Updated September 2022:

Click HERE for a Print Copy of Medical Alert Management Guidelines

Background

There are students in school who may have a physician diagnosed, potentially life-threatening medical condition, and may require emergency care by school staff. This is referred to as a Medical Alert Condition. The purpose of this document is to provide parents/guardians, students, administrators and school staff with guidelines for the development of the Medical Alert List and for managing the emergency plans for life-threatening medical conditions. Parents/guardians, students and staff all have a shared responsibility for keeping students safe at school.

​ ​ ​ ​ ​Guide to Medical Alert Conditions for Schools
​Medical Condition	​Description	​Emergency Plan	​Training	​VCH Contact
​Anaphylaxis (see Policy 304: Anaphylaxis and the Administrative Procedures)	Previous severe allergic reaction(s) which required or may require emergency care and use of Epinephrine (EpiPen). Does not include mild allergies that do not require urgent intervention or allergies to medications.	​Anaphylaxis Emergency Plan VCH Anaphylaxis Emergency Plan.pdf	​Training for all school staff (yearly)	​School Public Health Nurse
​Asthma	Previous asthma episode(s) requiring immediate medical treatment. Does not include controlled, stable asthma (needing rescue inhaler less than once per week).	​Asthma Emergency Plan VCH Asthma Emergency Plan.pdf	​None	​School Public Health Nurse
​Diabetes ​	​Requiring support at school: Students with Diabetes who require the assistance of school staff for blood glucose monitoring and/or insulin administration.	​Diabetes Support Plan and Medical Alert Information (pages 1&2) VCH Diabetes Emergency Plan.pdf Nursing Support Services delegated care plan	​Individual Care Plan, Training and Delegation for staff designated to provide extra support for student All staff review Taking care of Diabetes at School online module	​ Nursing Support Services Referral Process
	​Independently Managed: Students with Diabetes who independently manage their diabetes care at school (e.g. blood sugar testing, insulin injections).	​Diabetes Support Plan and Medical Alert Information (pages 1-3) VCH Diabetes Emergency Plan.pdf	​All staff review Taking care of Diabetes at School online module	​Nursing Support Services Referral Process
	​Who request glucagon at school: Students with Diabetes whose parents have requested that glucagon be administered as an Emergency treatment in the event of severe low blood glucose.	​Diabetes Medication Administration Form	​Designated school staff trained (yearly)	​School Public Health Nurse
​Seizures ​	​With Rescue Medication: Ongoing seizures that require first aid AND emergency rescue medications (e.g. Midazolam). Does not include one-time seizure more than 12 months ago.	​Nursing Support Services Care Plan	​Individual Care Plan, Training and Delegation for staff designated to provide extra support for student	​ Nursing Support Services Referral Process
	​Without Rescue Medication: Ongoing seizures that require first aid only. Does not include one-time seizure more than 12 months ago.	​Seizure Emergency Plan VCH Seizure Emergency Plan.pdf	​Training for all school staff (yearly)	​School Public Health Nurse
​Other Conditions Requiring Emergency Care	​Conditions that are potentially life-threatening or may require emergency support. For example: heart conditions that may require emergency intervention; blood clotting disorders that require immediate medical care in the event of injury (e.g. haemophilia).	​Generic Care Plan VCH Emergency Plan.pdf  To be filled in by parent (Public Health Nurse is available for support and clarification)	​As needed, can consult with family and Public Health Nurse	​School Public Health Nurse

Roles and Responsibilities

As per Policy 303: Student Health Services and Medication Management, the Board will cooperate actively with parents/guardians, public health services, and other social agencies to foster the good health and well-being of students.

Parent/Guardian Responsibilities:

• Provide the school with accurate and timely information about your child’s Medical Alert Condition, both at the time of registration and any time there is a change in the student’s emergency plan or care.
• At the beginning of the school year:
• Complete and return the appropriate parent/guardian and physician-signed Medical Alert forms.
• Meet with designated school staff on an annual basis to confirm emergency plan.
• Provide required medications and determine with the school where and how these should be stored and administered. Ensure that the medications have not expired. 
• Inform school staff if your child has the demonstrated maturity to carry and self-administer their own medication.
• Ensure your child wears a Medical Alert bracelet/necklace.

Principal or Delegate Responsibilities:

• Inform the school community (parents/guardians, staff, etc.) of the school district’s policies, procedures, and intent to provide a safe environment for all students with Medical Alert Conditions.
• Provide access to the appropriate Medical Alert​ forms with instructions to return to the school office.
• Meet with the parent/guardian to review the Medical Alert Condition emergency plan for the student. This is essential for new and newly diagnosed students with life-threatening medical conditions. An annual review of the Medical Alert emergency plan should also occur (if no changes to the medical condition/emergency plan, the parent/guardian may initial and date the emergency plan. Meet with the teacher to review the Medical Alert Condition emergency plan for the student.
• Ensure appropriate staff are aware of the Medical Alert List.
• Consult with the Public Health Nurse for training for school staff (e.g., use of an auto-injector, how to manage anaphylaxis, glucagon administration for diabetic student).

School Staff Responsibilities:

• Be familiar with students who have Medical Alert Conditions in your school/classroom. Be familiar with the student’s Medical Alert emergency plan and location of emergency medication.
• Maintain and update the Medical Alert List (annually and as required throughout the year).
• Receive training offered through the school/Public Health regarding Medical Alert Conditions, anaphylaxis prevention and management, diabetes care and emergency treatment, etc.
• Inform the teacher teaching on call (TTOC) of students in their classroom with Medical Alert Conditions, emergency plans, and location of emergency medication.

For student(s) with Anaphylaxis:

• Create an “allergy aware” classroom (or school if appropriate) for the student(s) with Anaphylaxis. Refer to the School Activities and Food Allergens Resource Website for guidelines. As needed, consult with the Public Health Nurse.

For field trips/extra-curricular activities:

• Bring a copy of the Medical Alert List, Medical Alert emergency plans, and appropriate medical supplies/medication as required.
• Ensure that you have a way to contact emergency response if needed (e.g., cellphone).
• Inform supervising adults/chaperones of students with Medical Alert Conditions and Medical Alert emergency plans.

Student Responsibilities:

• Be aware of your Medical Alert Condition.
• Let an adult know if you think you might be experiencing a medical emergency.
• For mature students (age-appropriate) follow the Medical Alert emergency plan.
• Wear a Medical Alert bracelet/necklace.

Role of Public Health Nurse and/or Nursing Support Services:

• Act as a consultant to the school community in their effort to provide a safe environment for children and youth who may require emergency medical management at school (Medical Alert Conditions).
• Provide information/resources about specific medical conditions.
• Offer health education on emergency procedures/responses and use of medications.
• Provide student-specific training as required by their Medical Alert emergency plan (or care plan for Students with Special Needs).
• Assist with “allergy awareness” education for the school community.

Organize Emergency Medications:

For those students who carry their own medication, or keep it in the classroom, it is recommended that there be a back-up dose in the school office. It is not recommended that students in the primary grades carry their own medication. The Medical Alert List must clearly state where the student’s emergency medication is located in the school.

1. Medication must be clearly labelled with the original pharmacy label, student name and expiry date. Rescue fast-acting sugar (e.g., juice, etc.) for students with diabetes should be clearly labelled with student name.
2. Label a clear zip-lock bag (or large envelope) for each Medical Alert student to store a copy of completed Medical Alert emergency plan and required medication.
3. A copy of the complete Medical Alert List should be stored with the medication.

Note: Medical Alert action plans, care plans and medications should be taken on field trips and school evacuations.

Advise Staff:

Staff (including casual/TTOC/volunteers) must be made aware of any student with a life threatening medical condition.

       Additional Resources

Food Allergy Canada (formerly Anaphylaxis Canada): http://foodallergycanada.ca/

Food Allergy Canada educates, supports and has resources to support individuals and communities to promote allergy aware environments. Some examples to support school environments include:

Sample Posters and Back to School checklist, online learning for Educators:

https://foodallergycanada.ca/professional-resources/educators/school-k-to-12/

Allergy Asthma Information Association (AAIA): http://www.aaia.ca/

The AAIA provides resources to promote safer environments and improve quality of life for Canadians affected by allergy, asthma, and anaphylaxis by empowering individuals and providing education, leadership and a national voice.

Anaphylaxis in Schools and other settings:

http://www.aaia.ca/en/Anaphylaxis 3rd Edition.pdf

Ministry of Education - Diabetes Resources and Support

https://www2.gov.bc.ca/gov/content/education-training/k-12/administration/program-management/safe-caring-and-orderly-schools/diabetes

Vancouver Coastal Health, North Shore:

School Nurse: 604-983-6700

School Health Manual:http://www.vch.ca/public-health/children-youth-schools/school-health/north-shore-school-health-manual

Section #12:  Medical Alerts, Allergies and Anaphylaxis

http://www.vch.ca/public-health/children-youth-schools/school-health/north-shore-school-health-manual/medical-alerts-allergies-info-north-shore-schools

• Sample posters: i.e. Nut Aware Classroom
• Management of anaphylaxis in schools and facilities
• Allergy Aware School and Childcare Settings: Tips for Parents