Student’s tragic death underscores implications for school nurses

According to a recent news report, a 13-year-old student at Cecil Avenue Middle School in Bakersville, Calif., collapsed while doing sprints in his physical education class. Two physical education teachers saw the student, Jose Manuel Beltran Salas, collapse, but did not administer CPR or call 9-1-1, according to the parents, Livia Salas and Jose Beltran. Rather, they called a district nurse whose job responsibilities required her to cover several schools and who was not at Cecil School when the incident occurred. When the nurse was reached, she reportedly told the teachers to call 9-1-1 and immediately went to the middle school herself. The 9-1-1 call was directed to "Northern 9-1-1" in Canada. After this misstep, the call was re-routed to the appropriate local agency. The nurse arrived at the school before the paramedics and found Jose lying face down on the gym floor. She placed him on his back and began CPR, which according to the complaint filed by the parents, was the first time any medical care was initiated and some 10 minutes after his collapse. The boy was taken to the hospital by paramedics, where he was pronounced dead. The parents' wrongful death suit, filed Nov. 12 against the Delano Union School District, five employees of the school district, the city of Delano, Kern County and the state of California, alleges responsibility for their son's death, alleges negligent hiring and seeks funeral and burial expenses. Now that the case has been filed, it is certain that additional facts, information and the circumstances surrounding the boy's death will emerge. Whatever the outcome of this case, the death has implications for school nurses. First and foremost, you are responsible for ensuring your school personnel are correctly trained in CPR and/or the use of defibrillators. If your state does not mandate defibrillators in schools, contact your legislators and convince them of the need in all schools. Educating parents and the community of this need, and of their participation in contacting legislators, also is essential. School personnel should be regularly certified in the proper use of CPR and/or defibrillators. This can be easily done through training programs provided by outside vendors who are experts in this area. Another duty for school nurses is to emphasize the importance of school personnel immediately calling 9-1-1 when an incident occurs. This call can be placed by a designated school employee who does so while resuscitation efforts are initiated. And this priority should be followed whether you are on-site or off campus when an incident arises. When calling 9-1-1, the caller must identify himself or herself, state the correct name and address of the school and the nature of the emergency. All school personnel need to know the correct number to call when a medical emergency occurs in the school setting. In this case, the proper number may have been called, but it may not have been routed correctly. For more resources, read the National Association of School Nurses' Issue Brief, "Emergency Equipment and Supplies in the School Setting." This young boy's death may have been averted or perhaps his cardiac condition could not have been reversed. That fact may never be known for certain. But fulfilling your obligations as a school nurse consistent with your overall standard of care to your students is essential. Editor's note: Nancy Brent's posts are designed for educational purposes and are not to be taken as specific legal or other advice.