Policy 4251

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The health and safety of students is a primary concern of the board of education. In emergency situations involving accident or illness, employees are generally expected to (1) render first aid and life-sustaining care to the extent of their knowledge and training and (2) seek assistance of school medical personnel and emergency medical resources, when appropriate. Because of the complexity and severity of the medical conditions of medically fragile students, parents or guardians sometimes may request that school personnel not resuscitate a child in the event of cardiac or respiratory arrest. However, the board believes that implementation of Do Not Resuscitate ("DNR") orders is not consistent with the duty to protect the health and safety of students. Therefore, it is the policy of the Chatham County Schools that school employees will neither accept nor honor DNR orders.

When a student with special health needs is enrolled, appropriate school personnel will determine whether an individualized health plan needs to be prepared for the student. School personnel will consult with the student's parents, school health officials and the student's physician, as appropriate, in making the determination. Individualized health plans should be reviewed annually to ensure that the student's health needs are being met.

If a school official receives a written DNR request from any student's parent/guardian and physician, appropriate school personnel will review the student's current health plan to determine whether it is still sufficient and make any adjustments as needed. In the rare event that parents and physicians can demonstrate that special circumstances justify alternate life-sustaining approaches, school personnel, in consultation with the parents and physician, may create an individually-designed medical resuscitation plan for the student. Such a plan shall not prohibit life-sustaining activities, but may describe emergency procedures appropriate to the individual student.

In the event of cardiac or respiratory arrest of a student, the following procedures will apply:

  1. Emergency care will be administered, including CPR to restore cardiac function or breathing.
  2. Emergency medical services (911) will be activated.
  3. When emergency medical technicians arrive, they will assume responsibility for the student/patient care.
  4. The parent or guardian will be notified as soon as possible.

It is the intent of the board that the underlying principle of any response to a DNR request be that no student is to be denied the fullest genuine, appropriate efforts to preserve life and health.

Legal References: Omnibus Budget Reconciliation Act of 1990, Pub. L. No. 101-508, ยงยง 4206, 4751, 104 Stat. 1388, 1388-115 to-117, 1388-204 to-206 (codified in various sections of 42 U.S.C.); G.S. 90-329; 115C-36

Cross References: Student Health Services (policy 6120), Administering Medicines to Students (policy 6125), First Aid/Emergency Health Care (policy 4250-6130)

Adopted: August 1, 1996, August 2, 2010

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