453.1

EMERGENCY NURSING SERVICES

Emergency nursing services for the Appleton Area School District are provided with input, direction, and coordination furnished by one or more registered nurses employed by the District. Emergency nursing services shall be available during the school day and during all school-sponsored activities for students, including summer school, field trips, athletic events, and other co-curricular and extracurricular activities.
To ensure the provision of an appropriate emergency nursing services program:

1. The Superintendent or Executive Director of Student Services shall have primary administrative responsibility for the District’s emergency nursing services program, including ensuring that the District conducts an annual review of the emergency nursing program and that the findings and recommendations from the annual review are presented to the District Administrator and School Board.
2. The District shall designate the registered nurse(s) whose employment responsibilities include the nursing-related duties identified in this policy.
3. The Board shall act to approve the emergency nursing procedures that are developed (or revised) under the direction of a registered nurse pursuant to applicable law and this policy.
4. The District shall arrange for a physician to serve as the District’s medical advisor for the emergency nursing services program and in connection with handling other significant student and school health concerns. The Superintendent or Executive Director of Student Services and the registered nurse(s) employed by the District shall be the primary point of contact with the District’s medical advisor on an as-needed basis.
5. The District shall make available the equipment and supplies necessary for providing emergency nursing services in the District. A health room/area shall be designated in each school.
6. In consultation with the registered nurse(s) employed by the District, the Superintendent or Executive Director of Student Services or an administrative-level designee shall assign direct responsibilities to appropriate school personnel related to the provision of emergency and other health-related services. The building principal of each school shall designate staff who are assigned and trained to serve as site-based first responders in the event of a health-related emergency. As used in District policy, the term “site-based first responder” is a local term that should not be equated with a “certified first responder” under state law.

In providing for the coordination and oversight of emergency nursing services, one or more registered nurses designated by the District shall:

1. Maintain and coordinate the day-to-day implementation of the District’s emergency nursing procedures, including protocols for the administration of medication to students, protocols for dealing with student injury and illness (e.g., first aid protocols and other emergency procedures), and related recordkeeping procedures. These procedures will be developed by a registered nurse in cooperation with the Superintendent or Executive Director of Student Services, and, on an as-needed basis, in consultation with the District’s medical advisor and/or representatives of the county health department or other community health agencies.
2. Disseminate the District’s current emergency nursing procedures and protocols to appropriate school personnel.
3. Provide or arrange for the provision of training of designated school district staff in regard to the District’s medical emergency protocols (e.g., general first aid, cardiopulmonary resuscitation (CPR), the use of an automated external defibrillator (AED), and the administration of medication to students. As needed, the nurse shall also provide or arrange for the training of school personnel related to the District’s provision of specialized health-related services to individual students.
4. Provide any necessary nursing-related supervision in connection with any specialized health-related services that the District provides to individual students with special health care needs.
5. Monitor and make recommendations to the administration regarding the equipment, supplies, and space needed for the appropriate provision of emergency care and other health-related services.

Closely related to the responsibilities identified above, the registered nurse(s) employed by the District shall also:

1. Assist in identifying and arranging for any necessary services and accommodations for students within the District who have medical or health concerns that may require a health plan, Section 504 plan, or individualized education program (IEP).
2. Serve as a resource person for administrators and school personnel on student and school health issues, and the District’s provision of instruction to students regarding personal health and life-saving skills.
3. Serve as a liaison between the schools and community-based health agencies and services.

Cross References:

Administration of Drug Products/Medications to Students, 453.4
2025 Injury and Illness Protocols

Legal References:

Wisconsin Statutes 118.076, 118.125, 118.29, 118.291, 118.2925, 118.293, 118.2935, 121.02(1)(g)t], 146.81 to 146.84, 440.01(1)(ad), 895.48
Wisconsin Administrative Code, Chapter N 6, PI 8.01(2)(g) SPS 332.50

Federal Laws
29 Code of Federal Regulations (CFR), Part 1910 - Subpart Z

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Adoption Date: June 8, 1992

Amended Date: November 10, 2014, April 28,2025

 

 

453.1-Rule

A. Student Emergency Information
1. An emergency information form must be completed for each student upon his/her initial enrollment or attendance in school or his/her participation in any District-sponsored athletic activity for students. The form shall be completed regardless of the student’s full-time status, enrollment status, or residency. At least annually, each school shall request that the student’s parent or guardian provide any updates to the emergency information that is presently on file. The student’s emergency information shall also be updated any time during the school year that a parent or guardian submits a change. The form shall include:

a. Emergency contact names and information in the event of an accident, injury, illness, or other emergency.

b. Information about any special health concerns or procedures relevant to the student.

2. Upon receipt of a new or amended emergency information form provided by a parent or guardian, the Building Principal or designee shall ensure that the information is reviewed by an appropriate staff member or other representative of the school to determine whether the District may need to follow up with a further response or inquiry. A registered nurse serving the District shall be consulted as necessary in connection with the review of emergency information forms.
3. Emergency health information shall be kept in the relevant school office and shall be shared with school personnel and other school officials as deemed appropriate and necessary, consistent with legal requirements and with the District’s student records policy and procedures.
4. When students are involved in school-sponsored activities away from school, student emergency information will be made available in order to enable activity supervisors to appropriately address any individualized health concerns or possible emergency situations. It is the joint responsibility of the Building Principal or designee and the staff who are planning/supervising the activity to ensure that this information is readily available.

B. Health/Medical Plans

1. The District develops health/medical plans for students on an as-needed basis and in a manner consistent with applicable law. In appropriate cases, individualized planning will occur in connection with the development of a Section 504 plan or individualized education program (IEP).
2. In most cases, a team-based approach will be used to develop any individualized plan, including consideration of relevant medical information and recommendations. A registered nurse serving the schools will generally be involved in the process of establishing and monitoring any such plan.
3. As needed, a nurse serving the school will provide nursing-related supervision, including but not limited to providing or arranging for appropriate training of designated school personnel, in situations where a student’s plan calls for the District to provide specialized health services.

C. Planning for Possible Medical Emergencies in Connection with Activities Held Away from School

1. When students will be participating in a District-sponsored activity that is being held away from school, activity organizers/supervisors are expected to engage in both general and student-specifi c planning for possible emergency care needs. General planning may involve tasks such as identifying unusual activity-specifi c risks (e.g., unusually hazardous areas, increased opportunities for student exposure to likely allergens, unusual physical demands), assessing the availability of medical and emergency services/facilities near the activity location(s), verifying that activity supervisors will have access to students’ emergency information, and informing accompanying school personnel and volunteers about what to do in case of a medical or health-related emergency. Student-specific planning involves an assessment of needs related to any special health concerns of the individual students who will be participating in the activity.
2. The extent of emergency care planning for such away-from-school activities should generally be proportionate to the uniqueness of the location and type of activity. For example, general emergency planning can often be less extensive in connection with recurring activities (e.g., away contests for students participating in athletics) when participating staff, students, and students’ parents and guardians can be expected to be reasonably familiar with the nature and location(s) of the activity.
3. Activity organizers/supervisors shall consult with the building principal and a registered nurse serving the District on an as-needed basis to assist with emergency care planning for such away-from-school activities.

D. Emergency Equipment and Supplies

1. First aid supplies and equipment will be available and in accessible locations within each school building.
2. A copy of the District’s first aid procedures/protocols will be maintained within each school building.
3. Mobile first aid kits shall be available for field trips and similar away-from-school activities involving students.
4. Each building principal shall assign a staff member(s) to maintain a regular inventory of the first aid supplies/equipment and to notify the principal or his/her designee when additional supplies/equipment are needed.
5. A copy of the Wisconsin Childhood Communicable Diseases Chart from the Wisconsin Department of Health Services shall be maintained in each school’s primary student health room/area.
6. An automated external defibrillator (AED) will be available in each school building in the District. The AED shall be used and maintained in accordance with legal requirements, the manufacturer’s specifications, and established District procedures.

E. Designation and Training of Emergency Care Providers
1. The Superintendent, Executive Director of Student Services, or building principal, in consultation with a registered nurse serving the school, shall:

a. Designate an appropriate number of staff members, by building, to serve as site-based first responders in case of a medical/health care emergency occurring in the school. A minimum of two staff members per school building shall be designated as site-based first responders.

b. Designate any staff members who, in addition to the site-based first responders, will receive role-appropriate training and be available to implement relevant emergency care procedures in connection with school-sponsored activities that take place off school premises or outside of the normal school day, such as field trips, athletic events, and other co-curricular and extracurricular activities.

2. The building principal, in consultation with a registered nurse serving the school, shall also monitor each school’s implementation of a role-specific training schedule for the individuals who have been designated to implement elements of the District’s emergency care procedures.
3. All individuals designated as site-based first responders shall receive broad training related to the District’s emergency care procedures, including training in at least the following areas:

a. the District’s general first aid protocols (e.g., student injury/illness response protocols);

b. cardiopulmonary resuscitation (CPR);

c. the use of an automated external defibrillator (AED);

d. the District’s policies and procedures concerning the administration of medication to students; and,

e. the District’s bloodborne pathogens/exposure control plan

4. A registered nurse serving the schools shall provide, or assist in arranging for the provision of, first aid training and such other role-appropriate training for designated emergency care providers as may be required by law and/or under District policies/procedures.
5. The Executive Director of Student Services or a designee shall maintain records of who has been trained, the specifi c training provided, and the date of the training.

F. General Emergency Care Procedures
In case of an accidental injury or illness occurring on school premises or during a school-sponsored activity, these general procedures shall be followed:
1. Serious Injury/Accident or Illness

a. Designated school personnel (site-based first responders whenever available) shall assess the situation and administer basic first aid as needed to:
● restore and maintain an open airway,
● restore and maintain breathing,
● promote adequate circulation, and/or
● stop severe bleeding

As soon as it is determined to be necessary/appropriate, a call should be placed to 911 to summon professional emergency medical assistance (ambulance, rescue squad, etc.).

If a healthcare professional (e.g., a registered nurse or physician) or any professional emergency medical assistance personnel are present at the location of an incident, he/she should be immediately summoned to the scene or contacted for consultation if practical.

b. No internal or external medication should be administered to the individual unless specifically prescribed or specifically authorized under the conditions outlined in state law and in the District’s medication administration procedures.

c. If the emergency situation involves a student, the student’s parent(s) or guardian(s) shall be contacted as soon as reasonably practical under the circumstances. If the parent or guardian cannot be reached, the emergency contact(s) as identified on the student’s emergency information on file with the District shall be called. A responsible adult should remain with the student until the parent(s) or guardian(s) assumes responsibility if possible.

d. The building principal or designee shall be informed immediately if the accident, injury, or illness occurs during the school day. If the accident, injury, or illness occurs outside of the school day or at an activity off school premises, the building principal or designee shall be informed as soon as possible, but no later than the next school day.

2. Minor Accidents/Injuries/Illness

a. Designated school personnel (i.e., on-site nurses, health assistants, or other designated site-based first responders, whenever available) will provide the appropriate intervention/response to any minor injury or illness occurring on school premises or during a school-sponsored activity as deemed necessary for the situation.

b. If a student becomes ill during the school day, school personnel should send him/her to the designated room in the building to rest or for attention. Office personnel will provide care for the student and/or contact parent or guardian to determine whether the student needs to be sent home. If the parent or guardian is unavailable, the emergency contact person identified on the student’s emergency information will be notified. In making a determination whether to send a student home from school, school personnel shall consider protocols outlined in the District’s emergency services and communicable disease management procedures. If it is determined the student is to be sent home, arrangements will be made for the student to leave the school premises. If all contact attempts fail and the student’s parent or guardian or emergency contact person are not available, continued attempts will be made to reach the parent or guardian or emergency contact person.

G. Accident Reporting and Recordkeeping

1. The person(s) administering emergency care or assistance under these procedures is responsible for ensuring that the first aid or other emergency care administered in relation to accidents, injuries, or illnesses are properly documented.
2. The relevant class/activity supervisor(s) and the school employee(s) who assumed primary responsibility for responding to a specifi c accident/incident have joint responsibility for ensuring that they promptly notify the building principal and complete a written Accident/Injury Report according to procedures outlined on Student Non-Employee Incident Report narrative instructions.

H. Annual Review of Emergency Nursing Services
The District shall conduct an annual review of the District’s emergency nursing services program and related policies/procedures, including medication administration policies/procedures, at the end of each school year.

1. The findings of the review shall include the identification of any recommended changes to the program that would improve quality, efficiency, or safety. The administration shall ensure that any new or substantive revisions to first aid, injury, illness, or medication administration protocols are reviewed and approved by a registered nurse serving the District prior to being presented for adoption by the School Board.
2. The Board shall normally be informed of the findings of the annual review of the District’s emergency nursing services program, related policies/procedures, and any recommended changes at a regular school board meeting.

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Adoption Date: June 8, 1992

Amended Date: November 10, 2014, April 28, 2025