Major vs. Minor Incidents
As a substitute, you always want to be prepared to help students or staff in the event of an emergency or injury. This resource will discuss major incidents, but it is important to distinguish the kinds of things that are considered major vs. minor.
Minor Incidents
Common minor injuries in schools include
- cuts
- scratches
- scrapes
- scabs
- bloody noses
- pinched fingers
- falling down
- horseplay, hits, kicks, shoves
For most minor injuries, you will be able to provide students with the help they need without additional support.
Major Incidents
The most common major emergencies or injuries at schools include
- any head injury, even if it seems minor
- seizure
- allergic reaction
- diabetic emergency
- severe asthma
- fainting
- choking
- serious bone or muscle injury
Other emergencies are less common, but you should always be watchful for any students or staff in medical distress.
Procedures for Major Incidents
General Procedures
- Send a student to get another teacher for help as an emergency is unfolding.
- Do not hesitate to give life-saving care when needed; use emergency equipment if needed (e.g., an EpiPen prescribed for allergies or diabetics, an AED, an inhaler prescribed to a student).
- For life-threatening emergencies, do not hesitate to call 911.
- For all major emergencies or injuries, even if not life-threatening, contact the school nurse or office for support.
- Never send a sick or injured student to the nurse/office alone; have a peer or available staff member accompany the student.
- Except for life-saving situations, such as the use of a prescribed EpiPen for a student, never give students medication. Any daily medication, and any over-the-counter medicines, should be administered by the school nurse or office.
Specific Injuries and Emergencies
For each injury or emergency discussed below, there are links to publicly available, expert first aid guidance provided by The American Red Cross. You are also encouraged to download the FREE First Aid mobile app by The American Red Cross, giving you access to guidance right on your phone. Download the iOS App, download from Google Play, or text "GETFIRST" to 90999.
Extensive Bleeding
Though rare, certain injuries can lead to extensive bleeding—most likely in a playground setting.
Click to read first aid procedures for extensive bleeding, provided by The American Red Cross.
If the bleeding is only minor, you should not handle blood or have other students handle blood. When the injury or emergency is stabilized, apply a tissue or paper towel to prevent blood from getting elsewhere until a bandage is ready. If blood has gotten on any surfaces or materials, use cleaning wipes if available, or call the office for support to get the blood cleaned up.
Head Injury
All head injuries need to be treated as major incidents and reported to the nurse/office. This includes things that seem minor, such as getting hit in the head by a ball, bumping into a wall, falling and hitting the ground, bumping heads with another student, and so on. Most schools have strict protocols for examining students and notifying parents after a head injury.
Click to read first aid procedures for concussions, provided by The American Red Cross.
Seizure
Review any medical notes in the teacher's sub plans regarding students with a recent history of seizures. The link below will help you understand the signs of different kinds of seizures and how to provide first aid.
Click to read first aid procedures for seizures, provided by The American Red Cross.
Allergic Reaction
Review any medical notes in the teacher's sub plans regarding students with food or other allergies, such as bee stings. The teacher's note should also share where any prescribed, life-saving equipment is stored in the classroom, such as an EpiPen to counteract the allergic reaction.
Many school lunchrooms have "allergy-free" tables set aside for students with food allergies, and friends should only be allowed to join that table if their lunch is free of foods with allergens (e.g., peanut butter).
Click to read first aid procedures for allergic reactions, provided by The American Red Cross.
Diabetic Emergency
Review any medical notes in the teacher's sub plans regarding students with diabetes. The teacher's note should also share where any prescribed, life-saving equipment is stored in the classroom, such as an EpiPen or fast-acting sugar tablets.
Older students may be able to manage their blood-sugar needs, but always be watchful for changes in behavior and signs of distress. Diabetic students often have set times that they must leave the classroom to check in with the school nurse/office. Even if a diabetic student is feeling well, it is best practice to send a peer to accompany them when they leave the classroom.
Click to read first aid procedures for diabetic emergencies, provided by The American Red Cross.
Severe Asthma
Review any medical notes in the teacher's sub plans regarding students with asthma. The teacher's note should also share where any prescribed, life-saving equipment is stored in the classroom, such as an inhaler.
Older students may be able to manage their asthma, but always be watchful for signs of distress. Even if a student seems to have their asthma attack under control, it is best practice to send a peer to accompany them when they go to check in with the school nurse/office.
Fainting/Loss of Consciousness
Any incident of fainting should be treated as serious; loss of consciousness can be the first indicator of a life-threatening emergency.
If the student is breathing, has a regular pulse, and regains consciousness quickly, you can follow the procedures in the link below to provide first aid for fainting.
If the student is not breathing and/or does not have a pulse, you should provide life-saving measures immediately.
If the student is breathing and has a pulse but is not regaining consciousness, follow the procedures in the link below to provide first aid.
If you see or learn of evidence that a student is unconscious due to a drug overdose, follow the procedures in the link below to provide first aid.
Choking
Students may choke on food, candy, gum, or other small items while in the classroom, lunchroom, or playground.
Click to read first aid procedures for someone who is choking, provided by The American Red Cross.
Serious Bone or Muscle Injury
The playground and PE class are the most likely places that a student will have a severe bone or muscle injury. This includes torn muscles, tendons, and ligaments as well as jammed, dislocated, fractured, or broken bones.
Staff Emergencies
There are a few emergencies that are more likely for staff members due to age and health conditions. Follow the procedures on the links below to provide first aid.
Click to read first aid procedures for a heart attack, provided by The American Red Cross.
Click to read first aid procedures for adult cardiac arrest, provided by The American Red Cross.
Click to read first aid procedures for a stroke, provided by The American Red Cross.
If you are in distress...
If you are experiencing medical distress while subbing in a classroom, call the office for support or send a student to get another teacher for help. If the emergency is life-threatening, do not hesitate to call 911.
