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Picture of child exiting school bus

Child exiting school bus

Wildfires have spread more rapidly than expected, invading communities, igniting homes, and cutting off transportation routes. You are the charge nurse in the emergency department of a local hospital.

You are in the parking lot awaiting an ambulance when a school bus unexpectedly arrives. After you identify yourself, the driver reports the school dismissed the children early due to increasing hazard from the wildfire. He was driving the children home with six remaining to drop off. The route he needed to take into their neighborhood was blocked off by fire crews. The driver tried to contact the school, but communications were down. He was unsure where to take the children and diverted course to your hospital.

You note the driver looks pale and sweaty. He is breathing heavily and clutching his chest. Fearing for his health, you alert one of the paramedics nearby and they take him into the emergency room for further medical evaluation. For the purposes of this case, the children are now considered unaccompanied minors. You verify that six children are aboard the bus, and they appear to be elementary school age.

Think about the questions below based on the case study presented and any additional information given in the question. How you would respond? For each question, think through your response, then click the     sign to view the correct answer and compare it to your response.

  • What information do you need from the kids to begin the tracking and reunification process?
  • How will you account for the children?

You suddenly realize that you are responsible for the six children on the bus. Meanwhile, the ambulance you were expecting approaches the ED carrying injured firefighters. As the charge nurse, you need to take report on the firefighters, triage them, and assure they get evaluated expeditiously. While you attend to these duties, you need to figure out how and to whom you will delegate responsibility for the children. Elizabeth is a nurse case manager and is great with children. She has worked at the hospital for years and is calm, organized, and responsible. She has also been vetted to supervise unaccompanied minors (background check and fingerprints). You see one of your physicians coming in to start her shift. After briefly conveying the story, you ask her to send Elizabeth out to the bus.

When Elizabeth arrives, you review her key tasks with regard to tracking the children and continuing reunification efforts.

  • What steps will you have her take to assure accurate tracking? What information does she need to identify the children? Who should be called next to begin reuniting the children with their caregivers?

Elizabeth takes the children to the well child waiting area on the pediatric ward, a designated pediatric safe area. She counts heads to assure she still has all six of them. By activating the hospital's emergency plan, access to this area is secured.6 While the children are playing, she talks with each one in turn. Smiling and kneeling down to put them at ease, she asks each child their age, name, parent's names, phone number, and address. She records this information and puts a wristband on each child. One of the older children was able to provide the name of the school they attend.

Elizabeth asks the pediatric social worker to assist her by calling the school. The school nurse gets on the line. He is busy working the reunification process at the school as the wildfires are headed that way. He clarifies the identity of some of the smaller children who only knew their first names and relays the information needed to contact their parents.

One by one, the children's parents arrive. At the end of the day, Elizabeth has yet to reunite two children with their parents.

  • Continuing to collaborate with the school, what are other resources she can use to assist with reunification of these unaccompanied minors?
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