Medical Urgencies In The Classroom

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Medical Urgencies In The Classroom

• Lori Christopher, RN, MSN, CNP
• Certified Nurse Practitioner/Nurse Manager
• University Health Services
• Adapted from the American Academy of Pediatrics
  8/03

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University Health ServicesEastway Dr.

• We are a large multi-disciplinary facility with
  over 30, 000 patient encounters per year.
• We have 15 clinicians, 4 psychologists, 1
  physical therapist, 10 nursing staff members and
  many ancillary staff members.
• We have a general medical clinic, urgent care
  clinic, womens clinic, psychology clinic,
  pharmacy, laboratory, x-ray department,
  immunization department, physical therapy and a
  health promotions department.

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Seizures/Convulsions

• Seizures can range from mild to severe brief
  blackouts, involuntary movements, sudden falls,
  periods of confused behavior, and involuntary
  muscle contractions.
• Severe seizures may involve uncontrollable muscle
  movements (jerking or spasms) and rigidity, loss
  of consciousness, loss of bladder and/or bowel
  control, and in some cases, breathing that stops
  temporarily.

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Seizures/Convulsions

• Have another student call 911 while you stay with
  the student who appears to be having a seizure
• Protect the person from injury
• Move all furniture or equipment that is nearby
• Do not hold or restrain the student
• Do not put anything in the students mouth
• Loosen clothing
• Roll the student on his/her side if vomiting
  occurs
• After the seizure activity has stopped
• Perform rescue breathing if person is blue or not
  breathing (if CPR certified)
• If breathing, lay person on side

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FAINTING

• Lay person on back with head to the side and legs
  elevated
• DO NOT give anything by mouth
• Send the student to the health center with
  another person, if the student has recovered and
  is able to walk across campus without difficulty
• If person doesnt wake up right away, call 911

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NOSEBLEEDS

• With person sitting, squeeze nostrils together
  between thumb and index finger for 10 minutes
• If bleeding persists, call the student health
  center or send the student to the health center.

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Cuts

• Apply pressure with a clean cloth to stop the
  bleeding
• If the cut is large and deep, call or send the
  student to the health center and maintain
  pressure
• For minor cuts, wash with soap and water and
  cover with dressing.
• If cut may need sutures, seek medical care as
  soon as possible

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Puncture Wounds

• DO NOT remove large objects such as knives or
  sticks, call 911
• For minor wounds, wash with soap and water and
  call the student health center
• The person may need a tetanus booster injection

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Stinging Insects

• Remove the stinger with the scraping motion of a
  fingernail
• DO NOT pull the stinger out
• Put a cold compress on the bite
• If hives, paleness, weakness, nausea, vomiting,
  tightness in chest, breathing difficulty, or
  collapse occur, call 911.
• For spider bites, call the student health center
  or Poison Control Center

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TEETH

• If knocked out, find the tooth and rinse it
  gently without touching the root
• Insert and gently hold the tooth in its socket or
  transport the tooth in cows milk
• If broken, save the pieces. Gently clean the
  injured area with warm water. Place a cold
  compress to reduce swelling.
• Send the student directly to the dentist or an
  emergency room. Time is important!

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Choking

• Partial airway obstruction with good airway
  exchange
• Partial airway obstruction with poor airway
  exchange
• Complete airway obstruction

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Choking

• Partial airway obstruction with good airway
  exchange
• Forceful cough
• Wheezing in between breaths
• Stay with the student and encourage them to
  cough

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Choking

• Partial airway obstruction with poor air exchange
• Weak, ineffective cough
• High-pitched noises while breathing
• This type of obstruction should be dealt with
  as if it were a complete obstruction

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Choking

• Complete airway obstruction
• Unable to breathe, speak or cough
• Clutching at his/her throat (universal distress
  signal for choking)
• If the student is still conscious, perform
  Heimlich maneuver
• If the student becomes unconscious, call 911
  and continue helping if familiar with First
  Aid/CPR

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Heart Attack

• Signs/Symptoms
• Chest discomfort or pain (it may be described by
  the student as pressure, squeezing, fullness,
  tightness, aching, crushing, constricting or
  heavy)
• Radiation of the pain to the neck, jaw or back
• Sweating
• Nausea
• Shortness of breath

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Heart Attack

• A quick response in case of a heart attack
  requires that you
• Recognize the symptoms of a heart attack and take
  action.
• Have the victim stop what he or she is doing and
  sit or lie down in a comfortable position.
  Loosen constrictive clothing. Do not let the
  victim move around.
• Have someone phone 911 for help.

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Depression

• More Americans suffer from depression than
  coronary artery disease, cancer and AIDS combined
• Symptoms of depression include
• Sadness or feeling down
• Loss of interest or pleasure in usual activities
• Poor appetite or overeating
• Trouble falling or staying asleep or sleeping too
  much
• Feeling tired or having little energy
• Feelings of worthlessness, self-reproach or guilt
• Trouble concentrating
• Moving or speaking very slowly, or the opposite,
  being fidgety or restless
• Thoughts of being better off dead or of hurting
  oneself in some way

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Depression/Suicide

• Suicide is the second leading cause of death
  among all youth 15-24 years old. In the US, only
  accidents and homicides claim more young lives.
• Nearly 4,000 people aged 15-24 die by suicide
  each year in the US.
• A person dies by suicide about every 18 minutes
  in the US and an attempt is estimated to be made
  once every minute.
• American Foundation for Suicide Prevention

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Depression

• Depression is a major problem for college
  students, not only because it can lead to
  suicide, but also because it is associated with
  poor physical health, substandard academic
  performance and irresponsible risk taking
  behaviors

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Depression

• Over 90 of youth who die by suicide had at least
  one psychiatric illness at the time of death in
  about half such cases, the psychiatric illness
  was present, although often unrecognized, for two
  years or more.
• American Foundation for Suicide Prevention

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Psychological Emergency

• If you suspect someone is in psychological crisis
  and/or suicidal
• Take it seriously
• Be willing to listen
• Voice your concern/Let the person know you are
  concerned and understand
• Encourage the student to get professional help
  immediately
• In the case of suicidal/homicidal behavior Call
  911

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When to dial 911?

• Warning signs of a Medical Emergency
• Fainting or convulsions
• Chest or upper abdominal pain or pressure
• Sudden dizziness, weakness, or change in vision
• Difficulty in breathing, shortness of breath
• Severe or persistent vomiting
• Coughing up or vomiting blood
• Bleeding that wont stop after applying 10-15
  minutes of pressure
• Change in mental status (confusion, unusual
  behavior, difficulty in staying awake)
• Suicidal or homicidal feelings

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When an Emergency Occurs

• Be prepared Keep the numbers of emergency
  services near your phone
• When you call for help, speak calmly and clearly
• Give name, address, phone number, location of
  victim and nature of problem
• Dont hang up until the dispatcher tells you to
  do so because they may need additional information

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KSU Nurse Help Line

• After-hours nurse information line
• Service is provided by the Rainbow Call Center
  which is housed in University Hospitals of
  Cleveland
• [phone]
• During regular business hours, line is answered
  by a nurse working at UHS

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IMPORTANT PHONE NUMBERS

• Fire, Police or Ambulance..911
• University Health Services........................
  672-2322
• University Nurse Help Line672-2326
• University Psychological Services.672-2487
• Poison Control Center..1-800-222-1222
• Kent State Police (non-emergent)672-2212
• Crisis Hotline/Townhall II..678-HELP
• Coleman Professional Services 673-1347
• Robinson Memorial Hospital..297-0811
• Med Center One678-4380

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Sick Notes

• We, at University Health Services, DO NOT give
  sick notes unless we truly feel the patient
  should not be going to class.
• We DO NOT give notes for an illness that has
  resolved or is getting better once the student is
  actually seen at the health center.
• Please do not send students to the health center
  for a sick note AFTER their illness has resolved.
  We are no better than you at detecting if
  someone WAS sick.
• Every student that sees a nurse/nurse
  practitioner/physician/psychologist, has
  diagnostic tests performed or buys medication
  (prescription or over-the-counter) is given a
  walk-out statement when they leave the facility.
  This statement in no way means the student was
  given permission by someone at the health center
  to miss class because of their illness.