Managing medical emergencies on educational visits
Managing medical emergencies on educational visits
This advice article refers to a coroner’s report published on 20 December 2023 following an inquiry into a fatality on an educational visit in 2019. It includes relevant details about the situation and provides advice on preventing and managing medical emergencies for Heads, Educational Visits Coordinators and others involved in managing educational visits.
What follows is a summary of the incident, which readers may find distressing.
Read the full Coroners Court Report 20th December 2023 (external link).
Educational Visits provide immensely valuable opportunities for children and young people. On very rare occasions, incidents happen, and the outcomes can be tragic. As Educational Visits Advisers, it is our responsibility to learn from, understand and share with schools any lessons learned to help prevent any future incidents.
Note: If you require any support in planning and running overseas visits, contact your Educational Visits Adviser/Employer and review OEAP National Guidance.
Brief background to the incident
A 16 year-old student attending an Australian school was travelling overseas in Vietnam, participating in a school trip organised through an expedition provider when they suffered a cardiac arrest precipitated by severe ketoacidosis (Diabetic ketoacidosis (DKA) is a serious condition that can happen in people with diabetes. It's where a lack of insulin causes harmful substances called ketones to build up in the blood. It can be life threatening and needs urgent treatment in hospital).
The student was subsequently repatriated to the Royal Children’s Hospital in Melbourne, but died soon afterwards from a non-survivable brain injury.
Key points
The student was said to be able to manage their condition diligently. They were diagnosed with Type 1 Diabetes at the age of 9.
The trip, due to last three weeks, was attended by the student after thorough medical evaluations, including a review by their GP.
However, on the trip, the student fell ill; experiencing vomiting and other symptoms. Despite efforts by the expedition leader and supporting staff, and a call to the expedition provider’s Operations Centre, the student’s condition deteriorated.
The circumstances leading to the student's tragic death highlight the complexities and challenges of managing pre-existing medical conditions during overseas expeditions.
Advice and recommendations
Based on lessons learned from this incident, we advise schools to review your training and visit policies. In particular, our advice is to:
1. Ensure your staff have appropriate training.
One of the coroner's findings was that the visit leaders and accompanying staff were not adequately trained in dealing with diabetes. Staff attending educational visits must have appropriate training. It is prudent to ensure you do not rely on just one staff member being trained and consider any last minute changes to staffing carefully. This should include specific medical issues such as diabetes, asthma, and anaphylaxis; general first aid; and administering medicines.
2. Carry either electronically/in hard copy all medical details, care plans or medical management plans.
Many schools use an electronic system such as EVOLVE to manage their educational visits; schools should upload medical details and care plans to their system and ensure they have PDF copies in areas where accessing the internet may be an issue.
If you are travelling ‘off-grid’ ensure you take printed copies in a secure folder or backpack, and that more than one member of staff has copies.
3. Share all medical and dietary information with your expedition provider/tour operator in the country/at the centre.
With the introduction of GDPR on 25 May 2018, schools have tightened up their data process. However, the sharing of data to safeguard students and staff is imperative. Schools should ensure that all relevant medical, dietary, etc. needs information is shared with the provider or centre you are staying at. A Data Protection Impact Assessment (DPIA) may be required in advance.
4. Know how to manage any conditions for members of your group.
At the point a student becomes ill, regardless of their capabilities, a member of staff must take over the management of their condition.
5. Seek medical support at the earliest opportunity.
When it comes to medical emergencies or concerns, seeking a doctor’s advice as soon as possible is always recommended. Don’t let lack of knowledge be a barrier to this – know how you would access support for each part of your itinerary (phone numbers, medical centre locations, how to access transport etc.).
In a medical emergency, do not delay in calling the emergency services.
One final mantra we always recommend to schools is: If in doubt, get it checked out.
- Jake Wiid, Educational Visits Adviser and Director of Legal and Compliance at EVOLVE Advice
Further reading from OEAP National Guidance and DfE:
If you’d like further support on this issue, or advice on other aspects related to educational visits, speak to your Educational Visits Adviser.