Emergency First Aid Guidelines for California Schools

1
Emergency First Aid Guidelines for California
Schools

• An Overview of Content
• And How to Use

2
About the Guidelines

• Based on the Ohio Department of Public Safetys
  2nd Edition (2001)
• Piloted in Alameda and San Diego County schools
• Reviewed by California Office of Education and
  California School Nurses Organization
• Reviewed by the EMSC Technical Advisory Committee
• Reviewed by the EMSC Coordinators
• Approved by EMS Commission (2004)

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Purpose

• To serve as a basic what to do in an emergency
  for school staff with or without medical
  training.
• The guidelines were created as a recommended
  procedure. Contact your school nurse if you have
  any questions about the guidelines.
• In a true emergency situation use your best
  judgment.

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It is strongly recommended

• that staff who are in a position to provide
  first-aid to students complete an approved
  first-aid and CPR course.
• that you familiarize yourself with the format of
  the guidelines prior to the actual emergency
  situation.
• that you use the guidelines for reference
  before, during and/or after an event.

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What do the Guidelines address?

• Emergency procedures
• When to call 9-1-1
• Basic information on infection control
• Information on emergency planning
• Planning for persons with special needs
• Recommended first-aid equipment
• Emergency phone numbers

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The Design

• Alphabetical order with tabs
• Flow charts guide you through decision steps to
  treat common illnesses and injuries
• Flow charts use color-coded shapes to clarify
  steps

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Key to Shapes and Colors
This note provides background information. This
type of box should be read before emergencies
occur.
START HERE
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Key to Shapes and Colors
? Question Being Asked? You need to choose
based on persons condition. Follow the pathway
for your answer.
YES
NO
       
 
Provides First-Aid Instructions
9
Key to Shapes and Colors
STOP HERE. This is the final instruction.
Final instruction for the algorithm. In some
emergencies, multiple algorithms may be used.
Additional Information or Signs and Symptoms
10
Key to Shapes and Colors
TIME TO CALL 9-1-1

• There may be additional directions to continue
  care or see another algorithm.

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Dont Delay 9-1-1 When Needed

• Have someone contact the 911 system, as soon as
  possible, after it is known that their assistance
  is needed. Delay in accessing the 911 system
  could result in worsening of a persons condition
  and may lead to additional injury.

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Direct Fire/Ambulance

• Have someone meet fire or ambulance response
  units
• Give directions to location of person.

13
Always Remember ABCs

• Airway Open the airway 1st
• No Air in, all else is lost.
• Breathing Ensure Breathing 2nd
• You may need to breath for the person or do CPR
• Circulation (i.e., bleeding) 3rd
• Heart beating or CPR Nothing else matters
• Control Bleeding Prevent the loss of blood

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Call 9-1-1 For

• Blocked Airway
• Unable to get air into lungs (i.e., choking)
• Difficulty Breathing
• Absent or labored breathing
• Wheezing due to an allergic reaction (i.e., after
  a bee sting)
• Near drowning even if awake and appears ok
  water can have a delayed effect on lungs

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Call 9-1-1 for

• Uncontrollable Bleeding you cant stop it
• Unconsciousness
• After any injury
• If person has history of Diabetes
• Unexplained reason
• Head Injury
• Possible Poisoning

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Call 9-1-1 Immediately

• GET ADVANCED MEDICAL HELP ASAP
• Answer Questions
• Follow Instructions
• Do Not Hang Up
• Stay Calm
• Provide First Aid until ambulance arrives

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WHAT TO DO FIRST
CHECK FOR RESPONSIVENESS
If Unresponsive, send someone to call 9-1-1
AIRWAY ENSURE AIRWAY IS OPEN. If patient is
unconscious use head tilt-chin lift or jaw thrust
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WHAT TO DO NEXT
BREATHING ENSURE PERSON IS BREATHING LOOK,
LISTEN, AND FEEL for breathing. If no breathing,
SEE CPR and Give Rescue Breaths
CIRCULATION CHECK FOR SIGNS OF CIRCULATION
(Pulse, movement, breathing, color). If no signs
of circulation, SEE CPR. CONTROL BLEEDING
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DO NOT FORGET THESE
DISABILITY - TREAT INJURIES/ILLNESS THAT MAY
RESULT IN DISABILITY. (Head injuries, spine
injuries, and fractures will need medical
attention)
FIRST AID / MEDICAL AID Provide first aid and
medical support to most serious injuries/illness
risks first.
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Which One First?

• Remember ABCs
• Unconscious due to injury call 911
• Is awake, therefore airway open breathing
• Bleeding, See Bleeding apply direct pressure
• Abrasions, See Cuts, Scratches Scraps

• Scenario
• Child falls from bleachers
• Dirty, abrasions
• Bleeding scalp
• Unconscious, then awakes

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Ready to Try One?
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Try this One

• Child is holding hand and tells teacher he was
  bitten by a dog. There is some blood oozing from
  several small punctures/scrapes. Child otherwise
  is crying and looks normal.

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Yes
The Whole Thing
No
No
Yes
Yes
No
No
Yes
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BITES (Human Animal)
Wear disposable gloves when exposed to blood or
other body fluids
Yes decision Leads to action box
YES

• Press firmly with a clean dressing/cloth on
  bleeding site
• See Bleeding

Is the person bleeding?
Check second protocol for additional help
25
BITES First Aid
YES

• Press firmly with a clean dressing/cloth on
  bleeding site
• See Bleeding

Is the person bleeding?
NO

• Hold bite area under running water for 2-3
  minutes
• Wash with soap and water
• If wound bled, apply clean bandage

NO
Is bite large or gaping? Is blood spurting?
First Aid Steps
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BITES (Cont)

• Press firmly with a clean dressing/cloth on
  bleeding site
• See Bleeding

Different Action steps
NO
Is bite large or gaping? Is blood spurting?
YES
GET HELP!
CALL 9-1-1 See Bleeding
Emergent condition, do you need 9-1-1?
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BITES Next Steps
Bandage
Decision, what type?
YES
Is bleeding uncontrolled?
If bite is from a snake, scorpion or other
reptile, hold the bitten area still and below the
level of the heart. Call POISON CONTROL
CENTER 1-800-876-4766 See Snake Bite, if
appropriate.
NO
Is bite from a human?
YES
Use Poison Control, and follow directions
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BITES Last Steps

• Dont try to catch or touch the animal
• Get description and location of animal
• Report to Animal Control or proper authority,
  usually the local Health Department, so that
  animal can be caught watched for rabies

Check immunization record for DT, DPT (tetanus).
See Tetanus for more information.
The END
Contact responsible school authority and
parents/legal guardians. Inform if a human bite
that both the person bitten and the person biting
may have been exposed to blood from other person.
ENCOURAGE IMMEDIATE MEDICAL CARE File Incident
Report
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Yes
No
No
The Whole Thing
No
No
Yes
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Implementing the Guidelines

• Review the Guidelines in advance
• Write down your local emergency phone numbers
• Make available to all who might use
• Provide training to staff in health office
• Encourage all school staff to take 1st Aid and
  CPR training.
• Check with school nurse or designated first aid
  person and local policies.