These days, it doesn't take much imagination to envision a weapon, bomb, chemical, or biological threat occurring at school. Such a situation, although unlikely, is a possibility in today's world. Consequently, parents must consider whether their diabetic child is properly prepared for a crisis. An examination of your child's school emergency plan may be well worth your time.

Schools emergency plans differ based on individual school layouts. Most follow a general guide and then tailor it to their specific needs. Depending on the type of emergency, school and classroom doors may be locked, or everyone may be taken to the gymnasium or cafeteria (where many schools store an emergency cache). According to your school's plan, is staff clearly identified to assist your child in such an event?

If you are fortunate enough to have a school nurse, much of the responsibility in an emergency falls on him or her. According to Sarah Butler, RN, MSN, CDE, NCSN, of the National Association of School Nurses (NASN), "the role of the school nurse is to work with teachers to create an Emergency Care Plan. Such a plan for an elementary or middle school child would recommend that parents supply a juice box or a snack in the classroom. High school students should carry a snack or juice."

A new program called H.A.N.D.S. (Helping Administer to the Needs of The Student with Diabetes at School), created by NASN, addresses how to handle such situations, says Butler. These emergency plans may be critical if your child is locked in a classroom for any length of time. Emotional distress alone may impact your child's blood sugar in such circumstances.

In an evacuation situation, school nurses are trained to carry an emergency backpack with health paperwork and supplies. Many schools practice for such situations, often timing themselves to see how much they can gather together on short notice. When there is no nurse on site, however, teachers and children must be prepared to contend with a crisis.

Unfortunately, staff members may be overwhelmed with responsibilities in an emergency, leaving them unable to reach your child with a snack or help manage a hypoglycemic episode. Moreover, if the regular staff happens to be absent on the day of an emergency, the substitute teachers and nurses could be unfamiliar with the emergency protocols and procedures. Under such circumstances, children may have to fall back on their own resources.

During an evacuation, is your child prepared to be delayed for hours on a bus? According to the National Association for Pupil Transportation, glucose tabs are not among the first-aid items routinely stored on school buses. What about walking more than a mile to a safe house? In most cases, the school nurse would carry necessary items. However, would those supplies be sufficient if children were detained for a long period?

The bottom line is that in the event of an emergency, children with diabetes are probably safest if they're prepared to tend to their own needs. A frequent inventory of your child's backpack for necessary supplies and food is important. But even this becomes problematic if children are too young or are not allowed to take their backpacks with them during an evacuation.

So if your school plan contains only vague directives which fall short of a definitive plan for children with diabetes, you may want to address the issue before your child is involved in an emergency situation. For more information about H.A.N.D.S., go to the National Association of School Nurses website at http://www.nasn.org/Default.aspx?tabid=411.