Emergencies in SBHCEmergencies in SBHC

Janet Matthews, MS, FNP, WHCNPJanet Matthews, MS, FNP, WHCNP Oregon State Program Office, DHS, OFH, AHOregon State Program Office, DHS, OFH, AH School-Based Health Centers Program ManagerSchool-Based Health Centers Program Manager

Identify Emergencies in SBHCIdentify Emergencies in SBHC Triage Triage

Laura Kuperstein Laura Kuperstein

Oregon Safe Net Program, 211Oregon Safe Net Program, 211

Visual Imagery Visual Imagery Home to worksite PreparednessHome to worksite Preparedness Prepare ; Hope Prepare ; Hope M & MM & M

Injury, suicideInjury, suicide

ID Risk Factors ID Risk Factors

Common Adolescent Presentation:Common Adolescent Presentation:

InjuryInjury

Vaso-vagal responseVaso-vagal response Allergic reactionAllergic reaction SeizuresSeizures Hypoglycemia;asthma Hypoglycemia;asthma OverdoseOverdose Heat prostrationHeat prostration Outbreak – Outbreak – EpidemiologyEpidemiology RF for violenceRF for violence Self DefenseSelf Defense

Common Adolescent Presentation:Common Adolescent Presentation:

SuicidalSuicidal

Suicide – Suicide – www.medscape.com/viewarticle/562647www.medscape.com/viewarticle/562647

AARAAARA Anti-dep. - rel. safeAnti-dep. - rel. safe Depression – rel. unsafeDepression – rel. unsafe ComplianceCompliance Withdrawal sxWithdrawal sx CollaborateCollaborate

FIRST LINE MEDICATIONSFIRST LINE MEDICATIONS EPINEPHRINE RESPONDERSEPINEPHRINE RESPONDERS

Epinephrine x 1Epinephrine x 1 ORS 433.805 - 30ORS 433.805 - 30 OAR 333-55-00 - 035OAR 333-55-00 - 035 Epipen = 0.3 ml SQ x 15 Epipen = 0.3 ml SQ x 15

min durationmin duration <60lbs = 0.15 ml <60lbs = 0.15 ml

SE; transfer asapSE; transfer asap

Other stock medsOther stock meds

First line responsesFirst line responses

TriageTriage Airway to AARAAirway to AARA

Safe environmentSafe environment Follow upFollow up Delegate prnDelegate prn

Emergency Kit ContentsEmergency Kit Contents

ABC needsABC needs First line suppliesFirst line supplies First Line MedsFirst Line Meds documentationdocumentation

Resources:Resources: AHA.orgAHA.org hsc.unm.edu/emermed/PED/school rn/school rn.shtmlhsc.unm.edu/emermed/PED/school rn/school rn.shtml

Align Policy with PracticeAlign Policy with Practice School’s ER policy inclusive of SBHC ?School’s ER policy inclusive of SBHC ? Visual ImageryVisual Imagery Mock CodeMock Code TOPOFFTOPOFF Regular ER kit, Oxygen checks?Regular ER kit, Oxygen checks? Use KPMs to guide:Use KPMs to guide:

F/UF/U CollaborationCollaboration Tx PlanTx Plan

Emergency PreparednessEmergency Preparedness

Medical Reserve CorpMedical Reserve Corp Natural DisastersNatural Disasters

Tsunami, flood, heat, ARSTsunami, flood, heat, ARS Mass CasualtiesMass Casualties

Bombs, ViolenceBombs, Violence RadiationRadiation

Nuclear; ARSNuclear; ARS ChemicalChemical BiologicalBiological

meningitis, TB, anthrax, meningitis, TB, anthrax, HIVHIV

Accidental and Accidental and IntentionalIntentional Origins Origins

9/11/019/11/01 Occams RazorOccams Razor Epidemiological cluesEpidemiological clues Complete PMHComplete PMH ResourcesResources

Poison Control Poison Control 1-800 222-12221-800 222-1222

www.CDC.govwww.CDC.gov www.ARC.orgwww.ARC.org www.APHA.org www.APHA.org

Optimal Emergency Optimal Emergency PreparednessPreparedness

Risk AssessmentRisk Assessment CollaborateCollaborate Inter - Agency DrillsInter - Agency Drills Plan AheadPlan Ahead

ENA.org; NENA.org; FEMA.orgENA.org; NENA.org; FEMA.org ACEP.org; AAEM.orgACEP.org; AAEM.org Triagefirst.com; Redcross.orgTriagefirst.com; Redcross.org AACN.org; AAP.orgAACN.org; AAP.org MISD.NET/CONNECTION/MENTAL.HTMMISD.NET/CONNECTION/MENTAL.HTM

Pyschnurse.orgPyschnurse.org Revolutionhealth.comRevolutionhealth.com

RESOURCES