Emergency Preparedness

Did you know that over 10 million people abuse prescribed opioids every year? According to the CDC, 1 in 7 high school students report that they have misused opioids at least once in their lifetime. The opioid crisis is a problematic pattern that can affect anyone regardless of race, gender, income level, or social class. Many of these incidents take place in educational settings, which is the one place where children should be safe. This makes it crucial that staff and students know what to do in the event of an overdose, share knowledge, and recognize the warning signs beforehand.

The Importance of Overdose Education in Schools

Detailed and comprehensive training within schools can empower the overall community to respond effectively to an overdose situation. Providing education about the dangers of opioids, along with how to prevent addiction and misuse, is an important initiative that schools can implement during this ongoing epidemic. Evidence-based prevention programs also have the ability to benefit schools by raising awareness and educating the overall school community about these drugs.

• Both students and staff can learn about the dangers of opioid misuse, how they can mitigate the risks in their environment, and ways to prevent addiction
• Schools can enforce an emergency plan outlining specific steps to be followed in the event of a drug overdose
• School communities can offer students support and guidance through addiction or recovery, promoting healthier coping mechanisms

What is Naloxone and Why Should Schools Have It?

Naloxone, also known as Narcan, is a medication used to rapidly reverse the effects of an opioid overdose. It works by binding to the same receptors in the brain that opioids bind to, reversing and blocking the harmful effects that occur during an overdose. It brings the fatal symptoms of an opioid overdose to a halt in a prompt, safe, and efficient manner. Typically administered as a nasal spray, this medication has the potential to restore normal breathing in the individual. Nevertheless, even if someone has received naloxone, they will likely still need professional medical attention to prevent a recurrence of symptoms. It’s important to acknowledge that naloxone only works if the person is suspected to have taken opioids. However, schools nationwide are prioritizing the implementation of it, with the goal of promoting safety and protecting students and staff. The Food and Drug Administration approved Narcan for non-prescription use in March of 2023, meaning that anybody has the ability to purchase it without a doctor's approval. Ever since, schools have been stocking naloxone in case of an emergency.

The Key Points of Naloxone

• Quick onset – Typically takes 1-5 minutes to restore normal breathing
• Safety – Not addictive and has low risk for adverse effects
• Over the counter - Accessible so that it is readily available for the people who need it

There are many steps that schools can take to prepare, prevent, and protect their community from opioid overdose. Overdose action plans should be thorough and involve a combination of education, support, and enforcement. School Health can help you get one step closer to saving a life with our new Naloxone Training Kits and other first aid necessities. Also, don’t forget to check out our recent webinar to learn more about this epidemic and what you can do to create a safer school environment, reducing the risk of opioid overdoses once and for all.

Resources

https://www.ed.gov/opioids/

https://www.cdc.gov/museum/education/newsletter/2022/july/index.html

https://dph.illinois.gov/topics-services/opioids/idph-data-dashboard.html

https://youth.gov/youth-topics/substance-abuse/opioids

https://drugabusestatistics.org/opioid-epidemic/

Due to recent incidents at sporting events and schools, there has been increased attention on CPR training. During health emergencies, performing CPR on an individual suffering from cardiac arrest could be the difference between life and death. According to the National Lung, Heart, and Blood Institute, there are around 300,000 to 450,000 deaths caused by cardiac arrest in the US every year.

The process to perform general CPR due to a cardiac arrest emergency is straightforward. Check to see if the individual is responsive and confirm that the surrounding area is safe. Call 911 immediately or have a bystander call for help. The individual should be on a flat surface, with their body and head in a neutral, laying position. Perpendicular to the chest of the individual, place your palm on the center of their chest, while interlacing your other hand on top. While positioning on your knees, stack your shoulder joints directly over your wrist joints with locked elbows for optimal compressions that will push the chest inward, about two inches deep, in a quick, constant rate until medical professionals arrive.

Men vs Women

It may come as a surprise that women are not only less likely to have CPR performed on them, but they are also found to have lower rates of survival than men, even when CPR is performed. According to the American Heart Association, the factors that play into this difference include fears of accusations relating to sexual assault or sexual harassment, fears of causing physical harm to the female receiving CPR, or the person administering CPR may feel uncomfortable or unsure working near breasts.

Most manikins that people train with are modeled after men’s anatomy. However, in recent years, models and attachments have been created to mimic female anatomy, such as School Health’s PRESTAN Female Accessory. This creates a more accurately designed manikin and allows for an individual to practice performing CPR in a more realistic situation.

Infants, Toddlers, Adults

Differences in CPR application do not end there. CPR can be performed on all individuals to continuously help pump blood through the body, but certain individuals require different techniques.

CPR is taught using the two-hand method, however, if the individual suffering a cardiac arrest emergency is not an adult, different styles of CPR may be used instead. A toddler or child would usually not require the full force of two adult hands. For a smaller child or toddler, a one-hand method can be used to provide CPR. This is similar to the regular CPR method, but without the second, overlaying hand. For an infant, a two-finger or two-thumb method may be used to compress the chest, so as not to hurt the newborn.

Results

Performing CPR on an individual can double, or even triple, their chances of survival if administered immediately. It is important to perform CPR correctly on both men and women to give each a better chance at survival. While a child or infant may have a lower chance of a cardiac arrest emergency that requires CPR, giving those individuals a higher chance of survival matters, too. Every second counts!

References

https://cpr.heart.org/en/resources/cpr-facts-and-stats

https://www.ahajournals.org/doi/10.1161/circ.142.suppl_4.139

https://www.heart.org/en/news/2020/11/23/why-people-fear-performing-cpr-on-women-and-what-to-do-about-it

https://www.nhlbi.nih.gov/health/cardiac-arrest

https://www.redcross.org/take-a-class/cpr/performing-cpr/child-baby-cpr

Cardiac Arrest

National CPR and AED Awareness Week is June 1st through June 7th! Now more than ever, it’s important to ensure that your equipment is up to date in case of emergency. According to the American Heart Association, cardiac arrest occurs in about 7,000 children outside of the hospital each year. In addition, there are also about 10,000 cardiac arrest events in the workplace every year. It could happen to any student or faculty member and making sure those in an educational environment are properly trained can save a life.

AED Maintenance & Accessories

Just as CPR (cardiopulmonary resuscitation) and AED (automated external defibrillator) certification needs to be renewed every couple years, batteries and pads for AED devices must also be maintained. Depending on model and life expectancy of the device, batteries and pads must be replaced every two to five years. For example, a Zoll AED 3 has both an electrode pad and battery lifespan of five years. This specific device even includes a warranty of eight years for the device itself and its battery. Be vigilant for any wear and tear of an AED, however, a service indicator light will appear if maintenance is necessary. Every AED is different, so always consult the owner’s manual for proper care and device use.

In preparation of an emergency, additional AED accessories, which include cases, wall mounted cabinets, kits, and more, can be used to extend device use and decrease upkeep. Not every educational facility requires the installation or availability of an AED device but being aware of AED locations is valuable in case of an emergency. For quick access, signage for AEDs should be placed in high traffic areas, such as hallways, main entrances, gymnasiums, auditoriums, cafeterias, and the nurse’s office. If unsure about proper care and display regulations, SH Connect, School Health’s AED compliance management service, helps schools ensure their AED Systems are compliant with local state and federal laws. This service and app can be accessed from anywhere with an internet connection, and it allows users to sort customizable reports to access information about their AEDs in order to ensure they are operating properly.

CPR & AED Training

CPR Certification through the American Heart Association costs about one dollar per student and only takes one class period to be trained. When a victim is given CPR immediately, their chances of survival double – or even triple. However, less than 40 states in the US require CPR training for high school students before they graduate. The CPR certification that students and faculty can receive will be valid for two years.

Along with CPR, an AED can further increase an individual’s chances of survival in a case of cardiac arrest. Those who receive a shock from an AED within the first minute of cardiac arrest, have a 90% chance of living through the event. While an AED can be an investment, the training certification through the American Heart Association is still a quick process and costs only slightly more than the cost of being CPR certified.

Stay Aware

National CPR and AED Awareness Week can help remind students and faculty how to prepare to save someone that experiences cardiac arrest. Applying CPR and maintaining AEDs might be a straightforward process but deciding which AED your school needs can be an overwhelming choice. School Health can assist with this impactful decision and can help find the correct device that would best fit your facility.

References

https://www.heart.org/en/news/2018/11/09/defibrillators-may-help-kids-survive-cardiac-arrest

https://cpr.heart.org/-/media/CPR-Files/Courses-and-Kits/CPRiS/CPR-in-Schools-Advocacy-Flyer-ucm_499702.pdf

https://cpr.heart.org/en/courses/cpr-in-schools-training-kits

https://cpr.heart.org/-/media/CPR-Files/Training-Programs/AED-Implementation/AED-Statistics-Infographic-English-ucm_501517.pdf

https://cpr.heart.org/en/courses/heartsaver-first-aid-cpr-aed-course-options

During periods of training and conditioning, such as the fall pre-season, instances of heat-related illnesses and emergencies in student-athletes increase. Over the summer, periods of intense heat cause concern not only for sports teams, but also for those who do not use proper protection from the heat and the sun. According to Cleveland Clinic, statistics about student-athletes say that around 9,000 cases of heat-related illnesses occur per year. In football, these cases are 11.4 times higher than all other sports combined. It is important to be aware of the causes and symptoms of heat-related illness and stay prepared in case of an emergency.

According to the National Athletic Trainers’ Association (NATA), the most common definition of heat illness includes three categories: heat cramps, heat exhaustion, and heat stroke. However, there are also other classifications of heat illness, such as heat syncope.

Depending on the type of heat illness, symptoms may vary, but some indicators include:

•  High body temperature (above 105 degrees Fahrenheit)
•  Dizziness
• Nausea
• Heavy sweating
• Cold, pale, and clammy skin
• Fainting

What to do in an Emergency

Emergencies can and do happen, so having the proper plan in place is essential to prevent further harm or injury to an athlete. The first step is to recognize that the athlete is suffering from exertional heat illness. NATA states that a rectal thermometer is the only way to get a fast and accurate measurement of an athlete’s core body temperature. A temperature of 105 degrees Fahrenheit or above is an indicator of an emergency.

NATA also recommends the “cool first, transport second” method, meaning that if an athlete’s core body temperature is 105 degrees or more, sports staff must get the player’s temperature down to 102.5 degrees before they can be taken to a hospital. NATA says that the best way to quickly cool down the athlete is through a full-body cold water emersion. Cooling tubs or other water immersion devices are essential for this process. 

After a heat-related emergency occurs, athletes should work with their physicians to create a plan that will allow them to safely return to their sport.

Preventing a Heat-Related Emergency

Luckily, heat-related emergencies are highly preventable if the proper training and procedures are followed.

One of the best ways to reduce the risk of illness is through heat acclimation. In other words, allow your athletes to get used to the heat by slowly increasing the amount of outdoor exercise. It’s also important to monitor the temperature and humidity outside, pay attention to how long athletes are playing and practicing, and allow them to take a break or rest.

Athletic Trainers, Athletic Directors, and sports staff should always make sure that there are plenty of hydration options for their athletes as well. Ensuring that athletes are staying hydrated before, during, and after practices and events is key. Athletes can also enhance their performance and reduce the risk of illness by getting the proper amount of sleep and eating a balanced diet.

If you are looking for the right heat illness prevention equipment for your sports medicine program, School Health can help you find everything you need to keep your athletes safe. Contact us today!

Resources:

https://my.clevelandclinic.org/health/diseases/16425-heat-illness

https://www.hopkinsmedicine.org/health/wellness-and-prevention/heat-related-illness-and-young-athletes-3-important-things-parents-and-coaches-need-to-know

https://www.nata.org/sites/default/files/externalheatillnesses.pdf

https://www.cdc.gov/disasters/extremeheat/warning.html

https://www.nata.org/press-release/092115/nata-publishes-new-exertional-heat-illnesses-position-statement

https://schoolhealth.my.salesforce.com/sfc/p/#U0000000K0lZ/a/6f000000kIhW/JM.X5iuIb0ZfXlqOyZTX8PGRe0M9W_6pxt7vaAEgXdE

https://www.news9.com/story/5e35a40283eff40362be4ee1/oklahoma-teen-survives-heat-stroke-warns-others

https://www.nbcnews.com/health/health-news/extreme-heat-becomes-more-common-ers-turn-body-bags-save-n1274675

Keep Students and Staff Safe at School

Students are currently going to school in a variety of settings, whether that is at home, in person, or a mix of both. However, as districts slowly welcome their students back to full in-person learning, it is important that schools are adequately prepared to keep their students safe in case of an emergency.

Traumatic Bleeding and Stop the Bleed

From 2013 to 2019, there were 549 incidents of gunfire on school grounds. Unfortunately, this number shows how important it is for districts to be prepared in case of a tragic event. In general, uncontrolled bleeding is the leading cause of preventable death in trauma patients. Providing students and staff with the proper training to respond to these situations is key not only for incidents involving gunfire, but also for other instances where traumatic bleeding can occur. The American College of Surgeons’ Stop the Bleed program is a great initiative that trains people on what to do in case of an emergency. You can shop Stop the Bleed kits, tourniquets, and more here.

Cardiac Arrest

According to the American Heart Association, cardiac arrest occurs in about 7,000 children outside of the hospital each year. This, coupled with new COVID-19 research showing that the virus has the potential to affect the heart, means that schools need to be prepared with the proper equipment in case of a cardiac emergency. As schools open, it is imperative that they check their AEDs and AED accessories for signs of wear.

• Verify that AED batteries are working and have not expired.
• Check the service indicator light.
• Check for any wear and tear on the AED.
• Ensure that AED pads and accessories are not expired.
• Consider adding additional AEDs and signage in high traffic areas such as hallways, main building entrances, gymnasiums, cafeterias, auditoriums, and nurse’s office.

Fire Prevention, Burn Treatment, and Weather Emergencies

The National Fire Protection Association states that from 2014-2018 fire departments responded to an average of 3,230 structure fires in schools per year. The organization also found that school fires mostly started in bathrooms or locker rooms. After being closed throughout much of the last school year, it is imperative that schools check that their fire systems, including fire alarms, fire extinguishers, cooking equipment and water-based protection systems and sprinklers, are still fully functional. When it comes to weather-related emergencies, it is important for schools to have working weather monitors to stay informed on severe weather as well as a well-rehearsed plan of action in case of a tornado, or other event.

In addition, make sure your building has:

• Working exterior lighting with timers or motion sensing capabilities
• Working intrusion alarms, ventilator openings, and roof hatches
• Trees, bushes, and other plant life trimmed to keep areas around the building clear
• Trash receptacles stored away from buildings
• Monthly fire drills with students and staff so that everyone knows all evacuation procedures
• Proper equipment to for fire prevention and fire treatment
• Proper emergency evacuation equipment

School Lockdown

In the United States, firearms are the leading cause of death in children and teens, according to Everytown. The organization also states that so far in 2021, there have been 18 incidents of gunfire on school grounds across the country. In 2020, there were 67 incidents. In light of these numbers, schools need to have a lockdown plan in place, regularly practice lockdown drills with students and staff, and have the necessary lockdown supplies and emergency equipment on hand.

Drug Deactivation

In a 2017 survey from the Substance Abuse and Mental Health Services Administration, 2.2 million adolescents between the ages of 12-17 were illicit drug users. In case of an overdose emergency at school, the National Association of School Nurses states that it is the responsibility of the nurse to respond and give medication like Naloxone, or other drug deactivation assistance, since they would be the first health professional to come in contact with a student experiencing an overdose emergency.

Accidents and Injury

Accidents and injury can happen at any time, so schools need to be prepared with the proper supplies like first aid kits and accessories, including blankets and emergency lighting. Common cause of injuries at school include bullying, slipping and falling, playground accidents, food poisoning, school bus accidents, and sports injuries.

Check your first aid kit for:

• Working flashlights and/or two-way radios with good batteries.
• Check the expiration dates and packaging on any antibiotics or ointments in the kit.
• Replace any supplies in your kit that looks like it has been used up.

It is impossible to predict an emergency, but it is possible to be prepared. By having the proper emergency procedures in place as well as the necessary equipment and supplies, schools can ensure the safety of their staff and students if an emergency occurs.

Visit our School Safety Center to see our full selection of emergency equipment and resources.

Important Links

https://everytownresearch.org/maps/gunfire-on-school-grounds/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887168/

https://everytownresearch.org/report/the-impact-of-gun-violence-on-children-and-teens/

https://www.schoolhealth.com/blog/equipment-guidelines-and-recommendations-for-reopening-your-facilities/

https://www.heart.org/en/news/2018/11/09/defibrillators-may-help-kids-survive-cardiac-arrest

https://www.nasn.org/advocacy/professional-practice-documents/position-statements/ps-naloxone

https://www.nfpa.org/News-and-Research/Data-research-and-tools/Building-and-Life-Safety/Structure-fires-in-schools

https://www.usfa.fema.gov/coronavirus/planning_response/covid19_fire_safety_school_reopening.html

https://blog.nationwide.com/school-fire-safety-checklist/

https://www.parkerlawfirm.com/library/common-ways-children-are-injured-in-school-accidents.cfm

https://www.mayoclinic.org/first-aid/first-aid-kits/basics/art-20056673

https://www.weather.gov/grb/schools

While states, counties, and individual school districts continue to release guidelines for re-entry, the transition from remote to in-person learning can have its difficulties. While PPE, infection prevention, and thermometry may be at the top of your mind, there are several pieces of equipment and areas of your buildings that may be overlooked.

With buildings empty for months, some of your school’s infection prevention and emergency supplies may need to be checked and updated. It is imperative for schools and facilities to have the proper equipment in case of an emergency, especially amid a pandemic. Below we have a brief outline of areas of your building that may require updates to equipment, additional cleaning protocols, or a change in normal operation.

The CDC’s K-12 Schools COVID-19 Mitigation Toolkit can be a great tool to implement mitigation strategies to reduce the spread of COVID-19. This toolkit includes strategies, checklists, resources, and more. 

General Equipment Check

AEDs - 

Research has shown that there might be a correlation between COVID-19 and the heart. In some studies, patients who had the virus also experienced heart inflammation. One study, which focused on student athletes at The Ohio State University, showed that many of the athletes who were diagnosed with COVID-19 had symptoms of myocarditis, too. As new information emerges about how the virus impacts overall health, it is important to be prepared in case of a cardiac emergency. Performing a comprehensive AED readiness check can help ensure your facility is ready. 

• Verify that the AED batteries are working.
• Check the service indicator light.
• Check for any wear and tear on the AED.
• Ensure that AED pads and accessories are not expired.
• Consider adding additional AEDs in high traffic areas such as hallways, main building entrances, gymnasiums, cafeterias, auditoriums, and nurse’s office.

Air Filtrations and Filters - 

Air purification and filtration in schools has been a highly discussed topic, but there are still many questions as to its effectiveness against COVID-19. However, airborne infection is 15-20 times more likely to occur indoors than outdoors.  For schools, experts also suggest that stronger filters for existing ventilation systems are a higher priority than providing individual purifiers for each classroom.

• Review any known issues and check for water leaks or mold growth.
• Look for any covered diffusers, closed supply diffusers, blocked return grilles, etc.
• Make sure fans and portable devices are not blowing from one person on to another.
• Operate all HVAC systems in occupied mode at least one week before reopening if the systems have been shut down for an extended period of time.

For more information on ventilation in Schools and Childcare settings, visit the CDC’s website for building recommendations.

To see a comprehensive guide for how to prepare your ventilation systems, visit the American Society of Heating, Refrigerating and Air Conditioning Engineers to see their full guidance on reopening schools and universities.

Oxygen Availability - 

Twenty-five percent of 911 emergencies in schools are due to breathing issues. Breathing emergencies can be caused by anxiety attacks, asthma attacks, cardiac arrest, food allergies, and more. With COVID-19, some severe cases of the virus led to patients having problems breathing as well. Therefore, schools should have emergency oxygen devices available in the case of a breathing emergency.

• Check shelf life of the oxygen if there is a date.
• Check condition of disposable oxygen masks, tubing, and other accessories.

Disposable Products, Disinfectants & PPE - 

Another major consideration before reopening is the ability to provide PPE for students and staff. According to one estimate from ASBO International, it may cost some districts up to $148,190 to provide disposable masks for students who do not bring them from home and another $44,415 for staff. The organization also estimates spending about $1,440 on gloves for custodians. Besides protective apparel, it is also important that schools have effective hand sanitizers, disinfectant sprayers, and cleaners. For a more detailed checklist, see the CDC’s Considerations for K-12 Schools.

• Replace expired hand sanitizer and make sure that it has at least 60% alcohol.
• Consider investing in electrostatic disinfectant sprayers and effective cleaners.
• Have a supply of gloves and masks for students and staff.
• Store all cleaning equipment away from children.

Autoinjectors & Inhalers for Allergies - 

According to the National Association of School Nurses, students may be eating in places other than the cafeteria due to social distancing rules. To avoid anaphylaxis, NASN recommends that students with known allergies always carry their autoinjectors with them, and that those with asthma continue taking their medications.

• Ensure that there is a supply of unexpired epinephrine available, extra syringes, disposable spacers and rescue inhalers.

Water Systems - 

After time away and reduced operation of normal water usage, it is important to take the proper health and safety measures to ensure your drinking water is free from lead or copper exposure or any other diseases associated with water.

• Plumbing flushing can help ensure all water systems (sink faucets, drinking fountains, showers, etc.) are safe to use after a prolonged facility shutdown.
• Drinking fountains should be thoroughly cleaned multiple times a day or closed until further notice.
• For additional resources, refer to the EPA’s Information on Maintaining or Restoring Water Quality in Buildings with Low or No Use.

Areas in Need of Special Attention

Entrance - 

A building’s entrance can be one of the most highly trafficked areas. Having a designated station for symptom and temperature checking at your entrance can help reduce the chances of an outbreak and limit building capacity while allowing for easy documentation.

Tips for building entrances:

• Post signs and messages in highly visible locations that promote everyday protective measures like mask use and hand washing.
• Have a designated healthcare professional help with contact tracing, taking temperatures, and symptom checking.
• Consider thermal imaging / infrared cameras for a more reliable and faster temperature reading.
• Limit nonessential visitors, volunteers, and activities that involve external groups or organizations coming into the building.
• Using Electronic Health Record Systems can help organize health records, monitor outbreaks, and keep track of Individual Healthcare Plans (IHPs), Medicaid documentation, vaccinations, and more.

Transportation - 

School Busses operating at a smaller capacity should still take proper precautions when it comes to social distancing and proper cleaning.

Tips for school transportation:

• Check students’ temperatures at the front door before a student gets on the bus.
• Students should keep their face protection on the whole time they are in the vehicle.
• Consider keeping a box of disposable face coverings in the front of the bus for any student who may forget theirs.
• Students should stagger seating from row to row and drivers can help organize seating by marking off every other seat.
• If possible and weather permitting, allow bus windows and/or roof hatch to remain open while transporting students to increase air flow.

Classroom and Instructional Areas - 

As an area where students spend most of their day, the classroom can be a breeding ground for germs and poor air circulation. Aside from a more intense surface cleaning regimen, making sure the classrooms’ ventilation systems are updated and running properly with new filtration can lower the chance of airborne infection.

Tips for classroom cleaning, social distancing, and ventilation:

• Use a non-toxic cleaner to disinfect frequently touched surfaces including desks and doorknobs.
• Limit the use of shared items and encourage hand washing and/or sanitizing before and after use.
• Keep students’ belongings separated from others’ and in individually labeled containers, cubbies, desks, or other areas.
• Space seating and desks at least six feet apart, facing one direction instead of facing each other, and use partitions when necessary.
• Bring in as much outdoor air as possible by opening windows and doors to the outside and/or hallways.
• Consider running your HVAC system at maximum outside airflow for 2 hours before and after the building is occupied.
• Use portable air cleaners that use high-efficiency particulate air (HEPA) filters to enhance air cleaning in higher-risk areas.

Nurse’s Office and Isolation Room - 

While developing COVID-19 symptoms is a serious call for concern, there are still a number of other reasons students make the trip to the school nurse, whether it be routine daily medication, diabetic check-ins, or other illnesses. Isolating students in a separate room/area who show symptoms of COVID-19 can help reduce traffic and maintain social distancing in the nurse’s office.

• School Nurses and other healthcare professionals should follow the proper infection prevention and control recommendations from the CDC and wear the proper protective apparel.
• Consider setting up an isolation room for students who experience COVID-19 symptoms.
• Parents or guardians should be contacted to transport sick students home as soon as possible.
• Areas used by an individual who developed symptoms should be cleaned and disinfected immediately.
• Students, teachers, and staff who have been in close contact (within 6 feet for a cumulative total of 15 minutes or more over a period of 24 hours) of someone with COVID-19 should not return to the building until they have completed their quarantine.
• COVID-19 tests can be administered in the facility without having to wait to schedule one outside of school.
• Parents, staff, and local health officials should be notified immediately of any cases of COVID-19 in the building.
• Stock both the nurse’s office and isolation room with disinfectant, hand washing area, furniture, and other PPE and infection prevention supplies.
• Portable carts can be a great way to provide care to students and keep them out of the confined space of the nurse's office. Carry everything you need to do classroom visits, temperature checks, screenings, and more.

Hallways - 

In normal circumstances, school hallways can be high-traffic areas, especially between class periods, lunchtime, and before and after school. Making changes to the normal traffic pattern in hallways can be essential in reducing the spread of airborne particles.  

• Place hand sanitizing stations/dispensers at classroom entrances, restrooms, and in high traffic areas.
• Reduce the number of students and staff in the halls at once by adjusting class passing periods and limiting time spent at lockers/cubbies.
• Establish one-way traffic routes using floor tape, floor signs, or other physical distance markers to help maintain safe distancing.

Restrooms - 

Restrooms are one of the most widely shared common spaces and can be an area where germs can spread quickly. Encouraging all students and staff to thoroughly wash their hands can be one way to prevent the spread of germs.

• Facility restrooms should be cleaned multiple times throughout the day, and including heavily touched areas such as doorknobs, faucet handles, and toilet levers.
• Social distancing can be maintained by blocking off stalls and sinks that do not have partitions or some sort of separation.

Physical Education and Facilities - 

For children and adolescents, physical exercise is shown to elevate self-esteem, improve concentration, reduce depressive symptoms, improve sleep, and more. It can also have great benefits to overall health and wellness which is extremely important to help promote healthy lifestyles and boost the body’s ability to fight off illness and infection.

• Physical Education settings should adhere to the school, district, and state guidelines to promote the health and safety of students.
• Choose activities that require little-to-no physical contact between students.
• Conduct physical activity outside if weather permits.
• Reduce equipment sharing and consider using personal PE kits for each student.
• Use floor markers and spots to promote traffic flows and physical distancing between students.
• Keep doors and windows open whenever possible to maximize circulation and airflow due to increased respiration by students during physical activity.

View Shape America’s School Reentry Considerations for more information to help administrators, staff, and teachers prepare an environment for safe and supportive instruction.

Athletic Trainers: Room, Facilities, and Return-to-Sport - 

Athletic Trainers play an important role in bridging health and safety recommendations into practice. While many pre-pandemic precautions have remained the same, Athletic Trainers have begun working in collaboration with school officials and other medical professionals to provide a safer and healthier environment for student athletes. Returning to sport and other activities requires more than just updated cleaning protocols, but also closer attention to athlete’s physical health, pre-participation examinations, and return to activity following COVID-19.

• Working with the school and districts other medical professionals to assemble a COVID-19 response team to implement a safe return-to-sport plan.
• Establish an effective communication plan with the athletic director and coaches to identify areas that require adjustments to adhere to local and state guidelines.
• Eliminate equipment sharing between athletes as much as possible and consider investing in electrostatic disinfectant sprayers and effective cleaners to sanitize equipment and shared spaces after use.
• Review and make necessary updates to cleaning and sanitization policies and promote proper hygiene to help reduce the spread of germs.
• Collect updated medical history for all returning athletes and review the Statement on PPE and Athletic Participation for more information on extending pre-participation physical examinations to reduce strain on physicians and clinics.
• Consider setting up general physical examinations at school that include a check of vital signs, COVID-19 symptom and exposure checking, and other cardiovascular, muscular, or general medical examinations.
• Identify and prepare for detraining, heat acclimation, conditioning, and condensed or expanded season concerns.
• Ensure venue-specific EAPs are in place and up to date due to COVID-19 related effects on the cardiovascular, neurologic and other systems.

For more specific details relating to Return to Sport considerations, view NATA’s Considerations for Secondary School Athletic Trainers or your local association’s guidelines and policies.

These are just a few ways schools can be better prepared before students return. For in-depth guides to reopening schools, please visit the CDC, WHO, and other health organizations to find more information to keep your students, staff, and communities safe and healthy.

Visit schoolhealth.com to shop all emergency preparedness equipment, infection prevention supplies, PPE, and more.

Important Links and Additional Resources

https://www.edweek.org/leadership/air-purifiers-fans-and-filters-a-covid-19-explainer-for-schools/2020/10

https://www.cdc.gov/coronavirus/2019-ncov/downloads/community/School-Admin-K12-readiness-and-planning-tool.pdf

https://www.schoolhealth.com/blog/impact-of-covid-19-on-cardiac-health-in-young-people/

https://www.ashrae.org/technical-resources/reopening-of-schools-and-universities#background

https://higherlogicdownload.s3.amazonaws.com/NASN/3870c72d-fff9-4ed7-833f-215de278d256/UploadedImages/PDFs/COVID-19_Considerations_for_School_Nurses_Food_Allergy_and_Anaphylaxis_in_School_during.pdf

https://www.nata.org/press-release/020514/nata-issues-new-recommendations-preparticipation-physicals-and-disqualifying

https://www.cdc.gov/healthyschools/physicalactivity/pdf/Classroom_PA_COVID_Considerations_FINAL_201008.pdf

https://www.shapeamerica.org/advocacy/Reentry/K-12_School_Re-entry_Considerations.aspx

https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/schools.html

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/ventilation.html

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/schools.html