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March 01, 1999  |   Comments (0)   |   Post a comment

Opinions Vary on Driver's Role in Medical Emergencies

School districts are often hesitant to expand first aid training because of liability and confidentiality concerns.

by Andria Segedy

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School bus drivers who are taught how best to respond to medical emergencies are more confident in their work, say transportation directors nationwide. However, not all state training requirements go beyond basic first aid. How much training drivers receive varies dramatically based on priorities of individual school districts. And while training material and courses are available, questions of liability and confidentiality remain concerns to some transportation directors, even though the level of training can impact students with disabilities. Certainly, drivers are better prepared to do their jobs when they know the medical needs of students, whether the student is medically fragile or just allergic to bee stings, according to some transportation directors.

Drivers left in dark?
Driver training for a student with special needs is unique for that specific child, notes Terry Voy, Iowa's director of pupil transportation. The child's Individualized Education Program (IEP) is the starting point for an exchange of information critical to the safe travel of that student. "To come up with a state training program is difficult," Voy says. "When it comes down to dealing with children who need feeding tubes or oxygen en route, that needs to be dealt with at the IEP staffing level." In many areas, drivers still do not receive the information and training they need for some of the children they have on board. "They may not even know a child is diabetic," Voy says. "There's the right to know and the need to know. Certainly drivers who transport these kids have a need to know."

Confidentiality is key
Understanding the rules of confidentiality is important. As long as the school bus driver is educated about confidentiality, there should be no problem, says attorney Peggy Burns, counsel for Adams Twelve Five-Star School District in Northglen, Colo. In 1996, the Family Educational Rights and Privacy Act was amended. Prior to the amendment, a school official was someone with a legitimate educational interest, she explains, and nobody thought of a bus driver as a school official. The amendment clarified that a school official includes support staff, and legitimate educational interest is defined as needing information to carry out job responsibilities, she explains. "Schools need to make a public statement on who is a school official, and they need to say it is a school bus driver, as long as certain training is given to the school bus drivers and they don't give the information to anyone else," Burns says. Specifically, trainers should explain to bus drivers that a student's confidential medical information "may not be disclosed to third parties, and they can use the information they are given only for the purpose for which it is given," Burns says. Liability is another concern, according to Ted Finlayson-Schueler, executive director of the Pupil Transportation Safety Institute in Syracuse, N.Y. "Operations say they aren't going to train in first aid because they'll be liable. That's a head-in-the-sand attitude. Given the fact that the federal government has identified that it's expected you would take care of your passengers until help arrives, we need to take care of people with a basic level of care," he says.

Knowledge is power
Information is critical, agrees Burns. However, she says that along with the training, it's important to give bus drivers the parameters as to how to use that information. "There is no question, if there are situations that you can predict that can come up on the school bus, for those situations absolutely there should be training to drivers," Burns says. Finlayson-Schueler says that drivers should focus on common injuries. "Running noses, bee sting allergies and asthma attacks; those are what all school bus drivers must deal with at one time or another," he says. "It's the minor stuff that they face, yet it's an asthma attack or bee sting that could be fatal if they aren't prepared."

Extra training saves a life
Joan Corwin is a registered nurse and an emergency medical technician. She also is president of Chappaqua Transportation Inc. in Chappaqua, N.Y., which contracts with school districts. Corwin teaches extensive first aid to her 126 drivers so they can respond comfortably to medical emergencies. In fact, during snow delays, her drivers are not out throwing snowballs, she says; they are inside watching training videos. "Your drivers are 90 percent of your safety program," she says. One of her drivers saved a girl's life by using the Heimlich maneuver when the girl started choking on candy. This alone justifies the cost of training, she says. "Look what I saved by teaching my drivers the Heimlich maneuver. How can you say it's expensive when you can save a child's life?" But it's the medical information provided to the driver that best helps them prepare for emergencies. In Ogden, Utah, Weber School District uses the medical information forms provided by parents, says Monty Hadley, transportation specialist. "Each child has a form that is filled out on their medical status so we know what to watch for," he says. "We put them in a location on our bus so we can get to them quickly." Driver and monitors on special-education buses receive additional emergency training, Hadley says. They're taught certain skills, such as how to replace or connect a trachea tube, how to respond to seizures and how to work with kids on oxygen. Hadley budgets one hour of extra pay per day to his drivers to compensate them for the time they take on their own to attend safety and medical training courses.

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