Emergency First Aid Guidelines for California Schools

1. Emergency First Aid Guidelines for California Schools An Overview of Content And How to Use

2. Purpose • To serve as a basic “what to do in an emergency” for school staff with or without medical training. • The guidelines were created as a recommended procedure. • In a true emergency situation use your best judgment.

3. It is strongly recommended… • …that staff who are in a position to provide first-aid to students complete an approved first-aid and CPR course. • …that you familiarize yourself with the format of the guidelines prior to the actual emergency situation. • …that you use the guidelines for reference before, during and/or after an event.

4. What do the Guidelines address? • Emergency procedures • When to call 9-1-1 • Basic information on infection control • Information on emergency planning • Planning for persons with special needs • Recommended first-aid equipment • Emergency phone numbers

5. The Design • Alphabetical order with tabs • Flow charts guide you through decision steps to treat common illnesses and injuries • Flow charts use color-coded shapes to clarify steps

6. Key to Shapes and Colors START HERE This note provides background information. This type of box should be read before emergencies occur.

7. Key to Shapes and Colors ? Question Being Asked? You need to choose based on person’s condition. Follow the pathway for your answer. YES NO Provides First-Aid Instructions

8. Key to Shapes and Colors STOP HERE. This is the final instruction. Final instruction for the algorithm. In some emergencies, multiple algorithms may be used. Additional Information or Signs and Symptoms

9. Key to Shapes and Colors TIME TO CALL 9-1-1 • There may be additional directions to continue care or see another algorithm.

10. Don’t Delay 9-1-1 When Needed • Have someone contact the 911 system, as soon as possible, after it is known that their assistance is needed. Delay in accessing the 911 system could result in worsening of a person’s condition and may lead to additional injury.

11. Direct Fire/Ambulance • Have someone meet fire or ambulance response units • Give directions to location of person.

12. Always Remember ABCs • Airway– Open the airway – 1st • No Air in, all else is lost. • Breathing– Ensure Breathing – 2nd • You may need to breath for the person or do CPR • Circulation(i.e., bleeding) – 3rd • Heart beating or CPR – Nothing else matters • Control Bleeding – Prevent the loss of blood

13. Call 9-1-1 For: • Blocked Airway • Unable to get air into lungs (i.e., choking) • Difficulty Breathing • Absent or labored breathing • Wheezing due to an allergic reaction (i.e., after a bee sting) • Near drowning – even if awake and appears ok water can have a delayed effect on lungs

14. Call 9-1-1 for • Uncontrollable Bleeding – you can’t stop it • Unconsciousness • After any injury • If person has history of Diabetes • Unexplained reason • Head Injury • Possible Poisoning

15. Call 9-1-1 Immediately • GET ADVANCED MEDICAL HELP ASAP • Answer Questions • Follow Instructions • Do Not Hang Up • Stay Calm • Provide First Aid until ambulance arrives

16. WHAT TO DO FIRST CHECK FOR RESPONSIVENESS If Unresponsive, send someone to call 9-1-1 AIRWAY ENSURE AIRWAY IS OPEN.If patient is unconscious use head tilt-chin lift or jaw thrust

17. WHAT TO DO NEXT BREATHING ENSURE PERSON IS BREATHING LOOK, LISTEN, AND FEEL for breathing. If no breathing, SEE CPR and Give Rescue Breaths CIRCULATION CHECK FOR SIGNS OF CIRCULATION(Pulse, movement, breathing, color). If no signs of circulation, SEE CPR. CONTROL BLEEDING

18. DO NOT FORGET THESE DISABILITY- TREAT INJURIES/ILLNESS THAT MAY RESULT IN DISABILITY.(Head injuries, spine injuries, and fractures will need medical attention) FIRSTAID / MEDICAL AID Provide first aid and medical support to most serious injuries/illness risks first.

19. Scenario Child falls from bleachers Dirty, abrasions Bleeding scalp Unconscious, then awakes Remember ABC’s Unconscious due to injury – call 911 Is awake, therefore airway open & breathing Bleeding, See “Bleeding” apply direct pressure Abrasions, See “Cuts, Scratches & Scraps” Which One First?

20. Ready to Try One?

21. Try this One • Child is holding hand and tells teacher he was bitten by a dog. There is some blood oozing from several small punctures/scrapes. Child otherwise is crying and looks normal.

22. BITES (Human & Animal) Wear disposable gloves when exposed to blood or other body fluids • Press firmly with a clean dressing/cloth on bleeding site • “See Bleeding” Is the person bleeding? Is bite large or gaping? Is blood spurting? • Hold bite area under running water for 2-3 minutes • Wash with soap and water • If wound bled, apply clean bandage CALL 9-1-1 See “Bleeding” Is bleeding uncontrolled? If bite is from a snake, scorpion or other reptile, hold the bitten area still and below the level of the heart. Call POISON CONTROL CENTER 1-800-876-4766 See “Snake Bite”, if appropriate Is bite from a human? Check immunization record for DT, DPT (tetanus). See “Tetanus” for more information. • Don’t try to catch or touch the animal • Get description and location of animal • Report to Animal Control or proper authority, usually the local Health Department, so that animal can be caught & watched for rabies Contact responsible school nurse or administrator and parents/legal guardians. Inform if a human bite that both the person bitten and the person biting may have been exposed to blood from other person. ENCOURAGE IMMEDIATE MEDICAL CARE File Incident Report Yes The Whole Thing No No Yes Yes No No Yes

23. BITES (Human & Animal) Wear disposable gloves when exposed to blood or other body fluids Yes decision Leads to action box YES • Press firmly with a clean dressing/cloth on bleeding site • See “Bleeding” Is the person bleeding? Check second protocol for additional help

24. BITES – First Aid YES • Press firmly with a clean dressing/cloth on bleeding site • See “Bleeding” Is the person bleeding? NO • Hold bite area under running water for 2-3 minutes • Wash with soap and water • If wound bled, apply clean bandage NO Is bite large or gaping? Is blood spurting? First Aid Steps

25. BITES (Con’t) • Press firmly with a clean dressing/cloth on bleeding site • See “Bleeding” Different Action steps NO Is bite large or gaping? Is blood spurting? YES GET HELP! CALL 9-1-1 See “Bleeding” Emergent condition, do you need 9-1-1?

26. BITES – Next Steps Bandage Decision, what type? YES Is bleeding uncontrolled? If bite is from a snake, scorpion or other reptile, hold the bitten area still and below the level of the heart. Call POISON CONTROL CENTER 1-800-876-4766 See “Snake Bite”, if appropriate. NO Is bite from a human? YES Use Poison Control, and follow directions

27. BITES – Last Steps • Don’t try to catch or touch the animal • Get description and location of animal • Report to Animal Control or proper authority, usually the local Health Department, so that animal can be caught & watched for rabies Check immunization record for DT, DPT (tetanus). See “Tetanus” for more information. The END Contact responsible school authority and parents/legal guardians. Inform if a human bite that both the person bitten and the person biting may have been exposed to blood from other person. ENCOURAGE IMMEDIATE MEDICAL CARE File Incident Report

28. BITES (Human & Animal) Wear disposable gloves when exposed to blood or other body fluids • Press firmly with a clean dressing/cloth on bleeding site • “See Bleeding” Is the person bleeding? Is bite large or gaping? Is blood spurting? • Hold bite area under running water for 2-3 minutes • Wash with soap and water • If wound bled, apply clean bandage CALL 9-1-1 See “Bleeding” Is bleeding uncontrolled? If bite is from a snake, scorpion or other reptile, hold the bitten area still and below the level of the heart. Call POISON CONTROL CENTER 1-800-876-4766 See “Snake Bite”, if appropriate Is bite from a human? Check immunization record for DT, DPT (tetanus). See “Tetanus” for more information. • Don’t try to catch or touch the animal • Get description and location of animal • Report to Animal Control or proper authority, usually the local Health Department, so that animal can be caught & watched for rabies Contact responsible school nurse or administrator and parents/legal guardians. Inform if a human bite that both the person bitten and the person biting may have been exposed to blood from other person. ENCOURAGE IMMEDIATE MEDICAL CARE File Incident Report Yes No No The Whole Thing No No Yes

29. Implementing the Guidelines • Review the Guidelines in advance • Write down your local emergency phone numbers • Make available to all who might use • Provide training to staff. • Encourage all school staff to take 1st Aid and CPR training. • Check with designated first aid person and local policies.