straight up or with hands on knees
 Gasping for breath
 Pursing lips to breathe
 Using neck muscles to take breaths
Allergic Reaction:
Anaphylactic Shock
 Care and treatment
 Call your dispatcher and report the situation
 Call 911 immediately
 If you district procedures and guidelines allow, you are
qualified, and you have received training, administer
epinephrine
Asthma
 Can be life threatening
 FOLLOW LOCAL PROCEDURES AND GUIDELINES
 Signs and symptoms
 Pale, cool, clammy skin
 Shortness of breath
 Wheezing
 Anxiety, exhaustion, rapid or weak pulse
 Collapse
 Care and treatment
 Call dispatcher and report
 Sit student upright
 Be calm and reassuring
 Assist using inhaler
Bites from Other Students
 Clean bites with antiseptic wipe
 Cover with band aid
 Report incident
External Bleeding
 Types of wounds
 Incision
 Laceration
 Abrasion
 Puncture
 Amputation
 Care and treatment
 Get help


Call dispatcher
Call EMS for serious wounds
 Use universal precautions
 Apply pressure using sterile bandage
 Raise and support above the heart
Internal Bleeding
 Signs and symptoms
 Visible internal bleeding
 Blood coughed by student (bleeding in lungs or stomach)
 Pale, cool, clammy skin
 Thirst
 Rapid, weak pulse
 Rapid, shallow breathing
 Guarding of the abdomen, in fetal position
 Pain or discomfort
 Nausea and/or vomiting
 Swelling
Internal Bleeding
 Care and treatment
 Get expert medical help
 If possible, position student on back
 Elevate legs
 Give nothing by mouth
Choking
 Do NOT slap them on the back
 Best not to do anything if person is coughing forcefully
and not turning bluish color
 Signs and symptoms
 Difficulty or absence of breathing
 Inability to speak or cough
 Distress – grabbing the throat, collapse
 Someone who cannot answer by speaking and can only
nod the head has a complete airway obstruction and
needs emergency help.
Choking
 Care and treatment
 Check mouth and clear any obstructions
 Stand behind the student and wrap your arms around the
their waist
 Make a fist with one hand
 Place the thumb side of the fist against the student’s abdomen
in the midline and slightly above the navel
 Grasp the fist with the other hand and press the fist into the
student’s abdomen with a quick upward thrust
 Each new abdominal thrust should be a separate and distinct
movement
 Repeat thrusts until student expels the obstruction
Dehydration
 Be careful of this during afternoon routes in warm weather
 Signs and symptoms
 Pale, cool, clammy skin
 Rapid breathing
 Profuse and prolonged sweating
 Thirst
 Loss of skin elasticity
 Sunken eyes
 Care and treatment
 Give cool water, if available
Diabetes
 Imbalance of sugar in blood
 You (driver) are not expected to manage student
diabetes by checking blood glucose levels or
administering medication
 Recognize signs and symptoms
 Know what to do
 Be especially aware at the end of the day
Diabetes
 Signs and symptoms
 Hot, dry skin
 Smell of acetone (nail polish remover) on the breath
 Drowsiness or change in mood
 Unconsciousness, progressing to coma
 Profuse sweating
 Grayish skin color
 Hunger
 Confused or aggressive behavior
 Rapid pulse
 May appear drunk
 May have seizures
Diabetes
 Care and treatment
 DO NOT give insulin injections
 Give sweet drink, if available
 Be familiar with Quick Reference Emergency Plan if
available
 Be aware of where students keep supplies
 Provide input to school health team when requested
 Communicate with parents and school nurse
 Respect student confidentiality
Heat Stroke
 Be particularly aware on afternoon runs in hot weather
 More dangerous than sunstroke
 Signs and symptoms
 Flushed, hot, dry skin
 The student has stopped sweating
 Rapid pulse, gradually weakening
 Irrational or aggressive behavior
 Staggering or fatigue
 Visual disturbances, headache, vomiting
 Collapse and seizure
 Care and treatment
 Cool the student as much as possible
 Give fluids and water if the person is conscious
Hyperventilation
 Signs and symptoms
 Rapid respirations and pulse
 Shortness of breath
 Pressure, tightness or pain across the chest
 Anxiety
 Blurred vision
 Tingling in fingers and toes
 Hand and finger spasms
 Fainting
Hyperventilation
 Care and treatment
 Reassurance
 Remove the cause of anxiety, if possible
 If the student has fainted, lay student down with legs
elevated.
Nose Bleeds
 Keep trunk of body higher than heart
 Tilt head forward
 Compress nostril for 5-10 minutes
Report All Incidents
 As with all of the above emergencies, FOLLOW
LOCAL PROCEDURES
 Report EVERYTHING to proper authorities
 Work with your Supervisor and parents to inform
substitute drivers on medical issues – keep
confidentiality in mind!
 Watch for after-affects from a crash
First Aid Kit
 Inspect
 Replace items as used
 Placement
 Clearly marked
 Mounted in accordance with manufacturer’s
instructions
 Removable
 Easily accessible
Body Fluid Clean Up Kit
 Inspect
 Replace items as used
 Placement
 Clearly marked
 Mounted in accordance with manufacturer’s
instructions
 Removable
 Easily accessible
Cleaning Body Fluid Spills




Always wear disposable gloves
Small spills can be cleaned with paper towels or tissues
Clean with disinfecting solution
Remove gloves and place into plastic bag with waste
and other cleaning materials
 Wash hands
 Soap
 Running water for at least 30 seconds
 If possible, carry hand sanitizer, extra gloves, and band
aids