crisis response & emergency protocol by: kevin cleland & erin ash
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Crisis Response & Emergency ProtocolBY: KEVIN CLELAND & ERIN ASH
Crisis vs. EmergencyEmergency – An emergency is a singular event or situation in which immediate physical harm or the threat of immediate physical harm is present.
Crisis – A crisis describes any situation in which physical, mental or emotional harm is present or on-going, but is not necessarily characterized by a singular event. (All emergencies are crises but not all crises are emergencies)
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Responding to Crises: The 4 Steps of Crisis Assessment
Threat to Self
Immediate Harm
Third Party Impact
Informational Impact
Identifying Objectives Amidst a Crisis
Many crises are similar but no two crises are exactly the same◦ How you successfully resolve a crisis and the skills you use will vary depending on the
situation
Similar crisis have the same objectives◦ You will use your training, personal skills and judgement to determine how to achieve those
objectives in a given crisis
Universal Rules for Crisis Response in Residential Education
1. Calling Up - Absolutely always call up to Senior Staff if you ever in doubt. You will never get in trouble for calling the Senior Staff on call if you are uncertain about how to handle a particular situation.
2. Parents – As an RA you should not be dealing with parents. If a parent contacts you regarding a resident, you cannot give them any information. Refer all parents to your Senior Staff member or the Senior Staff on Call.
3. Know Your Resources – Almost all crisis will require that you know both how to communicate with and what services are provided by various campus resources. In order to be effective at responding to crises make sure that you are well versed in USC campus and community resources.
1. Including: DPS, OWHP, Center for Women & Men, Title IX Office, Housing, Cultural Centers, Health Center, Counseling Center, etc.
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Medical Emergencies
Hospital Transports All of the following types of incidents are scenarios where an resident will likely be transported to the hospital. In the event that a resident is transported remember the following:
1. Any time a resident is transported to the hospital for any reason, you must call up to Senior Staff on Call.
2. You should never ride along with the resident to hospital
3. Give basic information to roommates so they do not panic if their roommate does not return home that night, but do not share any sensitive information (i.e. alcohol use, drug use, etc.)
InjuryLIST OF OBJECTIVES
Objective 1: Reduce potential for further injury or harm
Objective 2: Determine severity
Objective 3: Seek medical attention best suited to the severity and type of injury
TIPS, SKILLS AND ADDITIONAL INFO
a. If the injury is life threatening, the best way to reduce the potential for future harm is to contact DPS immediately
b. Do not touch any resident, unless absolutely necessary to prevent further harm or fatality. Guide the injured resident or other supporting third parties in how to help the situation.
Alcohol OverdoseLIST OF OBJECTIVES
Objective 1: Reduce potential for further harm
Objective 2: Determine severity
Objective 3: (If potentially severe enough for transport) Contact DPS immediately
Objective 3: (If not potentially severe enough for transport) Find a third party to watch over the resident in question until they are sober
TIPS, SKILLS AND ADDITIONAL INFO
a. Signs of an alcohol overdose:a. Nausea, Vomiting, Incoherence,
Unconsciousness, Lowered Body Temp., Blue/Pale Skin, Slow/Ragged/Irregular Breathing, Seizures
b. When in doubt always call DPS for medical support
c. Make sure that if left in care of third party, the third party is informed to call for help if the intoxicated resident worsens.
Drug OverdoseLIST OF OBJECTIVES
Objective 1: Reduce potential for further harm
Objective 2: Determine severity
Objective 3: Contact DPS immediately regardless of severity
TIPS, SKILLS AND ADDITIONAL INFO
a. Common drug overdose amongst college students (By frequency)
a. Antidepressants/Prescription Drugs, Cocaine, Ecstacy/MDMA (Molly)
b. Signs of a drug overdose:a. Nausea, Vomiting, Incoherence,
Unconsciousness, Increased Body Temp., Dilated Pupils, Chest Pain, Seizures, Panic Attack
Infectious DiseaseLIST OF OBJECTIVES
Objective 1: Determine severity
Objective 2: Determine if symptoms of common severe infectious diseases are present
Objective 3: Seek appropriate medical attention
Objective 4: Reduce potential for harm to third parties (Roommates, etc.)
TIPS, SKILLS AND ADDITIONAL INFO
a. Common Serious Infectious Diseases Amongst College Students and Symptoms:
a. Meningitis: Headache/Migraine, Dehydration, Stiffness in the neck/Pain when turning head side to side
b. Mononucleosis (Mono): Sore throat, Chronic Exhaustion/Fatigue, Fever, Headache
c. Strep Throat: Severe Sore Throat, Sudden Fever, Chills, Headache, Swollen Lymph Nodes
Practice Scenario 1
While on duty, you receive a call from a resident saying to come to their room
immediately because they are worried one of their friends has drank too much. When you get to the room there are 5 people crowded around a student who is sitting against a wall
who appears to be having trouble holding their head up. You notice a trashcan next to them
and see vomit on their shirt. They don’t appear to be responding directly to people talking to
them but are muttering incoherently. The other people in the room seem somewhat
intoxicated and a few are visibly scared and emotional. Some people are trying to help by getting the resident to drink water and asking them questions. Others are apologizing to you
and asking they will get in trouble.
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Mental Health Crises
Suicide IdeationLIST OF OBJECTIVES
Objective 1: Determine if intent to kill themself is present
Objective 2: Determine if the resident has a plan or has attempted to kill themself before
Objective 3: Get resident to agree to seek appropriate counseling or mental health service
TIPS, SKILLS AND ADDITIONAL INFO
a. If a resident has expressed any desire to kill themself, do not leave them alone, even when you call Senior Staff on Call or the Counselor on Call.
b. Be very direct in asking questions and don’t use euphemisms. Directly ask “Have you thought about killing yourself?”
c. If a resident will not seek counseling, but the potential for loss of life is too great, a resident can be involuntarily committed, but this is a last resort.
Self-HarmLIST OF OBJECTIVES
Objective 1: Identify and compassionately confront observed self harm
Objective 2: Determine motivation for self harm
Objective 3: Get resident to agree to seek appropriate counseling or mental health service
TIPS, SKILLS AND ADDITIONAL INFO
a. Self-harm is distinctly different from suicide ideation; self-harm is a means of coping
b. Self-harm is often the result of feeling a lack of control over one’s life; also described as feeling removed from one’s own life
c. Self harm is usually inflicted on commonly hidden areas of the body; self harm is not a plea for attention and there is often shame associated with the behavior
Eating or Exercise DisorderLIST OF OBJECTIVES
Objective 1: Engage resident in conversation about health and/or health goals
Objective 2: Identify motivations for particular eating or exercise behavior
Objective 3: Recommend professional resources to help the achieve goals in a healthy manner
(First attempt)
TIPS, SKILLS AND ADDITIONAL INFO
a. Eating and exercise disorders are not resolved in a single conversation; they can only be resolved through personal desire to change behavior
b. Do NOT tell the resident you think they have an eating or exercise disorder. Only engage with observable behaviors.
c. Mirror the language that the resident uses to describe their behavior
d. Eating and exercise disorders are most frequently tied to a distorted body image (Body dismorphia) – Trying to convince someone they are “fit”, “not fat” etc. is counterproductive.
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Active Harm Crises
HarassmentLIST OF OBJECTIVES
Objective 1: Make sure the resident does not feel as if they are immediate danger
Objective 2: Disclose that you are not a confidential resource
Objective 3: Determine how you can best make the resident feel safe and secure in their community
Objective 4: Explain reporting options
Objective 5: Encourage resident to seek professional counseling or appropriate support
TIPS, SKILLS AND ADDITIONAL INFO
a. When offering reporting options, do so without displaying judgement or preference towards a particular option. Remember that not reporting is a viable option for the resident, but you MUST report.
b. Treat every allegation as serious
c. Do not make promises about how or if the alleged perpetrator will be held accountable – Focus on harm reduction
Sexual Assault LIST OF OBJECTIVES
Objective 1: Ensure the resident is physically okay and does not need immediate attention
Objective 2: Disclose that you are not a confidential resource
Objective 3: Determine how you can best make the resident feel safe and secure in their community
Objective 4: Explain reporting options
Objective 5: Encourage the resident to seek appropriate counseling and support
TIPS, SKILLS AND ADDITIONAL INFO
a. Your tone should be soft and non-judgmental
b. Do not ask the resident “Why” questions or probe them for too many details
c. Be conscious of your own gender identity and the dynamic it creates with the student in crisis
d. Use mirroring language – Do not use the terms “rape” or “sexual assault” unless the resident does. Let them name their own experience.
Hate Crime/Bias Related Incident (Vandalism)LIST OF OBJECTIVES
Objective 1: Document the vandalism (Use camera on duty phone)
Objective 2: Cover up the vandalism as quickly as possible to prevent further harm
Objective 3: Determine the scope of the impact (Who has seen or was impacted by it)
Objective 4: Talk and listen to all impacted residents and refer them to appropriate resources
Objective 5: (Where appropriate) Create a community impact plan to address any community wide harm
TIPS, SKILLS AND ADDITIONAL INFO
a. Do not try to minimize the impact of a situation to a resident or tell a resident they are just being sensitive.
b. Do not make promises about finding out who did it or how the perpetrators will be held accountable – Focus on harm reduction
c. Be conscious of your identities
Hate Crime/Bias Related Incident (Direct)LIST OF OBJECTIVES
Objective 1: Ensure the resident is physically okay and does not need medical attention
Objective 2: Disclose that you are a mandatory reporter
Objective 3: Determine how you can make the resident feel safe and secure in their community
Objective 4: Explain reporting options
Objective 5: Refer resident to appropriate counseling resources
TIPS, SKILLS AND ADDITIONAL INFO
a. Do not try to determine if the incident was hate/bias motivated – If it is presented as such, treat it as such
b. Do not make promises about what will happen to the perpetrator(s) – Focus on harm reduction
c. Be conscious of your identities
AssaultLIST OF OBJECTIVES
Objective 1: Determine severity of injuries (if any) and seek appropriate medical attention
Objective 2: Determine is they know the assailant and if they feel in any immediate danger
Objective 2: Determine how you can make the resident feel safe and secure in their community
Objective 3: Explain reporting options
Objective 4: Refer resident to appropriate counseling resources
TIPS, SKILLS AND ADDITIONAL INFO
a. If you encounter a fight or assault in process, do not try to break it up or get in the middle of it – Call DPS immediately
b. Do not make promises about what will happen to the perpetrator(s) – Focus on harm reduction
Supporting an Alleged Perpetrator/Respondent
In many cases of active harm on campus, the alleged perpetrator may be a USC student who lives in our residential communities. As an RA you must be prepared to support them too. Below is important information to remember when supporting an alleged perpetrator:
1. An alleged perpetrator is also a student in crisis
2. Your support is not contingent upon their innocence
3. You should make efforts to ensure that an alleged perpetrator is seeking the appropriate counseling support resources
4. Make sure that the resident feels secure in their living community as well
5. Remember that, even if someone did actively harm another student, our goal is to educate the resident and mitigate any future harm but not to denigrate them for their actions
Missing StudentLIST OF OBJECTIVES
Objective 1: Make every attempt to contact the resident’s room, the floor/area RA, or any other reasonable contact
Objective 2: Determine when the resident was last seen
Objective 3: Determine if there are any aggravating factors that are cause for concern
Objective 4: Contact Senior Staff to report findings and determine next course of action
TIPS, SKILLS AND ADDITIONAL INFO
a. If parents/family call looking for a resident, remember that you cannot confirm a particular resident lives there even if you know they do. Refer them to the appropriate senior staff member.
b. If you are uncertain if a particular situation constitutes a “missing student”, contact Senior Staff
c. RAs should never key into a room looking for a resident by themselves. Welfare checks should only be conducted with professional staff present.
Death of a StudentLIST OF OBJECTIVES
Objective 1: Immediately call DPS and Senior Staff
Objective 2: Get all bystanders out of sight of the body
Objective 3: (After DPS and Senior Staff arrive) Talk to all bystanders and refer them to appropriate counseling resources
Objective 4: Wait for direction from DPS or Senior Staff
TIPS, SKILLS AND ADDITIONAL INFO
a. In any instance of death, consider all bystanders the “victims” in this crisis, including yourself.
b. Do not touch or move the body
c. Remember to practice self care – seek your own support in dealing with the impact of death following the incident.
Practice Scenario 2
You hear a knock on your door and open it to find four of your residents who all look very
upset. They tell you to come look what someone wrote. They take you to see a poster
with pictures of Laverne Cox and Caitlyn Jenner advertising an event discussing trans
icons and the portrayal of trans people in the media. Across the poster someone has
written “F****ts” with a sharpie. One of the residents that came to your door was one of the organizers of the program and appears to be on the verge of tears. The other residents
appear both hurt and angry and want to know what can be done.
Practice Scenario 3
You are in your room when you hear a loud knock. When you open the door it is one of your residents who has appears to have a bloody nose. They quickly say “Alex and
Robyn are in a fight down the hall. I tried to break it up and one of them elbowed me in the nose. Please come help!” You run down
to hall to see Alex and Robyn grappling, throwing punches at each other and yelling.
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