Emergency First Aid Guidelines For California Schools

Transcription

A-BGuidelines Pre-Incident Signs &Information Instructions SymptomsEmergency Medical Services AuthorityCalifornia Health and Human Services AgencyEMSA #196Original 1994Revised 2004Revised 2013Signs &Signs &Signs &Signs &Signs &Signs &Signs &Symptoms Symptoms Symptoms Symptoms Symptoms Symptoms SymptomsC-DS-TP-RE-FH-LV-ZM-NEmergency First Aid Guidelines forCalifornia Schools

Emergency First Aid Guidelines for California SchoolsEMERGENCY FIRST AID GUIDELINES FORCALIFORNIA SCHOOLS - 2013 EDITIONSpecial RecognitionOhio Department of Public Safety, Division of EMS, EMS for Children Program;North Dakota EMS for Children ProgramEmergency First Aid Guidelines for Schools - Pilot Project Staff (First Version)Les Gardina, MSN, RN, EMSC Coordinator, County of San Diego EMSCynthia Frankel, RN, EMSC Coordinator, Alameda County EMSKris Helander-Daughtery, RN, BSN, Prehospital Care Coordinator, Alameda County EMSAcknowledgementsWe would like to thank the following for their review and contributions to the development of theseguidelines:County of San Diego School Nurse Resource GroupCalifornia EMSC Technical Advisory CommitteeCalifornia EMSC Coordinators GroupSan Diego Unified School DistrictJim Harley, MD, San Diego Chapter of American Academy of Pediatrics, COPEMChris Riccitelli, RN, School Nurse Program Specialist, San Diego Office of EducationBarbara Muller, Coordinator for Bay Region IV, Alameda County Office of EducationTerri Christofk, Shannon Brandt, Jan Bagdasar, Meg Pesavento, San Marcos UnifiedFrank De Luca, Chula Vista Elementary SchoolAnita Gillchrist, RN, School Nurse, San Ysidro ElementaryStacy Hanover, RN, ED Supervisor, Children’s Hospital, Oakland, CARuth Hawkins, RN, School Nurse, Encinitas Union ElementaryPatricia Murrin, RN, MPH, EMS Coordinator, County of San Diego EMSDale Parent, Chula Vista Elementary SchoolJames E. Pointer, MD, Medical Director, Alameda County EMSMary Rutherford, MD, Director ED, Children’s Hospital, Oakland, CAAugusta Saulys, MD, Emergency Department, Children’s Hospital, Oakland, CAPat Stalcup, RN, School Nurse, Ramona UnifiedGary Vilke, MD, Medical Director, County of San Diego EMSThe San Diego project developed these guidelines with “Funding provided by the State of California Emergency MedicalServices (EMS) Authority under Special Project Grant #EMS-1055 and EMS-2062.”Funding for the Ohio project was supported by project MCH #394003-0 from the Emergency Medical Services for ChildrenProgram (Section 1910, PHS Act), Health Resources and Services Administration, Maternal and Child Health Bureau andthe National Highway Traffic Safety Administration.ii

Emergency First Aid Guidelines for California SchoolsAcknowledgementsEMS for Children Technical Advisory SubcommitteeErin Dorsey, RN School NurseHuntington Beach High SchoolCynthia Frankel, RN, MSNPrehospital Care CoordinatorAlameda County EMS AgencyMarianne Gauche-Hill, MD, FACEP, FAAPProfessor of MedicineDavid Geffen School of Medicine at UCLADirector of EMSHarbor-UCLA Medical CenterNancy McGrath, RN, MN, CPNPPediatric Liaison NurseHarbor UCLA Medical CenterCalifornia Emergency Medical Services AuthorityHoward Backer, MD, MPH, FACEPDirectorFarid Nasr, MDSpecialty Care Systems SpecialistSandy Salaber Associate Health Program AdviserTonya Thomas EMS for Children Program CoordinatorCalifornia Department of EducationGordon Jackson Assistant SuperintendentTom Herman Education AdministratorSan Joaquin County Office of EducationCheri Coburn, Ed.D, MS, RNDirector of Comprehensive Health ProgramsSacramento State UniversityJan Sampson, RN, DNP, CNEAssociate ProfessorSchool of NursingThe EMS Authority would like to acknowledge and express appreciation for the support of theEMS for Children Technical Advisory Committee. List of committee members:http://www.emsa.ca.gov/tech committeeiii

Emergency First Aid Guidelines for California SchoolsTABLE OF CONTENTSABOUT THE GUIDELINES. 4RECOMMENDED FIRST AID EQUIPMENT AND SUPPLIES FOR SCHOOLS. 6HOW TO USE THE EMERGENCY GUIDELINES. 7KEY TO SHAPES & COLORS. 8EMERGENCY PROCEDURES. 99-1-1 GUIDELINES FOR SCHOOLS. 10WHEN TO CALL EMERGENCY MEDICAL SERVICES (9-1-1). 11EMERGENCY PHONE NUMBERS. 12DEVELOPING AN EMERGENCY PLAN. 13PLANNING FOR PERSONS WITH SPECIAL NEEDS. 14MEDICATION ADMINISTRATION IN SCHOOL SETTINGS . 15INFECTION CONTROL. 18ALLERGIC REACTION. 19ASTHMA/WHEEZING/DIFFICULTY BREATHING. 20BEHAVIORAL EMERGENCIES. 21BITES (HUMAN & ANIMAL). 22BITES & STINGS (INSECT). 23BITES & STINGS (MARINE). 24BITES & STINGS (SNAKE). 25BLEEDING. 26BRUISES. 28BURNS. 29CPR. 31AUTOMATED EXTERNAL DEFIBRILLATORS (AED). 32LAY PERSON CPR. 33FOR CHILDREN ONE YEAR OLD TO ADULT. 34CHOKING. 35CHEST PAIN (POSSIBLE HEART ATTACK). 36CHILD ABUSE & NEGLECT. 37COMMUNICABLE DISEASES. 38DIABETES. 39DIARRHEA. 40DROWNING/NEAR DROWNING. 411

Emergency First Aid Guidelines for California SchoolsTABLE OF CONTENTSEARS. 42ELECTRICAL INJURY. 43EYES (INJURY). 44FAINTING. 46FEVER & NOT FEELING WELL. 47FINGERNAIL/TOENAIL INJURY. 48FRACTURES, DISLOCATIONS, SPRAINS OR STRAINS. 49FROSTBITE. 50HEAD INJURIES. 51HEADACHE. 52HEAT EXHAUSTION/HEAT STROKE. 53HYPOTHERMIA (EXPOSURE TO COLD). 54LOSS OF CONSCIOUSNESS. 55MENSTRUAL PROBLEMS. 56MOUTH & JAW INJURIES. 57NECK & BACK PAIN. 58NOSE. 59POISONING & OVERDOSE. 61PREGNANCY. 62RASHES. 63SEIZURES. 64SERIOUSLY ILL/SHOCK. 65SPLINTERS or IMBEDDED PENCIL LEAD. 66STOMACH ACHES/PAIN. 67TEETH & GUMS. 68TETANUS IMMUNIZATION. 70TICKS. 71VOMITING. 72WOUNDS (CUTS, SCRATCHES & SCRAPES INCLUDING ROPE & FLOOR BURNS). 73WOUNDS (PUNCTURE). 74WOUNDS (STABS & GUNSHOT). 752

Emergency First Aid Guidelines for California SchoolsABOUT THE GUIDELINESThe Emergency First Aid Guidelines for California Schools’ document was initially developed by SanDiego and Alameda Counties, funded in part by a grant from the California Emergency Medical Services(EMS) Authority. The Guidelines were originally based on the second edition of the Ohio EmergencyGuidelines for Schools, 2000. The Emergency First Aid Guidelines for California Schools manual ismeant to provide recommended procedures for school staff in responding to medical emergencies whenthe school nurse is not available and until emergency medical services responders arrive on scene.These guidelines provide recommended actions and do not supersede or invalidate any laws or rulesestablished by a school system, a school board, or the State.Due to declining school district budgets, school nurses are not always present on school grounds whenmedical emergencies occur. It is not uncommon to have a school nurse present for only two hours aweek per campus. Currently, only fifty percent (50%) of school districts in California have a school nurseon staff. The Emergency First Aid Guidelines for California Schools was developed over a two-yearperiod and piloted in thirteen schools in San Diego County and three schools in Alameda County. Theywere enthusiastically received in the pilot areas by school nurses and educators as a layperson’semergency medical reference tool.Once the pilot projects were completed, the draft Guidelines were reviewed and revised by the localEmergency Medical Services for Children (EMSC) Coordinators Group and the EMSC Technical AdvisoryCommittee (TAC). Extensive comments and revisions were made by these committees. The EMSCCoordinators Group is composed of local EMSC program managers and the TAC membership iscomposed of emergency physicians, nurses, prehospital and administrative experts in EMSC. TheEMSC TAC first approved the draft Guidelines during its January 29, 2004 meeting and forwarded thedocument to the EMS Authority for review and approval.During the first revision of the Guidelines document in 2004, the EMS Authority collaborated with theCalifornia Department of Education and the California School Nurses Association. The revisedEmergency First Aid Guidelines for California Schools’ document was sent out for a 30-day publiccomment period from April 16, 2004 to May 17, 2004. Comments and suggested revisions receivedhave been incorporated into the Guidelines and/or responded to as appropriate. The Emergency FirstAid Guidelines for Schools document was approved on June 23, 2004 by the Commission on EMS.One hard copy and a CD of the Guidelines were distributed to approximately 10,000 California schools.The current version, the second revision, is based on 2010 American Heart Association Guidelines forCPR and ECC, which was approved by the EMSC TAC and EMSC Coordinators Group on January26-27, 2012.3

Emergency First Aid Guidelines for California SchoolsABOUT THE GUIDELINES (CONT.)Please take some time to familiarize yourself with the format and review the “How to Use the Guidelines”section on page 6 prior to an emergency situation. The guidelines are recommended procedures forwhen advanced medically trained personnel are not available on the school site. It is stronglyrecommended that staff who are in a position to provide first aid to students complete anapproved first-aid and cardiopulmonary resuscitation (CPR) course. Please consult your schoolnurse if you have any questions concerning the recommendations contained in the guidelines.These guidelines should not delay calling 9-1-1 in the event of an emergency.Periodically, the EMS Authority may send out updates on procedures dealing with the medicalemergencies that are in the guidelines. When received, please remove the old information and replacewith the updated information.We welcome comments, suggestions, or experiences using these guidelines.Email address: firstaidguidelines@emsa.ca.gov4

Emergency First Aid Guidelines for California SchoolsRECOMMENDED FIRST AID EQUIPMENT ANDSUPPLIES FOR SCHOOLS1.2.3.4.5.6.7.8.9.10.11.12.13.Current National American Red Cross First Aid Manual or equivalent.American Academy of Pediatrics First Aid Chart.Portable stretcherCot: mattress with waterproof cover10 Triage TagsBlankets, sheets/pillows/pillow cases (disposable covers are suitable)Wash cloths, hand towels, small portable basinCovered waste receptacle with disposable linersManual resuscitation bag (Ambu bag) [optional]Bandage scissors, tweezersDisposable thermometer or electronic thermometer with disposable coversSink with running waterExpendable supplies (refer to ml forrecommended inventory): Pocket mask/face shield for CPR Disposable gloves (including latex free gloves for persons with a latex allergy) Soap (plain) Cotton tipped applicators, individually packaged Assorted Band-Aids (1”x3”) Gauze squares (2”x2”’; 4”x4”), individually packaged Adhesive tape (1” width) Gauze bandage (2” and 4” widths) rolls Ace bandage (2” and 4” widths) Splints (long and short) Cold packs Triangular bandages for sling & Safety pins Tongue blades Disposable facial tissues Paper towels Sanitary napkins One flashlight with spare bulb and batteries Hank’s Balanced Salt Solution (HBSS) – Available in the Save-A-Tooth emergencytooth preserving system or 1/3 cup of powdered milk for dental first-aid (for mixing withwater to make a liquid solution) Bleach for cleaning contaminated surface5

Emergency First Aid Guidelines for California SchoolsHOW TO USE THE EMERGENCY GUIDELINESThe last page of this document provides space for important emergency phone numbers in your area. Itis important to complete this information, when you receive the document, to have this information readyin an emergency situation.A colored flow chart format is used to guide you easily through all symptoms and management stepsfrom beginning to end. See the Key to Shapes and Colors (pg. 7).Emergency Procedures for an Injury or Illness section (pg. 8) gives a general overview of therecommended steps in an emergency situation and the safeguards that should be taken.Additional information includes when to call EMS (pg. 10), developing a school wide emergency plan(pg. 11), infection control procedures (pg. 12), and planning for persons with special healthcare needs(pg. 12).If medical assistance is needed, have someone contact the 9-1-1 system as soon as possible.6

Emergency First Aid Guidelines for California SchoolsKEY TO SHAPES & COLORSThis note providesbackground information.STARTHEREThis type of box should be readbefore emergencies occur.Initial Information, questions, actionsNO? Questions Being Asked ?You need to choose based onperson’s condition or response.Follow the pathway for your answer.YESProvides First-AidInstructionsSTOP HEREThis is the finalinstructionAdditional Information7

Emergency First Aid Guidelines for California SchoolsEMERGENCY PROC

Due to declining school district budgets, school nurses are not always present on school grounds when medical emergencies occur. It is not uncommon to have a school nurse present for only two hours a week per campus. Currently, only fifty percent (50%) of school