US Study on School-Based Medical Emergencies May Have Lessons for Nigerian Schools

By Victory Onyenekwe. B.Sc. Ed Physical and Health Education. Freelance Health Writer. Reviewed by: A.. Odutola, MB,BS, PhD, FRCSEd.

Students in a school clinic. IClick on image to enlarge. Credit: Google Gemini

Highlights

• Medical emergencies are quite common in schools, with infectious diseases and non-communicable diseases being the most common cause of medical emergencies in Nigerian schools.

• A new US study showed that seizures, substance abuse, and trauma-related injuries are the three main reasons paramedics respond to schools for medical emergency calls.

• Unpreparedness for medical emergencies can lead to severe consequences, including long-term impairment, preventable death, and parental anxiety.

• Nigerian schools can better manage medical emergencies for best outcomes by:
  • Having emergency response plans that are reviewed regularly
  • Ensuring adequately equipped sick bays that are staffed by licensed nurses
  • Providing essential medications that are relevant to the common causes of emergencies in school.
  • Mandating regular First aid and CPR training for teachers
  • Collaborating with neighbouring health facilities for health seminars on handling emergencies

Introduction

A medical emergency is a short-term injury or illness that poses an immediate threat to a person’s life or long-term health, and requires swift medical attention. 

Medical emergencies are quite common in schools, with infectious and non-communicable diseases being the most common causes in Nigerian schools.

By comparison, a new US study conducted between 2018–2022 found that seizures, substance abuse and trauma-related injuries were the three main reasons paramedics responded to medical emergency calls from schools. 

As Nigerian Schools also have their fair share of medical emergencies, and recognising that the school and medical emergency response systems in the two countries are different, are there any lessons for Nigerian schools to learn from the US study?

Let’s find out by unpacking the US study.

About the US Study

The study was conducted in the United States by Chicago, Illinois based researchers. Using the National EMS Information System data, the study analysed more than 506,500 Emergency medical service responses that occurred between 2018 and 2022, and included treatment of children aged 5 to 17 to determine the most common medical emergencies in school children.

What the Study Found

About half of the medical emergencies among US school children were mostly caused by these three common conditions:

• Brain-related crises like seizures
• Psychiatric conditions or substance abuse, and 
• Trauma-related injuries. 

Specifically, the study found that:

• 19% of emergency medical service calls were attributed to brain-related crises or neurologic problems like seizures, 
• Nearly 17% of emergency calls were for psychiatric conditions or substance abuse
• 15% were for accidents or trauma-related injuries 

Elementary school children were found to be most likely to need treatment for physical injuries (18%), while teenagers were more likely to require emergency care for psychiatric conditions or substance abuse (19%). 

Cardiac (heart-related) assessment (20.1%) and vascular access (establishing intravenous line) (17.4%) were the most common interventions EMS service providers offered.  

The most frequently administered drugs by EMS providers were analgesics (pain relievers) (4.1%), albuterol (asthma reliever) (2.7%), and antiseizure medications (1.5%) 

More than 69% of school medical emergencies encountered resulted in the affected students being taken to the hospital.

The researchers concluded that their findings provide evidence to shape school-based medical emergency preparedness planning by highlighting (a) specific areas of need for training school staff and EMS personnel and (b) the emergency medications/equipment that should be available in the school setting.

What the Study Means for Nigerian Schools

The key lesson that the US study provides for Nigerian school systems is that the planning and implementation of a robust school-based emergency medical preparedness and response must be anchored on reliable data.

Although the Nigerian government has put in place a framework for comprehensive school safety and emergency preparedness through the National School Health Policy, and the National Policy on Safety, Security and Violence-free Schools, it is unclear what data was relied upon in the establishment of these policies, which set guidelines in very broad terms like: 

• Establish a school health committee
• Provide a functional sick bay
• Ensure staff training in basic first aid, hygiene, and disease prevention
• Collaborate with health and emergency services

Even with these broad guidelines, many Nigerian schools are negligent with implementing a medical emergency response plan [MERP], with absolutely next to no provision for counsellors, medical personnel, adequate health facilities and continuing training programmes in basic emergency care and services.

For example, studies conducted across several schools in Nigeria showed that while first aid boxes are provided, staff are generally not trained in administering first aid in the event of a medical emergency needing Cardiopulmonary Resuscitation [CPR], or proper administration of inhalers during an asthmatic crisis etc. Studies have also reported shortage of medical personnel, and sickbays within Nigerian schools.

A study conducted in primary schools In Abakaliki, South Eastern Nigeria, reported that only 1 in 15 (6.5%) primary schools had nurses, nearly 1 in 10 (9.7%) had doctors and close to 1 in 3 (32.3%) had trained first aiders. The study further reported  that while First aid boxes were found in 8 out of 10 (80.6%) schools, only 7 of 10 (67.7%) of those with first aid boxes  could offer first aid treatment in an emergency. These anomalies were mostly found in public schools.

Another study conducted in South Western Nigeria, found that about 9 out of 10 (90%) schools sampled have First aid boxes, only 1 out of 50 ( 2%) have sick bays, 1 out of 20 (5%) have health personnel on ground and just 1 of 33 (2.9%) schools have trained first aiders.

Sadly, preparedness for medical emergencies in Nigerian schools has still not gone beyond having a first aid box for show during quality inspection.

Related: School health programmes in Africa: What You Need to Know

Why Preparing for Medical Emergencies Matters

A significant amount of a child’s day is spent within the school environment, with over 95% of young Nigerians spending 6-8 hours/ day in school. This means that children can present with physical injuries, allergic reactions, triggers from underlying health conditions or short-term illnesses at any point in time. 

Unpreparedness for medical emergencies can lead to the following consequences:

• Severe injuries resulting in long term impairment
• Legal liabilities for schools
• Increased parental anxiety
• Parental and Community distrust of the educational system
• Long-term health complications
• Disruption of learning
• Preventable deaths

Related: School Health Programmes in Africa, Benefits to Students and Staff

Recomendations

Nigerian schools can adequately prepare for medical emergencies by taking the following steps:

• Research collaboration : Research is needed to provide data that will inform policies and plans for school-based emergency preparedness services

• Mandatory First aid and CPR Training for Teachers: All teachers must be trained on the administration of first aid, especially on health issues that research confirms are common within school environments. Examples may include trauma related injuries like sprains, strains, fractures and dislocations, asthma, nose bleeding etc. Regular refresher courses on CPR and first aid training programs should also be organised to keep up with global health trends.

• Standardized Emergency Response Plans: This includes developing and practicing safety drills for emergencies like fire outbreak, floods, stampedes, etc. it will provide staff and students with the tools to navigate these emergencies.

• Adequate Sick Bays and Medical Kits: Every Nigerian school must have a well – equipped, accessible and fully staffed health facility, to provide immediate care for health emergencies.

• School Health Personnel: Employment of trained nurses, doctors or health assistants in schools.

• Government Policy and Enforcement: Through regulations and policies, the ministries of health and education should improve standard guidelines for school health programs in the country and hold schools accountable for the guidelines through programmed inspections and reporting requirements.

• Parental Engagement: Parents can advocate for and support better preparedness for medical emergencies at their children’s schools. This can be done by donating resources, or offering their skills, particularly for those who work in the education or health sectors.

• Inter- sectoral Collaboration: To effectively handle medical emergencies, school administrators should partner with local health facilities and emergency services, for resources and expert guidance.

Wrap Up

School-based medical emergency services are very important for the assurance of safety and immediate attention that they bring to students in moments of acute need.

The greatest lesson that the leaderships of Nigerian schools can learn from the US study is that credible local data on the type, nature and frequencies of acute illnesses in schools, provides the foundation on which effective school-based medical emergency preparedness plans and programmes can be built. 

Medical emergencies demand more than just a few items in a first aid kit; they require a high level of well organised preparedness. When schools fail to act, the results can be permanent impairment or even death of pupils/students.

The Nigerian government has a vital role to play by ensuring that all schools are held accountable and fully comply with school health program standards.

Ultimately, the issue of school health and emergency preparedness is a shared responsibility. While the government must establish and enforce regulations and schools must comply, school administrators, parents, health facilities, and the community must also all play a part.

By working together, all stakeholders can ensure that every Nigerian child has access to a safe learning environment where their well-being is top priority.

Source: Harries MD, Saper JK, Macy ML, Martin-Gill C. Emergency Medical Services Responses to School-Based Medical Emergencies. Pediatrics, 2025;156 (2):e2024068886. doi:  10.1542/peds.2024-068886. Available from here.

Published: August 29, 2025

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