A new study published in the journal Pediatrics has identified the three most common medical emergencies in U.S. schools that require immediate paramedic response: brain-related conditions such as seizures, psychiatric issues including substance abuse, and trauma-related injuries.

Together, these three types of health crises account for nearly half of all emergency medical service (EMS) calls made to schools, according to the study, which analyzed over 506,000 EMS responses involving children aged 5 to 17 between 2018 and 2022.

Dr. Michael Harries, the study's lead author and a pediatric emergency medicine fellow at Ann & Robert H. Lurie Children’s Hospital of Chicago, emphasized the importance of preparedness. “While many schools have taken steps to ensure they are prepared for medical emergencies, many can still enhance their preparedness,” said Dr. Harries. “Our study results highlight specific target areas for training of school staff, given that timeliness of treatment in an emergency is essential.”

The study revealed that neurologic emergencies, including seizures, accounted for 19% of school EMS calls. Psychiatric conditions and substance use followed closely behind at 17%, while trauma-related injuries made up 15% of the total cases.

Younger children, particularly elementary school students, were more frequently treated for injuries, while teenagers were more likely to experience psychiatric crises or substance-related episodes.

Senior author Dr. Sriram Ramgopal, also from Lurie Children’s, pointed to the mental health challenges faced by today’s youth. “Given the ongoing mental health crisis in youth, we were not surprised to find that psychiatric conditions and substance abuse were among the most common emergencies in schools,” he said. “This underscores the need for schools to proactively address mental health needs of students, especially teenagers.”

Experts suggest that proactive mental health strategies could include building partnerships with local mental health facilities and improving school staff training for handling psychiatric crises.

The study also stressed the need for ready availability of emergency medications in schools, including benzodiazepines for seizures, epinephrine for severe allergic reactions, and albuterol for asthma attacks.

Importantly, the study found that more than two-thirds (69%) of EMS responses resulted in the child being transported to a hospital, indicating the seriousness of many of these incidents.

In an accompanying editorial, Dr. Kathleen Adelgais, professor of pediatric emergency medicine at the University of Colorado School of Medicine, called for a collaborative approach between schools, EMS providers, and pediatricians.

“Joint training and preparation between schools and EMS, along with the collaboration from community pediatricians, are essential,” the editorial noted. “This ensures access to life-saving medications and improves EMS resource utilization within communities.”

Experts suggest that summer break is an ideal time for schools to organize training programs and prepare staff for the coming academic year, ensuring they are equipped to handle emergencies efficiently and effectively.

As schools prepare for a new academic session, the findings serve as a wake-up call: beyond books and blackboards, school preparedness must include robust health emergency response systems — especially for mental health, seizures, and trauma.