A Framework for School Safety and Risk Management

This year’s holiday season marked the fifth anniversary of the deadly Sandy Hook Elementary School shooting in Newtown, Connecticut.

Since 2013, there have been at least 272 school shootings in the United States—about one per week, according to Everytown USA, a nonprofit organization that researches and reports on public gun violence. In 2017 alone, there were 64 shootings at schools and universities, with 31 of those resulting in injury or death.

As Everytown USA asks, how many more students will have to die before legislators pass common-sense laws to prevent gun violence and save lives?

Until that question is settled, teachers and administrators are on the front lines of protecting their schools from targeted shootings. In a new article published this month in The Educational Forum, school violence expert Ann Marie C. Lenhardt, professor of counseling and human services at Canisius College, reports on “A Framework for School Safety and Risk Management: Results from a Study of 18 Targeted School Shooters.”  With coauthors Lemuel W. Graham and Melissa L. Farrell, Lenhardt expands on the long-term study they first reported in the Forum in 2010.

According to the authors, although awareness of targeted school violence has increased in the last decade, school-based mental health services and resources with a framework for threat assessment and prevention are still largely absent. The authors’ current paper builds on their previous study of 15 cases of targeted school shooters between 1996 and 2005, which focused exclusively on school culture, peer/social dynamics, and disclosure of intentions. The new paper focuses on 18 premeditated cases (16 incidents) of targeted secondary school shooters between 1996 and 2012, using publicly available resources to look at the contextual root variables.

In their new paper, Lenhardt and her coauthors examined 22 indicators in three areas—individual factors and behaviors, family dynamics, and triggering events—and found that the higher the number of risk factors present, the greater the potential for violent acts.

According to the authors’ data, environmental factors within the family may play a key role in how an adolescent responds to stress. Results showed that 94% percent of the shooters had demonstrated a lack of resiliency or an inability to rebound from an unsatisfactory experience, hindrance, or insult. This lack of inner resolve or self-confidence, coupled with poor coping skills in 83% of the shooters, was the deadliest combination of indicators measured. In addition, 67% of the shooters felt alienated, had been bullied, or had issued a violent threat. Five indicators were present in 61% of cases: signs of depression, lack of empathy, poor anger management, intent to carry out threats, and a history of previous threats or attempted suicide. Most of the shooters (83%) had access to weapons in their homes.

The authors recommend that teachers and principals use the study’s indicators to identify students at risk of violent behavior, and then take these steps to preclude school shootings: enhance mental health services in schools, include threat-assessment services, and promote family engagement in services. Everytown USA points out that in addition to the heartbreaking losses from targeted homicides, affected schools experience a drop in student enrollment and a nearly 5% decline in surviving students’ standardized test scores.

Lenhardt and her coauthors note that all students who receive counseling support services can become more resilient and, as a result, will be more likely to achieve academic and life goals.

KDP is proud to partner with Routledge to share Lenhardt, Graham, and Farrell’s research with the education community. Access their article at Taylor and Francis Online, free through January 31, 2018.

Becoming a Food Allergy–Aware School Community

Food allergies in schools have become an increasingly serious concern for students, teachers, and school personnel.

As an educator, you likely didn’t plan on providing medical care for students, but the reality is that almost half of severe allergic reactions, called anaphylaxis, that happen at school occur in the classroom on your watch (Hogue, 2017).

It isn’t enough to just have a plan for students in your class that are known to have an allergy because one out of every four food allergy reactions that happen at school happen to students with no known history of a food allergy (McIntyre et al., 2005; Sicherer et al., 2001). While rare, students have died from the effects of suffering an allergic reaction and not receiving the life-saving medication called epinephrine soon enough (Schoessler & White, 2013; Robinson & Ficca, 2011; Sicherer & Simons, 2007).

What can you do to prepare for the possibility of a food allergy reaction happening in your class? You can become allergy-aware by learning the signs and symptoms of a reaction, responding to a potential allergic reaction, and preventing allergic reactions from happening.

Signs and symptoms of an allergic reaction

The early symptoms may be mild but can quickly become life threatening. The following chart from the Epinephrine Policies and Protocols Workgroup of the National Association of School Nurses (2014) provides guidance for educators.

Are any of these signs and symptoms present and severe? Or is there a COMBINATION of symptoms from different body areas?
LUNG: Short of breath, wheeze, repetitive cough SKIN: Hives, itchy rashes, swelling (eyes, lips)
HEART: Pale, blue, faint, weak pulse, dizzy, confused GUT: Vomiting, cramping pain, diarrhea
THROAT: Tight, hoarse, trouble breathing/swallowing HEENT*: Runny nose, sneezing, swollen eyes, phlegmy throat
MOUTH:  Obstructive swelling (tongue and/or lips) OTHER: Confusion, agitation, feeling of imp

ending doom

SKIN: Hives all over body [OR Hives visible on body] If YES, quickly follow the student’s emergency action plan or your school’s policies and procedures.

*Head, eyes, ears, nose, and throat.

How to respond to an allergic reaction

Once it is clear that an allergic reaction may be occurring (or even if you think, “I wonder if this might be an allergic reaction.”), take action quickly.

For a student with a known allergy, refer to the student’s emergency action plan. For a student with no known allergy, contact the school nurse if your school has one and take action according to your school’s policies and procedures.

Students experiencing anaphylaxis need emergency epinephrine. Every state and every school district has different rules and regulations about which school personnel can administer this life-saving medication. If you are not allowed to use an epinephrine auto-injector, get someone who can quickly.

If you are allowed to use an epinephrine auto-injector, take heart because epinephrine auto-injectors are very easy to use. Demonstration videos are available online:

If an epinephrine auto-injection is required, immediately dial 911 or call your emergency services. Contact your school nurse if he or she is not already on the scene, as well as a parent or guardian.

Preventing food allergy reactions

No plan is fool-proof. Even the most meticulous person cannot avoid all potential exposures to allergens, especially food allergens. However, some simple steps can decrease the likelihood of a student’s exposure to his or her allergen.

: https://attendee.gotowebinar.com/register/6292635169625597441

About the Author
Andrea Tanner, MSN, RN, NCSN, is a National Association of School Nurses (NASN) Epinephrine Resource School Nurse, Anaphylaxis Community Expert, National Certified School Nurse, selected as one of the 2015 Robert Wood Johnson Foundation’s Breakthrough Leaders in Nursing, and Coordinator of Health Services in southern Indiana. Mrs. Tanner served on a committee with the American Academy of Pediatrics to develop national guidance for school allergy policies and procedures. She has presented on food allergy policies, procedures, and staff training at state and national conferences, and has published articles on the topic in Principal Leadership and NASN School Nurse.

References

Epinephrine Policies and Protocols Workgroup of the National Association of School Nurses. (2014). Sample protocol for treatment of symptoms of anaphylaxis – Epinephrine autoinjector administration by school health professionals and trained personnel. Retrieved from https://www.nasn.org/portals/0/resources/Sample_Anaphylaxis_Epinephrine_Administration_Protocol.pdf

Hogue, S, et al. Abstract 696. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 3-6, 2017; Atlanta.

McIntyre, C., Sheetz, A., Carroll, C., & Young, M. (2005). Administration of epinephrine for life-threatening allergic reactions in school settings. Pediatrics, 116(5), 1134-1140.

Robinson, J. & Ficca, M. (2011).  Managing the student with severe food allergies.  Journal of School Nursing, 28(3), 187-194.  doi: 10.1177/1059840511429686.

Schoessler, S. & White, M.  (2013) Recognition and treatment of anaphylaxis in the school setting:  The essential role of the school nurse.  NASN School Nurse, 29: 407-415.  doi:  10.1177/1059840513506014

Sicherer, S., Furlong, T., DeSimone, J., & Sampson, H. (2001). The US Peanut and Tree Nut Allergy Registry: Characteristics of reactions in schools and day care. Journal of Pediatrics, 138(4), 560-565.

Sicherer, S. & Simons, F.E. (2007).  Self-injectable epinephrine for first aid management of anaphylaxis.  Pediatrics, 119(3), 638-646.  doi: 10.1542/peds.2006-3689.