July 2008 1

Health Care Guidelines Non-health Staff Training

July 2008

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Overview

Introduction

Benefits of Health Care Guidelines

What is a life-threatening emergency?

What should be done in a life-threatening emergency?

What is an urgent situation?

What should be done in an urgent situation?

July 2008

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Overview (continued)

What should be done when health staff are not available?

What are Symptomatic Management Guidelines (SMGs)?

Who is authorized to use SMGs?

Where can SMGs be found on center?

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Overview (continued)

SMG example

How should non-student health problems be addressed?

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Introduction

Health care guidelines for non-health staff provide instructions on procedures to use when confronted with a variety of health situations including life-threatening emergencies, urgent health situations, and response to a health problem when health staff are not readily available

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Benefits of Health Care Guidelines

Benefits of Health Care Guidelines include: Help ensure the safety and comfort of students

Provide evidence-based scientific rationale to support decisions regarding treatment of students

Decrease the possibility of medicolegal concerns for center staff

Provide information and training on current health care practices for the staff

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Benefits of Health Care Guidelines (continued)

Benefits of Health Care Guidelines include: (continued)

Save time for the consulting medical personnel to address other problems requiring their special attention

Allow the center physician to assume a supervisory/teaching role rather than only a service delivery role

Facilitate the orientation of new health and non-health staff

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Benefits of Health Care Guidelines (continued)

Benefits of Health Care Guidelines include: (continued)

Provide non-health staff with direction for action, especially when a member of the health services staff is not available or not on center

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What is a life-threatening emergency?

Causes death in minutes Includes the inability to breathe, inability of the heart

to pump at a normal rate, and uncontrolled bleeding

Examples: choking, severe allergic reaction, poisoning/drug overdose, gunshot/knife wound, drowning, head trauma, severe chest pain, acute asthma with difficulty breathing, shock, attempted suicide

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What should be done in a life-threatening emergency?

First contact the local emergency response team by calling 911

Maintain airway and administer CPR if indicated

Control bleeding

Prevent and treat for shock Monitor vital signs

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What should be done in a life-threatening emergency? (continued)

Inform the rescue team of known medical history, student medications and details of the event (when began, what changed, medications and treatment administered, vomiting)

Once student is stabilized and/or transported off center, notify health staff, center director, and family contact

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What should be done in a life-threatening emergency? (continued)

Document all that occurred in writing for inclusion in the student’s health record

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What is an urgent situation?

Health problems that need evaluation by the center physician, center mental health consultant, or center dentist within a few hours

May soon result in a life-threatening situation or produce permanent damage

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What is an urgent situation? (continued)

Examples Fractures

Serious lacerations

Second degree burns (blistering)

Diarrhea or vomiting lasting more than 24 hours

Abdominal pain

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What is an urgent situation? (continued)

Examples (continued)

Complication of pregnancy

Moderate/mild asthma

Foreign body in the eye

Severe depression or anxiety

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What should be done in an urgent situation?

Notify the on-call health staff member immediately

If health staff is unavailable, contact the local emergency response team

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What should be done in an urgent situation? (continued)

If the student is taken off center, inform the rescue team of known medical history, student medications and details of the event (when began, what changed, medications and treatment administered, vomiting)

Once student is stabilized and/or transported off center, notify health staff, center director, and family contact

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What should be done in an urgent situation? (continued)

Document all that occurred in writing for inclusion in the student’s health record

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What should be done when health staff are not available?

For an emergency situation

First contact the local emergency response team (Call 911)

For an urgent situation

If health staff are not reachable after repeated attempts, contact the local emergency response team

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What should be done when health staff are not available? (continued)

For an urgent situation (continued)

If authorized to do so, follow symptomatic management guidelines for non-health staff

Provide basic first aid measures if needed: o Keep the student warm and comfortable

o Administer CPR if properly trained and certified

o Stop bleeding by applying constant, direct pressure on the wound

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What are Symptomatic Management Guidelines (SMGs)?

Assist non-health staff during hours when no health staff are present on center

Provide guidance on how to handle common student symptoms

Suggest parameters to follow (i.e., when to refer student urgently to the on-call health staff or to local emergency response team when on-call health staff are not available)

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Who is authorized to use SMGs?

SMGs are approved by the center physician in consultation with the health and wellness manager (HWM)

The center physician, center director, and HWM determine which patient care activities a center staff member may be called on to perform

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Who is authorized to use SMGs? (continued)

Personal Authorization—the document outlining which patient care activities a center staff member may be called on to perform

Personal Authorization is filed in the health and wellness center and in each staff member’s personnel folder

Each department/dorm on center should have a copy of the SMGs and a copy of the personal authorizations for those staff members who usually work in that department/dorm.  For instance, the RA's authorizations should be in the dorm they usually monitor, teachers personal authorizations should be with the SMGs in academics, the rec staff authorizations should be in recreation with the SMGs, etc.

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Where can SMGs be found on center?

Residential advisor’s office

Security office

Health and Wellness Center

Center Director’s office

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EXAMPLE:

SYMPTOMATIC MANAGEMENT GUIDELINES FOR NON-HEALTH STAFF

 COLD AND SINUS CONGESTION 

 

Authorized non-health staff may manage a cold and sinus congestion as follows:

 

1.  For fever, offer the student acetaminophen 1000 mg every 4 hours or ibuprofen 400 mg every 6 hours as needed. Encourage oral hydration.

 

2.  Students with fever >101oF should be referred to the health and wellness center for further evaluation.

 

3.   For severe sinus congestion, offer saline nasal spray or nasal decongestant spray or pseudoephedrine (Sudafed) 30 mg – 60 mg every 8 hours until evaluated by health staff. Note that nasal decongestant spray should not be used for more than 3 days.

  

WHEN TO CONTACT THE ON-CALL HEALTH AND WELLNESS STAFF

 

·      If the student has a persistent fever >101oF that is unresponsive to medications listed in #1

·      If the student is wheezing or has difficulty breathing

·      If the student has a severe sinus headache

 

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How should non-student health problems be addressed?

For an emergency situation First contact the local emergency response team

(Call 911)

For all other situations  Provide basic first aid and make patient comfortable

Suggest person go to private physician or hospital emergency room

Complete appropriate records and an incident report