BSU SPESES Accident Report Form (PDF)
Evaluate the accident: Emergency numbers: 5-1111 on campus, 911 off campus, or CODE RED walkie/talkie.
Is the condition life-threatening? Are you in the FSB, HP, Arena Complex, or SRWC?
IF YES: Walkie talkie: call the equipment room to report a CODE RED at your location, phone call 5-1111, You should provide care* until other faculty, recreation or EMS staff arrive at your location and take over care. SEND STUDENTS TO RETRIEVE THE AED’S AS NEEDED.
IF YES to life-threatening but you are not in the building: If on-campus report CODE RED on the walkie talkie or call 285-5111 with your cell phone and report your emergency and location, hand the phone or walkie talkie to a student and tell them to relay information for you while you provide care* Provide Care* until EMS arrive and take over care. If 5-5111 is busy call 911 to report the emergency. IF POSSIBLE SEND STUDENTS TO GET BUILDING AED’S.
IF the injury or accident is not life threatening: Send 2 student and call the equipment room (285-3712) to report your location (Room #___________, Field Name ___________, etc.) and to report the following CODE:
CODE ORANGE : Injury: sprains, strains, contusions, bleeding lacerations, to serve dislocation and fractures, bodily fluid in or on an activity area.
CODE PURPLE: Physical Altercations
1. If you are outside, send a student to meet the ambulance as needed.
2. Transfer care to recreation or EMS staff when they arrive.
3. Assist EMS staff as directed to do so.
4. Complete the SPESES accident report, if the accident was life-threatening, ask witness to the injury to write in their words a statement to what they saw and heard. The witness must print their name, sign and date below their statement. The witness may deliver the statement directly to HP-316Q (first aid and safety officer) or HP 316 (SPESES Chair).
5. Turn in your completed report to HP 316
6. Do not discuss the accident with anyone except Police, EMS, Recreation staff or SPESES Administration (Chair, Dr. Weidner, Judy Donahue (PFW) or Lee Yarger) on the scene.
7. If the accident was life-threatening turn-in your report immediately and call Lee Yarger at (765)760-1250 day or night. If you cannot reach Lee please call Dr. Weidner at 285-5039.
8. For Life-threatening accidents or deaths, students and faculty can ask for Critical Incident Stress Debriefing by asking the Police on scene to request counseling. You or students may contact Student Services at 285-3309 for reference to counseling after the accident as well.
9. Do NOT contact student parents, friends or others even if requested. Pass this information on to EMS and document your statements made to EMS. Share the injured students request with SPESES administration ASAP.
Note: Take the time necessary to complete accident reports when the accident happens. If the accident was life-threatening the accident and witness reports take priority over scheduled class. Suspend class as needed and if students need verification for being late to their next class, you may write a note to their instructor and ask them to verify the note with Lee Yarger at HP 360, 5-8282.
*Provide Care only to the level of your current certifications and authorization in your duty to act with SPESES.
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