MEDICAL AND HEALTH EMERGENCIES

Transcription

1 IX.041 MEDICAL AND HEALTH EMERGENCIES POLICY The Board shall provide medically appropriate, immediate, quality emergency care in the event of an accident or illness that may compromise the well-being of any individual we serve. The Medical Emergency Service procedures shall include the implementation of all appropriate medical procedures, training staff and individuals we serve regarding health and safety, and the assurance of timely, appropriate, follow-up of all incidents requiring emergency intervention. The superintendent shall develop procedures to implement this policy. This policy replaces the previously effective Policy IX.041, adopted September 21, References: IX.04 IX.042 IX.13 Approved by Legal Counsel: First Reading: May 20, 2014 Second Reading: June 17, Effective Date: July 17, 2014

2 IX.041 MEDICAL AND HEALTH EMERGENCIES PROCEDURES I. Each facility which is Board owned, operated or utilized on a regular basis by the individuals we serve and/or Board staff, shall develop a step-by-step plan for emergencies at that facility. When Board staff is in a host facility, those staff shall follow the Emergency Plan for the host facility. This plan shall be reviewed annually by the Safety Committee and approved by the Chair of the Board Safety Committee. The plan shall include the following as a minimum: A. Listing and location of emergency phone numbers for fire, police, ambulance and poison control (including which phones can be utilized for outside calls). B. The location of all first aid kits, emergency first aid equipment, eye wash stations, and automated external defibrillator (if applicable). The facility nurse or designee is responsible for contents of first aid kits. The first aid kits and first aid equipment must be checked monthly and after each use by the facility nurse or designee. C. Emergency contact numbers for individuals we serve and staff shall be maintained and updated annually as part of the I.P. process. A hard copy shall be made available for removal during emergency drills and evacuation of building. D. A team of certified/trained first aid providers (not less than three persons, including the facility nurse) shall be identified by the Division Manager/ Supervisor. This team shall be called the First Aid Crisis Team (F.A.C.T Team). The nurse has primary charge of first aid in the facility and shall assist in designating and chairing this team. The First Aid Crisis Team shall meet quarterly and maintain minutes of their meetings. 1. First Aid Crisis Team members must maintain current certification for CPR/First Aid and Automated External Defibrillator. a. Red Cross CPR/FA training will be provided to all F.A.C.T. members by trained American Red Cross certified instructors at no cost to the staff.

3 MEDICAL & HEALTH EMERGENCIES PROCEDURES, PAGE 2 IX First Aid Crisis Team members shall be inserviced by facility nurse on THE responsibilities of emergency treatment and operating within parameters of their training. 3. Nurses shall in-service First Aid Crisis Team members in accordance with the medical procedures set forth in this policy and procedures. E. Responsibilities of staff in response to the medical emergency: (Each facility shall determine the following): 1. Who contacts Emergency Medical Service (EMS) (911) 2. What information will be given 3. Involvement of staff 4. Responsibility of First Aid Crisis Team 5. Who contacts family/guardian/residential provider, Division Manager/ Superintendent 6. Who will obtain the emergency medical information to give to EMS. 7. Who will accompany the individual we serve to the hospital II. Emergency Procedure for Accident or Illness A. Assess the situation. Be sure the situation is safe to approach (i.e., live electrical wires, gas leaks, building damage, fire or smoke, traffic or violence). B. Staff witnessing an emergency is to initiate emergency first aid, and send word for person(s) designated to handle emergencies (nurse and First Aid Crisis Team). Staff will stay with the ill or injured person until designated person(s) to handle emergencies arrives. The nurse or First Aid Crisis Team, in the nurse s absence, will take charge of the emergency and render any further first aid needed. 1. Do not give medications unless there is a prior written order by the physician. 2. Do not move a severely injured or ill person unless absolutely necessary for immediate safety. 3. Follow protocols for Medication/Dietary Errors or Bites if applicable. 4. In the case of possible transmission of blood and/or body fluid, see VII.421 D.

4 MEDICAL & HEALTH EMERGENCIES PROCEDURES, PAGE 3 IX.041 C. A designated Board staff will notify parent/guardian/residential provider immediately to determine the appropriate course of action. Emergency medical care shall not be withheld in the event that a parent/guardian is not able to be reached. D. If deemed necessary by the nurse, First Aid Crisis Team or Division Manager, contact EMS (911). 1. Give information to EMS Dispatch: Where (facility name, address and phone number); What: (What is the nature of the emergency and what is currently being done for the individual). E. Provide EMS with Medical Assessment Profile, Medication Profile and/or emergency information with medical history. Stay with injured/ill individual to provide information as requested by EMS. Staff should stay with the individual served until transferring care to the family, guardian or residential provider, or, until hospital staff determine the individual served is stabilized. F. Facility Manager/Supervisor will contact Superintendent and Department Director to advise of incident. G. Facility Manager/Supervisor will evaluate the completeness and content of the paper flow appropriate for each incident. H. Only the Superintendent/Designee is authorized to release information to the media. III. Documentation of Incident. A. Documentation of incidents will be according to the Incident Reporting Procedure for MUI/UI s in Policy IX.13. IV. Reportable Health Concerns A. The following are situations which constitute a health emergency and should be reported to the nurse immediately or in the absence of the nurse to the Division Manager or First Aid Crisis Team to initiate appropriate action. This is only a guideline and not exhaustive. 1. Airway compromise, difficult or absent breathing 2. Unconsciousness or difficult to arouse 3. Lacerations with moderate to severe bleeding

5 MEDICAL & HEALTH EMERGENCIES PROCEDURES, PAGE 4 IX Seizures (first time seizures, seizures longer than 5 minutes, and/or seizures with injuries) 5. All eye injuries 6. All head injuries 7. All electrical shocks 8. Complaints of chest pain 9. Any change in level of consciousness or change in ability to move extremities 10. Any suspected abuse (physical, sexual, or verbal) or neglect 11. Any attempted suicide 12. All burns 13. All crushing injuries 14. Ingestion of foreign substance NOTE: When in question, always consult the nurse or call 911. B. The following are routine situations and health/medical concerns that should be reported to the nurse as soon as possible or in the absence of the nurse to the Division Manager or First AID Crisis Team to initiate appropriate action. This includes, but is not limited to: 1. Complaints of illness and/or mild pain 2. Small cuts and bruises 3. Seizures typical in nature for the individual 4. Vomiting 5. Diarrhea 6. Suspected fever 7. Rashes, sores or lice C. The facility nurse is responsible for in-servicing staff annually on these health concerns. D. When contacting EMS, ensure that you identify the facility by name, address and phone number. Also see that they are aware of the nature of the emergency and what is currently being done for the individual. V. Criteria for removal from programming and holding individuals we serve from programming.

6 MEDICAL & HEALTH EMERGENCIES PROCEDURES, PAGE 5 IX.041 A. The nurse is responsible for determining medical removal from program. In the absence of the nurse, the Division Manager /Supervisor shall be responsible for removal, utilizing the following guidelines: 1. Fever of greater than or equal to 100 degrees oral or 99 degrees axillary; 2. Persistent vomiting (an attempt will be made to handle isolated episodes at the program location); 3. Persistent diarrhea (an attempt will be made to handle isolated episodes at the program location); 4. Rashes of unknown nature if symptomatically indicative of contagious situation; 5. Complaints of persistent earache, abdominal, head throat, etc. pain not relieved by authorized analgesics; 6. Post seizure complications, multiple seizures, seizure not of typical nature for the individual; 7. Any uncontrolled blood and body fluid causing a health risk situation for others, i.e., uncontrolled nosebleed, drainage from wound, etc.; 8. Evidence of lice, scabies or other contagious parasitic infections; 9. All other illnesses or injuries determined by nurse, assessment, medical history or when lack of treatment constitutes a health risk. B. If the medical conditions of the individual we serve presents a potential threat to the health and safety of the individual or others a Medical Removal from program will be initiated. 1. This would require immediate removal of the individual by the parent or residential provider. An authorization to return to program, signed by the physician is required following a Medical Removal. 2. Persistent exclusion from program may necessitate the involvement of the Department of Safety and Protection for investigation. 2. if an individual is sent home for either a behavioral or medical removal, the facility manager, the service and support administrator (SSA), the habilitation specialist and the SSA director will be immediately notified so as

7 MEDICAL & HEALTH EMERGENCIES PROCEDURES, PAGE 6 IX.041 to address the individual s due proces. (review of their legal rights). Medical care shall not be delayed to complete the above contacts. C. Transportation can only be canceled by the Division Manager, Supervisor or nurse. VI. Criteria to Return to Program A. The need for a return to Program authorization statement will be at the discretion of the facility nurse based on the following criteria: 1. Hospitalization 2. Emergency treatment 3. Long-term absence due to illness 4. Communicable disease 5. Other as deemed necessary by the nurse B. If required, prior to an individual returning to Program, written authorization signed by the physician must be received by the facility nurse. C. The physician authorization to return to Program will be filed in the medical section of the permanent file. A copy or notation of receipt will be placed in the health service file. VII. Serious Health Risk Situations A. Should a serious health risk situation be identified by the nurse or another staff, the immediate supervisor and the Nursing Supervisor, shall be notified. If it is determined that there is a serious health risk situation or that a health risk situation has the potential to develop, the Nursing Supervisor or designee, after monitoring efforts and consulting with the Superintendent, shall coordinate with the Public Health, Dayton and Montgomery County and/or the Medical Director to develop a procedure to minimize or eliminate the serious health risk situation. It is the responsibility of the Nursing Supervisor/or designee in Children s Services, to keep the Superintendent s office informed. B. Vagus nerve stimulator and rectal diastat: see Policy ix.04. C. The Board does not discriminate against providing service to individuals with medically identified disease if they are not considered at risk to the general population, as determined by the Health Commissioner. Submitted to the Board: June 18, 2014