REMINDER: Please Complete Student Accident/ Incident Reports When Necessary

Guidelines for When to Complete a Student Accident/Incident Report

• All student injuries or incidents when 911, Fire/EMS, or other outside medical assistance is called to the scene.
• All student injuries where the student is taken from school or a school event to a doctor or hospital either by school staff or a parent or guardian.

• Student injuries involving the head, neck or back, other than minor bumps, scrapes or bruises.
• Student injuries, other than minor scrapes and bruises, that occur in the shop (wood or metal), weight room, physical education class, and athletic events/practices.
• Playground injuries, other than minor scrapes and bruises.
• Student injuries that involve severe burns or electrical shock.
• Student injuries involving exposure to, ingestion of, or contact with chemicals.

• Severe allergic reactions.
• An incident involving administration of injectable or nasal rescue medications (Epinephrine auto-injector, glucagon, Midazolam etc.).
• An uncontrolled asthma attack or any respiratory emergency.
• Student seizures, if the student has never had a seizure before, or as directed by student’s emergency care plan to call 911.
• Injuries that involve a defect in school equipment or facilities (actual or perceived).

• All drug-related incidents, whether overdose or reaction from prescription drugs or illegal substances.
• All student incidents involving loss of consciousness.
• If a student goes into shock.
• Student injuries involving entering, exiting, or while riding on a school bus, other than minor scrapes and bruises

Things to Remember for Proper Completion of a Student Accident/Incident Report

1. Use a Student Accident Report/Incident Report form if available.
2. Write legibly. Complete all information.
3. Report all information that you have at the time; someone else may need to complete the report more fully later; please include student’s date of birth.
4. If you did not observe the incident yourself, say how you found out about it.
5. Report just the facts – no opinions; do not comment on fault.
6. In the injury description, do not give a medical diagnosis (unless you are a trained medical professional); if an injury is suspected, state what you know about any injuries.
7. Be as specific as you can as to exactly where the accident/incident occurred (location and equipment involved).
8. List all persons involved including their names and how they are related to the accident/incident (i.e., bus driver, other driver, witness).
9. List all responding authorities (fire, police, ambulance, etc.).
10. Detail what action has been taken (i.e. – where the vehicle was towed to and by whom, what equipment was taken out of service, the hospitals students were sent to, etc.).
11. If an incident form is not available or does not request relevant information that you have, complete a report on a separate sheet, answering who, what, when, where, why and how the incident happened.
12. Complete within 24 hours of the incident. Include follow up comments on student status. The person completing it should sign the report.
13. *Send original document through courier to Risk Co-Op at ESD 112 or by mail, 2500 NE 65th Avenue, Vancouver, WA 98661