What to do?? You are teaching class and suddenly you hear someone fall out of their chair. There are 30 other students in the classroom and it takes you a few seconds to see the student lying on the floor towards the back of the room. What do you do?
Do Not Move Student Call For Help (move other students away from area/room) • Keep student in flat position • Elevate feet and legs • Loosen clothing around neck and waist • Keep airway clear and monitor breathing • Control bleeding if needed (wear disposable gloves) • Attempt to gather any useful information
ASK YOURSELF? Why did they faint? -Low blood sugar? -Low blood pressure? -Anaphylaxis? -Seizure? -Asthma event? -Illness/Injury? -Unknown ? If you are aware of the specifics of your students’ health issues, you can remain calm, know what to do and how to best help them.
Know if your student has an underlying health condition…How ? EAP’s
Emergency Action Plans • Provide important individualized information about student health issues. • Written by the School Nurse - with the help of the student, parent and healthcare provider - at the beginning of each semester. • Will now be sent to you via email from your School Nurse, along with a receipted response. • Print and keep in a Confidential file and ensure accessibility for your substitutes. • Please review these carefully and periodically to refresh your memory.
If your student has diabetes… • You will have already been given an EAP and had training by your school nurse on how to take care of this student. It is easier to prevent a low blood sugar than to treat the student after their blood sugar is so low they become unconscious.
Why do I have to do this? SENATE BILL 911 Requires schools to provide care to the student with diabetes, unless is declined by the parents and clearly documented. Requires that all school personnel have a basic understanding of diabetes. Requires that all schools have a designated Diabetes Care Manager with a back up in that persons absence – even on field trips. Requires the school develop and implement a diabetes care plan that is updated each school year.
So, how do you prevent a low blood sugar (hypoglycemia)? DON’T PANIC…however, DO ACT QUICKLY TO PREVENT AN EMERGENCY • Know your student. Be cognizant of his/her EAP. • Be mindful of their specific symptoms. If you suspect their blood sugar is low, give them a fast acting carb, (juice, candy, etc). Follow their plan. • Allow and/or assist them to check their blood sugar – only if does not delay treatment.
Possible signs/symptomsof low blood sugar • Argumentative • Disengaged • Anxious • Irritable • Shaky/Sweaty/Pale • Drowsy/Sleeping • Confusion If unsure, always treat as if blood sugar is LOW.
Fast-acting Carb’s 2-4 glucose tablets 4 oz apple or orange juice 4-6 oz soda 4-8 chewy life savers 2 tablespoons raisins 3-4 teaspoons sugar or syrup 1 cup low fat milk 1 tube of cake gel
DO NOT SEND A STUDENT WITH A LOW BLOOD SUGAR TO THE OFFICE/NURSE. GIVE THEM SUGAR… …or, this may be the next thing you see! (The more they move, the lower their blood sugar becomes.)
High blood sugar is usually a more gradual process. As the blood sugar rises, you may observe: • Frequent urination • Increased thirst • Increased hunger • Fatigue/weakness • Weight loss • Blurry vision • Fast, deep breathing • Slow or confused thinking
Students with elevated blood sugars must follow their exact plan of care (EAP). Things that may or may not be in their plan: -Drinking water -Exercising -Insulin What works for one may not work for another, so remember… follow their plan. If unsure, always treat as if blood sugar is LOW.
If your student has asthma… • You will have already been given an EAP for this student by your School Nurse on how to take care of this student – including information on rescue medication (inhaler) they may or may not carry themselves or have at school to treat their asthma. • As with diabetes, it is easier to prevent a full blown asthma attack than to treat the student after they become unconscious.
So, how can I help prevent a full blown asthma attack? • Know your student. • Review his/her EAP. • Be mindful of their specific symptoms and when you suspect they may be having a problem with their asthma, follow their plan.
DO NOT SEND A STUDENT THAT IS HAVING AN ASTHMA ATTACK TO THE OFFICE/NURSE. LET THEM USE THEIR INHALER AND/OR CALL THE NURSE …or, this may be the next thing you see!
If your student has a severe allergy… • You will have already been given an EAP for this student and had training by your School Nurse on how to take care of this student – including any medication they may have at school to treat the reaction. • If the student does have a Epi-Pen, remove the top and push into their thigh. 911 must ALWAYS be called if Epi-Pen is administered.
If your student has seizures… • You will have already been given an EAP for this student and had training by your School Nurse on how to take care of this student – including any medication they may have at school to treat their seizures. • Note the time, call for help, observe closely • Keep the student safe • Do Not hold them down • Do Not put anything into their mouth • Follow their plan regarding Diastat and post- seizure intervention. 911 must ALWAYS be called if Diastat is administered.
Now, lets review what to do if there is NO information available on the student, or perhaps a staff member or visitor who has fainted.
CALL 911 if… • Anyone: student, staff, visitor, is: - Unconscious and no school nurse present - Has chest pain radiating into neck, arm, jaw - Has slurred speech, facial drooping - Has a seizure with no prior history - Has a seizure that lasts more than 5 minutes - Diastat is administered - Epi-Pen is administered - Has an EAP that instructs you to do so. • Someone asks you to call. • You ever feel it is or may be necessary
When in doubt, call for help! • If the victim is not responsive or has stopped breathing and does not have a pulse, start CPR until further help arrives. • Remain calm and remember that you know more than you think!
CPR…the basics • The 3 C’s- Check, Call, Care! • Check the scene for safety • Call for help- 911 • Provide care until your relief comes • Check for signs of life (breathing, coughing, moving, etc.) – if none, • Begin CPR http://handsonlycpr.com • Automated External Defibrillators (AED’s) are in all Middle and High Schools – find them in your school!
-All employees are responsible for reporting student accidents and/or injuries. -It is important to document the injury on the appropriate form and to notify your School Nurse.
This includes injuries to athletes during practices and games …whether on home or away fields.
Review Accident/Injury and Head/Neck Injury forms and learn where they are kept in your school. Please ask your school nurse if you have any questions.
it’s up to ALL of us… • We are responsible to contact the parent if we feel it may be necessary following an accident or injury. If you do contact them, you must document it on the Accident/Injury form. • It is MANDATORYthat we contact the parent if there is an injury to the head or neck. It is also mandatory that you document your conversation in the appropriate space on the form.
Employee Accident Forms Employee accidents or injuries are not documented on the Student/Visitor forms. Report employee accidents or injuries to your administrator and school nurse. (see next slide for example)
“Emergency Guidelines For Schools” You can find the online link to this manual on your school homepage. The School Health Advisory Council (SHAC) has created a Quick Reference for all classrooms to be kept in the Emergency Procedures Rack. Please make yourselves familiar with these.
ALWAYS… • Act on the side of caution and safety • Call EMS if you feel there is a chance you may need them.
Possible Choking • The universal sign is hands to the throat • Encourage the victim to speak or cough if they can • Perform the Heimlich maneuver • Fist one hand and place thumb knuckle above belly button. Grab the fist with your other hand and thrust upward with both hands. • If victim looses consciousness, Call 911 and begin CPR.
HEART ATTACK • May have chest pain for longer than 15 seconds that spreads towards the neck, arms, shoulders, jaw, and possibly teeth. • Call 911! • Chew or swallow Aspirin if available. • If the victim becomes unconscious, begin CPR.
STROKE • Call 911! • A stroke is a true medical emergency. • FAST • Face • Arms • Speech • Time
IMPALED OBJECT • Do NOT remove an impaled object! • Call for help • Stabilize the object
NOSEBLEEDS • Instruct the victim to sit upright and lean slightly forward. • Pinch bridge for 5-10 minutes. • The pressure on the nose stops the flow of blood. • Seek medical care if bleeding occurs after an accident or lasts longer than 20 minutes.
BLEEDING • Use Gloves! • Apply pressure, using gauze if available, until bleeding has stopped. • Do not remove gauze, rather reinforce as needed. • Elevate the site if possible. • Lay person flat and elevate legs if they feel faint. • Always call the nurse for help! • Call 911 as needed.
Speaking of bleeding… • Bloodborne pathogens (BBP’s) are infectious materials in blood/body fluids that can cause disease in humans. • These include hepatitis B and C and human immunodeficiency virus, or HIV. • People exposed to these pathogens risk serious illness or possibly even death.
How are Bloodborne Pathogens Spread A person can be infected when blood or body fluid from an infected person: • Enters the skin from contaminated needles or other contaminated sharp objects (i.e.. Broken glass) • Enters the body through broken skin (scratch, cut, chapped hands) • Enters mucous membranes by spraying or splashing of blood (or body fluids containing blood) into the mouth, nose or eyes.
Basics of Infection With Boodborne Pathogens All of these factors must be present for a potential exposure to occur: • An infected source • An entry site • Potential route of transmission • An unprotected, susceptible person
Hepatitis A virus (HAV) is not a bloodborne pathogen. • HAV is found in the stool (feces) of persons with hepatitis A. • HAV is usually spread from person to person by putting something in the mouth (even though it may look clean) that has been contaminated with the stool of a person with hepatitis A. This is called “fecal-oral” transmission. • There is no chronic (long-term) infection. • Once you have had hepatitis A you cannot get it again. • There is now a vaccine available for protection.
HEPATITIS B (HBV) • Is a virus that results in liver cell damage and lead to scarring of the liver (cirrhosis) and increased risk of liver cancer in some people. • It is 100 times more infectious than HIV, has no cure, and can be fatal. • In a dried state, HBV may remain viable on surfaces for up to 1 week and maybe even longer. • It is the only bloodborne disease with a vaccine available for protection.
Hepatitis B Virus (HBV) HBV is transmitted primarily through “blood to blood” contact: • by accidental needle sticks • other contaminated sharps injuries • sexual contact • mucous membrane contact • through open cuts. Risk most often occurs in unprotected direct or indirect contact with infected blood. It is not transmitted by casual contact.
HEPATITIS B VACCINE • Hepatitis B Vaccine can be given at your doctor’s office or at the local county health department. • It consist of a series of three shots over a period of 6 months. • All three shots must be completed to ensure immunity.
Hepatitis B Vaccine • Employees who have been identified as having a high potential of occupational exposure to blood or other infectious materials, will be offered the Hepatitis B vaccine at no cost, through the Pender County Health Department.
Hepatitis C Virus (HCV) • Hepatitis C Virus (HCV) is a virus that causes inflammation of the liver. • Injection drug use is the main route of transmission. • Many infected individuals show no signs or symptoms. • Hepatitis C is a slow-progressing disease that may take 10-40 years to cause serious liver damage in some people.