San Diego Unified School District First Aid How to Proceed in Case of Injury to Student. Nursing and Wellness Program September 2011

Transcription

1 San Diego Unified School District First Aid How to Proceed in Case of Injury to Student Nursing and Wellness Program September 2011

2 Objectives O Become familiar with protocol: First Aid How to Proceed in Case of Injury to Student O Calling 911 O Become familiar with forms sent home when student is injured. O Know where to find SDUSD Report on Accident for students and others not in the employ of the School District.

3 General Information O First Aid protocol. Calling 911 is on page 15 O Wear non-latex disposable gloves when exposed (or potential) to blood or other body fluids O Cleaning wounds, abrasions, and such use soap and water (use antiseptic only if no access to soap & water ) O Notify parent/guardian/person listed on the emergency contact after rendering aid

4 Report of Injury O Injuries to students (accidental or not) Principal or designee completes form: Report on Accident (Students and others not in employ of the school district) O Injuries to staff members Principal or designee completes form: Supervisor s Report of Injury/Illness form 78 Both of these forms are available on the Risk Management website.

5 General Rules of First Aid OStay calm OBe prepared OUse universal precautions

6 Universal Precautions OHandwashing OGloves OTrash Disposal

7 Definition O First Aid is the immediate care provided to a suddenly ill or injured person

8 Examples of Serious Injury/Illness O No breathing or pulse O Difficulty breathing O Chest pain O Amputation O Back/neck/head injury O Burns to large area of body O Penetrating injury (do not try to remove object) O Snake bite O Eye injury O Prolonged seizures O Allergic reactions O Hemorrhage O Poison ingestion O Heatstroke

9 Serious Injury or Illness O Do not move the patient until he or she has been assessed O Notify nurse (if on site), and principal O Determine if 911 needs to be activated and do so (refer to page 15 of procedure ) O Render first aid according to district protocol O Notify parent/guardian

10 If Unconscious: O Make sure 911 has been called and assess for CAB O Circulation -check for pulse, if absent, start compressions - do thirty compressions O Airway position the patient to open airway O Breathing if absent, give mouth-to-mouth with mask

11 When 911 called O Notify Parent/guardian; if unavailable, school or city police may assist in contacting O Have ready for Emergency responders the parent s contact information, any allergies, medications or underlying illness O Remember to always let the site administrator know 911 called O Complete Irregular Occurrence form and send to Nursing & Wellness

12 Abrasions and Cuts O If needed, control bleeding by applying direct pressure O Cleanse wound with soap & water O Apply dry, sterile dressing or band aid O Depending on severity, notify parent and refer for medical care

13 Bites - Animal O Cleanse wound thoroughly with soap and running water for 5 minutes O Apply clean & dry dressing O Notify parent for referral to physician O Notify Animal Control if appropriate

14 Bites - Human O Wash with soap and running water for 5 minutes O Apply sterile dressing or clean bandage O Notify parent and recommend medical follow-up

15 Bites - Snake O Call 911 O Have patient lie down & keep calm and warm O Do NOT apply ice or tourniquet O Immobilize bitten extremity and keep at or below heart level O Flush bite with large amounts of water; or wash with soap and water

16 Bee Sting O Check for history of allergy. Anaphylaxis on next slide O If stinger is present, scrape it away O Cleanse area & apply cold for 15 minutes O Monitor for 1 hour O Administer prescribed medication if available O Notify parent of event

17 Anaphylaxis O Rapid onset (5 60 minutes) O Signs/symptoms O Tingling, itching, hives O Trouble breathing O Weakness, warmth O Feelings of anxiety, nausea O Swelling of mouth, throat, face O Abdominal cramps, vomiting O Loss of consciousness O Anaphylactic shock

18 Anaphylaxis treatment O Nurse to administer Epinephrine 1:1000 O Other staff may administer EpiPen, Twinject, Adrenaclick O Call 911, even if improved, and call parent/guardian O CPR if needed. Monitor vital signs every 5 minutes O Transport to emergency room for further treatment

19 Bleeding: Wounds O Apply direct pressure via bandage and/or pressure points O Elevate the injured part unless fracture is suspected O Treat for shock and follow serious injury routine as appropriate

20 Blisters O Do not open or break the blister O If open, cleanse with soap and water and apply dressing O If closed, may apply bandage to protect from further injury

21 Nosebleeds O Have patient sit with head slightly forward O Apply firm pressure to lower portion of nose for at least 5 minutes O Advise against nose blowing and active play for 24 hours O Notify parent of prolonged bleeding (>20 minutes)

22 Burns O Rinse in cool water for 2-5 minutes; 15 minutes if chemical burn O Do not apply ice, ointment, butter or salve O Do not open blisters O Apply non-stick, loose & dry dressing O Refer for treatment as indicated. For electrical & chemical burns, call 911

23 Ear Problems O Do not apply heat or cold to the ear O Check temperature for fever O Check for drainage or foreign bodies O Do not remove foreign bodies O Notify parent

24 Eye Foreign Body O Flush with clear, tepid water for at least 5 minutes O Do not attempt to remove embedded objects O Encourage not to rub eyes O If pain persists, notify parent & advise immediate medical care

25 Eye Chemical Burn O Irrigate immediately with large amounts of clear, tepid water for at least 30 minutes O Cover eye with sterile dressing O Refer for immediate medical care & send with information on chemical type

26 Eye - Contusion O If blurred vision, loss of vision, or pain with movement of eye obtain immediate medical attention O Apply cold compress

27 Eye - Penetrating Injury O DO NOT WASH EYE OR ATTEMPT TO REMOVE OBJECT O Cover both eyes loosely with sterile dressing O Keep patient quiet move via stretcher O Obtain immediate medical attention

28 Fainting/Dizziness O Have patient lie down with feet elevated O Keep airway open O Rest until recovered O Notify parent & refer for follow-up medical care O May use aromatic ammonia only if student over age 12, and has no history of asthma

29 Fractures O Immobilize injured part O Do not attempt to straighten deformity O Apply ice (use towel/cloth as a barrier) to decrease swelling O Elevate if possible O If spine or skull fracture is suspected, call 911 & do not move the patient O Complete accident report

30 Head Injury - Minor O No loss of consciousness or stunned for less than 5 seconds O Keep patient lying down O Monitor for at least 30 minutes O Notify parent, provide head injury information sheet & refer for medical care if indicated O Watch for change in level of consciousness, blurred vision, bleeding from facial orifices, unequal pupils, trouble breathing, vomiting

31 Head Injury - Severe O Loss of consciousness greater than 5 seconds O Do not allow student to be moved until further assessment O Call 911 and transport, immobilize neck O Do not elevate feet or give fluids O Always notify parent regardless of degree of head injury

32 Poisons O Identify poison, amount consumed and time of ingestion O Call Poison Control at (800) & follow their directions O Send bottle of poison and vomitus, if any, with child to hospital

33 Puncture Wounds O Call 911 if large object in wound, if wound seems deep, if uncontrolled bleeding, or if air is escaping form chest. O If no object in wound, bleeding is not profuse, and no other symptoms, wash area gently with warm, soapy water & cover with clean bandage. Notify parent. O If object in wound, do not try to remove it. Wrap in bulky dressing around object, keep calm. Notify parent and refer for medical care.

34 Seizures O Position patient on side and maintain open airway and time how long the seizure lasts O Protect head and create safe environment O Do not insert anything in patient s mouth O Prevent self-injury to patient O Allow rest period after seizure subsides O Notify parent & refer for medical care when indicated O Call 911 if seizure activity lasts greater than 5 minutes; if multiple seizures; or if this is the first time student has seizure

35 Shock O Pale, cool, clammy skin, restless, thirsty or nauseated, weak and rapid pulse O Have patient lie down with feet elevated O Cover to maintain body temperature O Call 911 O Notify parent and refer for medical care

36 Skin Conditions O If draining or weeping, cover with dressing O If contagion is suspected, exclude from school, notify parent and refer to physician

37 Splinters O Remove only if readily accessible O Wash area with soap and water O If deeply imbedded, notify parent & advise physician visit

38 Sprains O Treat as a fracture until diagnosed O Elevate injured art O Apply covered ice pack O Have patient avoid O Moving and weight bearing O Notify parent to follow up with physician

39 Swallowed Foreign Bodies O Assess for choking O If unable to cough, speak or breathe, administer Heimlich maneuver O If unsuccessful, activate 911 and continue Heimlich maneuver O If not choking, notify parent & refer for medical care

40 Teeth O Toothache refer for dental care O Lost baby tooth use gauze to stop bleeding O Lost permanent tooth place tooth in whole milk, student s saliva or warm salt water & refer for immediate dental care

41 Heat Exhaustion Signs/symptoms O Cool, clammy skin O Weak, nausea, cramps O Feels faint Treatment O Call 911 and call parent O Rest, lying down O Keep cool O Give sips of water, up to one quart

42 Heat Stroke Signs/symptoms O Hot, dry, red skin O Rapid, strong pulse O Temperature >103 Treatment O Call 911 and call parent O Loosen clothing O Quickly cool body O Sponge skin with cool water

43 O Stay calm O Assess CAB s In Summary O Control bleeding using universal precautions O Protect from further injury O If in doubt whether to notify parent, go ahead and notify parent

44 Resources O SDUSD First Aid Procedure be familiar with its contents, including last page is When to call Emergency Medical Services (911) O District Procedure 6371 Illness and Minor Injuries O Emergency First Aid for California Schools: