Emergencies in the school setting: are public school teachers adequately trained to respond?

This study attempted to determine the extent of training and emergency care knowledge of public school teachers in midwestern states. A secondary purpose was to assess the frequency of injury and illness in the school setting requiring the teacher to first-respond.

A questionnaire and 14-item, scenario-based, emergency medical care test was developed and pretested. A discrimination index was used for validation of the instrument and a reliability coefficient of .82 was computed using the Kuder-Richardson Formula 20. A randomly recruited group of public school nurses from Arkansas, Kansas, and Missouri administered the instrument to 334 teachers who had no prior knowledge of the test. A random telephone survey of local school patrons also was completed to determine parental assumptions and expectations for emergency care and cardiopulmonary resuscitation (CPR) training in teachers.

One-third (112 teachers) had no specific training in first-aid and 40% never had been trained in CPR. However, most (87%) of the respondents strongly agreed that emergency care training should be required in teacher preparation programs. Eighteen percent of the teachers responded to more than 20 injured or ill students annually, and 17% reported that they had encountered at least one life-threatening emergency in a student during their career. The average score for all respondents on the emergency care test was 58% (chi 2 = 8.12 +/- 2.42). Those with prior first-aid training averaged 60.5% (chi 2 = 8.47 +/- 2.32). Significant deficiencies were noted for recognition and appropriate treatment of student emergencies involving basic life support (BLS) and airway interventions, diabetic emergencies, and treatment of profuse bleeding. Forty of the 50 (80%) parents surveyed assumed that all teachers were adequately trained in first-aid and CPR.

Public school teachers represent a potentially effective first-response component during disasters and isolated emergencies in the school environment. Overall, most of public school teachers in this study were deficient in both training and knowledge of emergency care and BLS modalities. Lack of effective, formal emergency care training in teacher preparation programs coupled with no continuing education requirement is a possible explanation of these results. Emergency medical services providers should seek opportunities to help with first-responder training and continuing education in their schools.