Health Care Guidelines

1. Health Care Guidelines Non Health Standing Orders Presented by Gala Fair, RN Health and Wellness Manager

2. 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?

3. 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? • SMG example • Q & A

4. 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

5. 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 medico legal concerns for center staff • Provide Information and training on current health care practices for the staff

6. Benefits of Health Care Guidelines (continued) • Benefits of health Care Guidelines include: • Facilitate the orientation of new health and non-health staff • Provide non-health staff with direction for action, especially when a number of the health services staff is not available or not on center

7. What is a life threatening emergency? Any situation or condition that causes death in minutes. • Includes the inability to breathe, inability of the heart to pump at a normal rate, and uncontrolled bleeding

8. What is a life threatening emergency? (continued) Examples: • Acute asthma with difficulty breathing • Severe chest pain • Choking • Severe allergic reaction • Poisoning/drug overdose,

9. What is a life threatening emergency? (continued) • Gunshot/knife wound • Drowning • Head trauma • Shock • Attempted suicide

10. 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 (per personal authorization and/training)

11. 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 it began, what changed, medications and treatments administered, vomiting) • Once student is stabilized and/or transported off center, notify health staff, other appropriate disciplines as per department protocol, as well as family contact

12. What should be done in a life threatening emergency? (continued) • Document all that occurred in writing for inclusion in the student’s health record

13. 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

14. What is an urgent situation?(continued) Examples: • Fractures • Serious lacerations • Second degree burns (blistering) • Diarrhea or vomiting lasting more than 24 hours • Abdominal Pain

15. What is an urgent situation?(continued) Examples: • Complication of pregnancy • Moderate/mild asthma • Foreign body in the eye • Severe depression or anxiety

16. 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

17. 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 it began, what changed, medications and treatment administered, vomiting)

18. What should be done in an urgent situation? (continued) • Once student is stabilized and/or transported off center, notify family contact and appropriate center staff promptly ( i.e. health staff, center physician, mental health consultant, and or dentist). • Document all that occurred in writing for inclusion in the student’s health record

19. What should be done when health staff are not available? For an emergency situation, • First contact the local emergency response team (Call 911)

20. What should be done when health staff are not available? (continued) For an urgent situation, • If authorized to do so, follow symptomatic management guidelines for non-health staff

21. What should be done when health staff are not available? (continued) • Provide basic first aid measures if needed: 1. Keep the student warm and comfortable 2. Administer CPR if properly trained and certified (if applicable) 3. Stop bleeding by applying constant, direct pressure on the wound

22. What are Symptomatic Management Guidelines (SMGs) • Instructions that assist non-health staff during hours when no health staff are present on center • Provide guidance on how to handle common student symptoms without expecting the non-health staff to make a definitive diagnosis • Suggest parameters to follow about when to refer the student urgently to the on-call health staff or, if they are not reachable, to a local response emergency team

23. Who is authorized to use SMGs? • SMGs are approved by the center physician in consultation with the center director, health and wellness manager, center dentist, and center mental health consultant which will designate which tasks each non-health staff member is authorized to perform

24. Who is authorized to use SMGs?(continued) Personal Authorization • Directives outlining which patient care activities a center staff member may be called on to perform • Personal Authorizations are filed in the Health and Wellness Center and must be filed in his/her personnel record

26. Where can SMGs be found on Center? • Residential Advisor’s Office • Security office • Health and Wellness Center • Center Director’s office

27. SYMPTOMATIC MANAGEMENT GUIDELINES FOR NON HEALTH STAFF(EXAMPLE)

29. Q&A