Advise the Parents to Inform the School About Her Medical Condition
The ER physician should advise the parents to inform the school directly about their child's seizure disorder, rather than the physician contacting the school themselves. This approach respects patient privacy while ensuring the child receives appropriate emergency planning at school.
Rationale Based on Medical Ethics and Privacy
The ER physician's primary ethical duty is to protect patient confidentiality while acting in the child's best interest 1. While schools should be aware of children with potentially life-threatening medical conditions like seizure disorders, the healthcare provider guiding the child's care—not an ER physician during an acute visit—should provide information to school personnel about emergency actions 2.
Why the ER Physician Should Not Directly Contact the School
- Privacy protection is a core duty of reasonable physicians, who must maintain confidentiality of patient information 1
- The ER physician lacks the ongoing relationship and comprehensive understanding of the child's seizure management plan needed to properly educate school personnel
- Direct communication without explicit parental authorization could violate privacy regulations
- The healthcare provider guiding the child's ongoing care (typically the child's primary care physician or neurologist) is the appropriate person to coordinate with the school 2
The Appropriate Process for School Notification
Parental Role and Responsibility
Parents should be the primary communicators with the school about their child's medical condition, working in conjunction with the child's ongoing healthcare provider 2. This approach:
- Maintains parental autonomy in medical decision-making for their minor child 3, 4
- Ensures accurate, comprehensive information is shared through the proper channels
- Allows parents to control what information is disclosed and to whom
School Emergency Planning Requirements
Once informed, the school has specific obligations for children with seizure disorders:
- The school nurse should develop an emergency care plan specific to the child 2
- The child's teachers and school nurse should be prepared to activate the emergency plan when needed 2
- Schools should have access to specific medical information about the child's baseline condition, medical plan of care, current medications, and potential complications 2
- A standardized Emergency Information Form (developed by the American Academy of Pediatrics and American College of Emergency Physicians) should be completed and provided to the school 2
What the ER Physician Should Do
Immediate Actions
- Provide appropriate emergency treatment for the acute seizure
- Ensure the child is medically stable for discharge or arrange appropriate admission
- Educate the parents about the importance of informing the school and establishing an emergency action plan 2
Discharge Planning
- Recommend follow-up with the child's primary care physician or a pediatric neurologist for ongoing seizure management
- Explain that the ongoing care provider should coordinate with the school to develop an individualized emergency care plan 2
- Provide written discharge instructions that parents can share with appropriate school personnel if they choose
Common Pitfalls to Avoid
- Do not breach confidentiality by contacting the school without explicit parental authorization and proper documentation 1
- Do not assume the ER visit alone provides sufficient information for comprehensive school emergency planning
- Do not dismiss parental concerns—acknowledge their legitimate worry while directing them to the appropriate process 1
- Recognize that patient well-being should be the primary motivating factor, which in this case means ensuring proper channels are followed for school notification while maintaining privacy 1
Answer: D. Advise the parents to inform the school about her medical condition