Publication date: Jul 01, 2025

Ensuring the readiness of school staff and emergency medical services (EMS) personnel to respond to individual school-based medical emergencies aligns with priorities identified by the American Academy of Pediatrics and National Association of School Nurses. We sought to characterize EMS responses to school-based emergencies from a national registry. We analyzed school-based emergency responses in National EMS Information System data before, during, and after the COVID-19 pandemic (2018-2022). We included encounters for children aged 5 to 17 years. We describe EMS clinical impressions (grouped by Diagnostic Grouping System [DGS]), geography, urbanicity, level of service, and common interventions by age group. We identified 506 573 school-based EMS encounters (51. 5% male; median age 14 years [IQR, 11-15]), representing 11. 3% of all pediatric EMS scene responses. Most (69. 1%) resulted in transport to the hospital. Neurologic diseases (19. 1%), psychiatric conditions/substance abuse (16. 7%), and trauma (15. 0%) were the most common DGS groups. Trauma occurred more frequently in elementary school-age students (17. 5%), and psychiatric conditions/substance abuse occurred more frequently among adolescents (18. 6%). Cardiac assessment (20. 1%) and vascular access (17. 4%) were the most common interventions. Analgesics (4. 1%), albuterol (2. 7%), and antiseizure medications (1. 5%) were the most frequently administered medications. Most EMS responses to schools resulted in transport to the hospital setting. Our findings highlight specific target areas for training of school staff and EMS personnel and highlight what emergency medication/equipment should be available in the school setting.

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