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School preparedness includes the possibility of a natural disaster, but recent events also confirm a need for preparedness and prevention efforts for intentional mass casualty incidents (MCIs). This survey examined the preparedness for the prevention and response for MCIs at public schools in Arkansas. This survey demonstrated that most school districts in Arkansas have plans for responding to a mass casualty event, but less than one half have a plan for prevention or mitigation of such an event. Since this survey was conducted, Arkansas has passed a law requiring all school districts to develop such an emergency response plan. The findings highlight a need for continued planning and preparation. For example, most schools had not conducted a mass casualty drill. Most superintendents had not met with local EMS officials, and only a few have regularly scheduled meetings. Schools should continue to plan and prepare for the unwelcome prospect of a disaster at a school. School district administrators, nurses, physicians, local emergency response agencies, and the local medical community should all be involved in formulating a coordinated plan for their local community schools.

OBJECTIVE. Recent school shootings and terrorist events have demonstrated the need for well-coordinated planning for school-based mass-casualty events. The objective of this study was to document the preparedness of public schools in the United States for the prevention of and the response to a mass-casualty event. METHODS. A survey was mailed to 3670 school superintendents of public school districts that were chosen at random from a list of school districts from the National Center for Education Statistics of the US Department of Education in January 2004. A second mailing was sent to nonresponders in May 2004. Descriptive statistics were used for survey variables, and the [chi square] test was used to compare urban versus rural preparedness. RESULTS. The response rate was 58.2% (2137 usable surveys returned). Most (86.3%) school superintendents reported having a response plan, but fewer (57.2%) have a plan for prevention. Most (95.6%) have an evacuation plan, but almost one third (30%) had never conducted a drill. Almost one quarter (22.1%) have no disaster plan provisions for children with special health care needs, and one quarter reported having no plans for postdisaster counseling. Almost half (42.8%) had never met with local ambulance officials to discuss emergency planning. Urban school districts were better prepared than rural districts on almost all measures in the survey. CONCLUSIONS. There are important deficiencies in school emergency/disaster planning. Rural districts are less well prepared than urban districts. Disaster/mass-casualty preparedness of schools should be improved through coordination of school officials and local medical and emergency officials. KEY WORDS. disasters, emergency aid, school health, terrorism. URL: www.pediatrics.org/cgi/doi/10.1542/peds.2005-0927

School preparedness includes the possibility of a natural disaster, (1,2) but recent events also confirm a need for preparedness and prevention efforts for intentional mass casualty incidents (MCIs). (3-7) This [...]