Managing the Needs of Students with Chronic Diseases in a School Emergency
Developed by Vicki Taliaferro, RN, BSN, NCSN, School Health Consultant (vickit@vltconsultants.com)
Providing a safe environment that is conducive to learning necessitates that schools accommodate students with chronic medical conditions. This involves
developing emergency plans for those students in the event of a school-wide emergency. The following are considerations that schools can build on in
developing a multi-hazard emergency plan:
Communication and Planning
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Clearly define the responsibilities of the school nurse, teacher, and administrator prior to an emergency.
Develop a communications system that involves the school nurse. Is there a regionalized communications system,
radios, cell phones, intercoms? Problems associated with communication difficulties during disasters cannot be
overemphasized.1 Consider the nurse’s assignment – fulltime in the building or off campus certain days.
Establish a communication plan that includes the person taking care of special needs students, e.g. if students with
special needs are to be moved to another location, how will supplies, meds be retrieved and transported with them?
Include all teachers that will have the student in class in planning/training (PE, art, music, etc.).
Clearly define how to address the needs of a student with special needs in every scenario – lock down, shelter in place,
evacuation, duck and cover. Will a nurse be able to come to a classroom to care for a student in distress in a lock down?
If not, how will they communicate with the staff in charge of that room?
Plan for substitutes.
Confirm that the school staff responsible for planning emergency health care for a school’s multi-hazard plan is in
communication with emergency responders as plans are developed.
Individual student emergency plans
□ When developing an emergency care plan for a student, expand it to include plans for lock down, shelter in place and
evacuation.
□ Involve parents and students in individual student emergency planning. Parents may be able to assist students in
knowing what to expect in an emergency, thereby reducing anxiety.
□ Secure from parents/guardians a three-day supply of medications, food for children with special dietary needs, supplies
for special procedures (e.g. g-tube feedings, suctioning, etc.).2
□ Mark the supplies as emergency equipment for the specific child and decide the storage location for this equipment so
that it is safely stored but accessible to the child in the emergency.
□ Review individual plans with classroom teacher(s) and devise a system to inform substitutes of the plans.
□ Explore with parents/guardians the advisability of I.D. bracelets, etc. for students with special needs, including visually
and hearing impaired students.
□ Plan for staff with special medical concerns.
Emergency situations and evacuation
□ Develop an emergency evacuation plan for students with physical, mental or communication limitations, including
visually/hearing impaired individuals3, autistic4, and “English Language Learners” (ELL) students5 .
□ Identify a staff person to accompany a student or develop a buddy system. Plan for a backup if that support person is
unavailable. Staff and “buddies” should feel comfortable with the assignment.
□ Involve special needs students in all disaster/emergency/fire drills.6 Explain what is taking place to the student.
□ Use alarm systems that incorporate audible and visual elements.7 This should include restrooms.
□ Devise special provisions to assist students with limited physical abilities with duck and cover protection.8
□ Consider a picture schedule for students with autism to use in a duck and cover or evacuation9.
□ Design and practice basic hand signals and verbal commands for visually and hearing impaired students and provide
light in order that hearing impaired students may be able to read lips or use sign language.10
□ Have teachers, nurses, and other school staff practice for an emergency. This involves taking emergency
equipment/supplies on each drill.
© 2014 Vicki Taliaferro, RN, BSN, NSCN, School Health Consultant. May not be used without the express written permission of the author.
Published by School Health Alert, P.O. Box 150127, Nashville, TN 37215
Managing the Needs of Students with Chronic Diseases in a School Emergency
Supplies
Develop a system to have pertinent information and supplies readily available in an emergency/disaster. This would include:
□ A school disaster preparedness kit including one specifically for the school nurse.11
□ A means to evacuate/move medications and supplies, using carts, wagons, portable containers and/or backpacks.
□ Back up power source for specialized equipment.
□ Medications, dietary supplies, equipment.
□ Copies of emergency care plans, emergency contacts, and medication logs.
□ Maintaining supplies and medications. Take into consideration expiration dates and any special storage requirements
such as keeping medications at a safe temperature.
□ Ensure that others know where this information and supplies are located.
Staff Training and Practice
□ Provide ongoing, timely professional development on school health issues related to emergencies/disasters for teachers,
program administrators, school health and mental health providers.
□ Provide individual education/training for the teacher with a student who requires special attention in a crisis.
□ Have teachers, nurses, and other school staff practice for an emergency. This means taking emergency
equipment/supplies on each drill.
□ Educate first responders re special needs populations, e.g. autistic children.12
Psycho-social considerations
□ Crises increase anxiety in everyone. That anxiety can lead to an exacerbation of a student’s chronic health condition.
Plan for that.
□ Train and prepare the school community to counter fear, anxiety and lack of confidence that can accompany the
response to a crisis.13
□ Expect a certain percentage of staff to be unavailable in a crisis. Plan for this.
□ Do not underestimate the anxiety that staff may feel. Discuss this very normal reaction to a crisis.
□ Involve school counselors/psychologists/social workers in professional development planning and programs.
□ Restore balance – all staff, students and parents will need help with recovery. Special needs students may have
increased feelings of vulnerability.
Evaluation and Review
□ Review drills or actual crisis incidents. Revise the plan as necessary.
□ Schedule frequent, periodic review and evaluation of the plan.
□ Solicit feedback from teachers, staff and students. What do they need? What went well in a drill, what did not?
Doyle, J. (2011). Disaster preparedness - Guidelines for school nurses. Silver Spring, MD: National Association of School Nurses.
Ibid.
3 Ibid.
4 Autism Alliance of Michigan. (2014). Student emergency and behavior response, school & home safety plan. Retrieved from http://autismallianceofmichigan.org/wpcontent/uploads/2014/04/Student_Emergency_Plan.pdf
5The Center for Health and Health Care in Schools. (2013). Emergency preparedness: A quick guide for school staff. Retrieved from http://www.healthinschools.org/Health-inSchools/Health-Services/School-Health-Services/School-Health-Issues/Emergency-Preparedness/A-Quick-Guide-for-School-Staff.aspx
6 Washington Military Department, Emergency Management Division. (2011). Special needs comprehensive planning for schools.
7 Ibid.
8 Ibid.
9 Indiana Institute on Disability and Community, Indiana University. (2014). Individuals with autism spectrum disorder and preparation for emergencies. Retrieved from
http://www.iidc.indiana.edu/index.php?pageId=513#sthash.6J5o3nVC.dpuf
10 Washington Military Department, Emergency Management Division. (2011). Special needs comprehensive planning for schools.
11 Doyle, J. (2011). Disaster preparedness - Guidelines for school nurses. Silver Spring, MD: National Association of School Nurses.
12 Indiana Institute on Disability and Community, Indiana University. (2014). Individuals with autism spectrum disorder and preparation for emergencies. Retrieved from
http://www.iidc.indiana.edu/index.php?pageId=513#sthash.6J5o3nVC.dpuf
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© 2014 Vicki Taliaferro, RN, BSN, NSCN, School Health Consultant. May not be used without the express written permission of the author. Published by School Health Alert, P.O. Box
150127, Nashville, TN 37215
Managing the Needs of Students with Chronic Diseases in a School Emergency
13
Moore, C.C., & Susan, M.K. (2012). Sonoma County, school crisis response & recovery, resource guide the study guide, background and references for best practices.
Retrieved from http://www.scoe.org/files/sos-crisis-response-manual.pdf
© 2014 Vicki Taliaferro, RN, BSN, NSCN, School Health Consultant. May not be used without the express written permission of the author. Published by School Health Alert, P.O. Box
150127, Nashville, TN 37215