Reference material: EFR First Aid at Work Instructor Guide (Asia Pacific Edition)
|
|
- Ethel Ferguson
- 5 years ago
- Views:
Transcription
1 Reference material: EFR First Aid at Work Instructor Guide (Asia Pacific Edition) To develop student knowledge and skills, conduct the following presentations: Knowledge Development Primary Care, incl. AED Emergency Care in the Workplace Emergency Reference / First Aid procedures for: o Illness Assessment, incl. asthma, allergic reactions, bites & stings Skills Development Primary Care Skills #1 through #9 plus AED Use To assess student competency, use the following assessment tools: Knowledge Assessment Primary Care Knowledge Review and Final Exam Emergency Care in the Workplace Knowledge Review BLS Exam (enclosed) Skills Assessment Scenario 1 Scenario 2 Scenario 3 Scenario 4 To document student competency, use the enclosed BLS Assessment Record Sheet. NOTE TO INSTRUCTORS: On the RTO Student Registration Form, pls tick appropriate YES box if your student s statement of attainment needs to also list the sub unit HLTCPR201A Perform CPR (expiry in 1 year). BLS EXAM INSTRUCTOR ANSWER KEY 1. wheezing 4. a. b. c. d. 2. a. b. c. 5. b. c. d. e. f. 3. rapidly 6. a. b. c. d. f. g. Product No (01/09) BLS version 1.1 1
2 BLS - INCIDENT REPORT FORM Product No (01/09) BLS version 1.1 2
3 BLS EXAM STUDENT ANSWER SHEET Student Name: Date: This theory assessment is a multiple-choice exam; unless otherwise indicated in the question, please select all responses that apply and best answer the question. 1. In severe asthma attacks you may not be able to hear the sound. 2. Asthma is a lung condition which is usually controlled by medication. Which statements are correct in case of a severe asthma attack? a. In a severe asthma attack you may not be able to hear the wheezing sound b. A patient may experience difficulty speaking, drowsiness, or unconscious. c. A severe asthma attack is a medical emergency. d. Severe asthma attacks should not be treated by Emergency Responders. 3. Severe allergic reactions occur, usually immediately after the incident. 4. Severe allergic reactions occur in response to: a. Something the patient eats. b. Being bitten by an insect, such as a fire ant. c. Being stung by insects such as bumble bees, honey bees or wasps. d. In response to ingested or injected medications. e. In response to being too hot. 5. Symptoms of severe allergic reactions include: a. Itchy eyes and runny nose b. Chest tightness c. Stomach pain or nausea d. Wheezing e. Difficulty breathing and swallowing due to swollen throat f. Blood pressure may drop leading to dizziness and fainting [continued on next page] Product No (01/09) BLS version 1.1 3
4 6. Emergency care procedures for allergic reactions include: a. Stop, Think, Act b. Check for medical alert tags c. Phone EMS d. DRABCD S e. Give patient sugary drinks or sweets f. If patient carries an epinephrine kit, help the patient use if following included directions. g. Monitor patients Lifeline Student Statement: I have reviewed the questions and any incorrect answers with my EFR Instructor. Any incorrect answers have been explained and I understand what I had missed: Student Signature: Date: Instructor Name: No.: Instructor Signature: Date: Product No (01/09) BLS version 1.1 4
5 BLS Assessment Record Sheet HLTCPR201A Perform CPR HLTFA201A Provide Basic Emergency Life Support Student Name: Course Date: Knowledge C/NYC Comments Primary Care and Emergency Care in the Workplace Mark: % Mark: % Knowledge Reviews Primary Care Final Exam Mark: % BLS Exam Mark: % Skills C/NYC Comments Scene Assessment Barrier Use Primary Assessment One Rescuer, Adult CPR One Rescuer, Child CPR One Rescuer, Infant CPR Choking Adult Choking Child Choking Infant Serious Bleeding Management Shock Management Spinal Injury Management Automated External Defibrillator (AED) Orientation Skills - continued C/NYC Comments Emergency Oxygen Use Emergency Reference: First Aid procedures for illness assessment incl. asthma, allergic reactions, bites & stings Scenario Practice C/NYC Comments Collapsed Family Member A or B Down in Public A or B Recreational Accident A or B Multi-person accident A or B Reports C/NYC Comments BLS Incident Report Form C = Competent NYC = Not Yet Competent I agree that this assessment has been conducted in a fair and ethical manner and that the results are an accurate reflection of my performance of the skills. Student Signature: Date: I hereby certify that the above results are accurate and have been reached in an ethical and fair manner. I further confirm that the participant has only been assessed as competent in any given skill or scenario when they have demonstrated competence in each and every element of that skill or scenario (as per Emergency First Response First Aid at Work Instructor Guide, Asia Pacific Edition, version 2.0 and RTO Instructor Quick Reference Guide for HLTFA201A Provide Basic Emergency Life Support). Instructor Name: No.: Instructor Signature: Date: HLTFA201A Assessment Record Sheet v1.0 PADI RTO ID#6729, March 09
Management of ANAPHYLAXIS in the School Setting. Updated September 2010
Management of ANAPHYLAXIS in the School Setting Updated September 2010 What is an Allergy? Allergies occur when the immune system becomes unusually sensitive and over reacts to common substance that are
More informationShelley Westwood, RN, BSN
Shelley Westwood, RN, BSN The body requires a constant supply of oxygen for survival. AMERICAN RED CROSS FIRST AID RESPONDING TO EMERGENCIES FOURTH EDITION Copyright 2006 by The American National Red Cross
More informationHealth Point: Understanding Allergic Reactions
Health Point: Understanding Allergic Reactions What are allergies? Every person s body is different. People s bodies can react differently to the same things. For example, you may like to eat fish, but
More information4. PAEDIATRIC ILLNESS AND INJURY
4. PAEDIATRIC ILLNESS AND INJURY As well as dealing with emergency situations it is important that you can manage the more common paediatric illnesses and injuries which you are likely to experience in
More informationMIAMI-DADE COLLEGE. Common Course Number: HSC Course Title: Basic Emergency Care. Course Catalog Description:
Common Course Number: HSC 2400 MIAMI-DADE COLLEGE Course Title: Basic Emergency Care Course Catalog Description: Designed to provide opportunities to develop, practice, and display skills concerning emergency
More informationACTION PLAN FOR. Difficult/noisy breathing Swelling of tongue Swelling/tightness in throat Wheeze or persistent cough ACTION FOR ANAPHYLAXIS
www.allergy.org.au Name: Date of birth: Photo Confirmed allergens: Family/emergency contact name(s): ACTION PLAN FOR Anaphylaxis SIGNS OF MILD TO MODERATE ALLERGIC REACTION Swelling of lips, face, eyes
More informationManaging Illness 8/9/2010 1
Managing Illness 1 Fainting Caused by a temporary drop in blood pressure thus causing a reduction in oxygen to the brain. Insufficient oxygen causes casualty to black out and fall. Consciousness normally
More informationADMINISTRATIVE CHECKLIST FOR ANAPHYLAXIS
Appendix 317A ADMINISTRATIVE CHECKLIST FOR ANAPHYLAXIS Information gathering: Physician s information sheet completed Parent consent to give medical treatment form signed Student Care Plan readily available
More informationEpinephrine Intramuscular (IM) Injection Administration EMT Optional Scope Highlights
Epinephrine Intramuscular (IM) Injection Administration EMT Optional Scope Highlights Nor-Cal EMS February 2018 version 1 Special Thank You To Seattle / King County EMS NY State Department of Health, Check
More informationSt. Joseph s Primary School Numurkah
St. Joseph s Primary School Numurkah Anaphylaxis Procedure March 2014 Basic Beliefs: Our school community nurtures the development of the whole child. Our School is built on respect and an appreciation
More informationAllergic Reactions and Envenomations. Chapter 16
Allergic Reactions and Envenomations Chapter 16 Allergic Reactions Allergic reaction Exaggerated immune response to any substance Histamines and leukotrienes Chemicals released by the immune system Anaphylaxis
More informationAllergy Awareness & EpiPen Administration
Allergy Awareness & EpiPen Administration 2017-18 Common Allergens in Children! Shellfish! Milk! Egg! Peanut! Tree Nuts! Fish! Soy! Latex! Insect Stings! Exercise What is an allergy? * An allergy is an
More informationNew Patient Questionnaire
- - Toda y 's Date: Primary Care Provider's Name: Was a consultation recommended? Primary Clinic: Referring provider's name (if different): Please answer the following questions to facilitate the diagnosis
More informationAnaphylaxis Emergency Plan (individual)
Appendix D Anaphylaxis Emergency Plan (individual) Recommendation In schools and other child care settings, each child at risk of anaphylaxis should have an Anaphylaxis Emergency Plan. (See following page.)
More informationPDP 406 CLINICAL TOXICOLOGY
PDP 406 CLINICAL TOXICOLOGY Pharm.D Fourth Year ENVENOMATION Mr.D.Raju.M.Pharm., Lecturer POISONING Poisonous substances can be swallowed, injected, inhaled, absorbed. Poisoning and envenomation can be
More informationShock Video Shock (3)
CHAPTER 9 Shock Video Shock (3) Lesson Objectives 1. Explain what happens inside the body with severe blood loss. 2. List common causes of shock. 3. Describe first aid steps for a victim in shock. 4. Describe
More informationCHAPTER 9. Shock National Safety Council
CHAPTER 9 Shock Shock Dangerous condition: Not enough oxygen-rich blood reaching vital organs, such as brain and heart Caused by anything that significantly reduces blood flow Life-threatening emergency
More informationEMT OPTIONAL SKILL. Cell Phones and Pagers. Epinephrine Auto-injector. Course Outline 9/2017
EMT OPTIONAL SKILL Epinephrine Auto-injector Cell Phones and Pagers Be courteous to your classmates! Please set your cell phones and/or pagers to silent or turn them off. Course Outline Introduction and
More information1. The 2010 AHA Guidelines for CPR recommended BLS sequence of steps are:
BLS Basic Life Support Practice Test Questions 1. The 2010 AHA Guidelines for CPR recommended BLS sequence of steps are: a. Airway, Breathing, Check Pulse b. Chest compressions, Airway, Breathing c. Airway,
More informationLIFE THREATENING ALLERGIES POLICY
LIFE THREATENING ALLERGIES POLICY What is Anaphylaxis? Anaphylaxis is a severe systemic allergic reaction at the extreme end of the allergic spectrum. The whole body is affected usually within minutes
More informationMedical First Responder Program Protocols
Medical Scene Safety Protocol Verify Scene Safety with Police or Dispatch UNKWN Scene Safe? Enter Continue to Appropriate Protocol Possible to Make Safe Make Safe Then Continue Exit Area and Stage Outside
More informationWILDERNESS EMERGENCY CARE COURSE ADVANCED FIRST AID
RESCUE DYNAMICS 5109-17A Avenue NW Edmonton, Alberta T6L 1K5 (780) 461-5040 phone / fax website: http//:www.rescuedynamics.ca WILDERNESS EMERGENCY CARE COURSE ADVANCED FIRST AID COURSE OUTLINES COURSE
More informationBelow are tips for keeping bugs away. Try not to use soaps, shampoos, and deodorants that have a fragrance or perfume.
F O R Y O U R H E A L T H What Do I Do if I Get an Insect Bite? Have you ever been stung by a bee, a wasp, or a hornet? The answer is probably yes! You may have come into contact with all kinds of insects.
More informationAllergy to: NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction. USE EPINEPHRINE.
Name: D.O.B.: Allergy to: PLACE PICTURE HERE Weight: lbs. Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe
More informationBelow are tips for keeping bugs away. Try not to use soaps, shampoos, and deodorants that have a fragrance or perfume.
F O R Y O U R H E A L T H What Do I Do if I Get an Insect Bite? Have you ever been stung by a bee, a wasp, or a hornet? The answer is probably yes! You may have come into contact with all kinds of insects.
More informationShould you have questions or concerns, please contact the Program Supervisor at the location your child is registered.
Community Services Department, Recreation Division 201 City Centre Drive MISSISSAUGA ON L5B 2T4 mississauga.ca/recreation Dear Parent/Guardian, We are excited to have you join us for camps this season!
More informationAllergy to: Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No For a suspected or active food allergy reaction:
Name: D.O.B.: Allergy to: Weight: lbs. Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No For a suspected or active food allergy reaction: PLACE STudent s Picture here SEVERE SYMPTOMS [ ] if checked,
More informationManaging Allergies and Anaphylaxis at School EPI-PEN TRAINING FOR SCHOOL PERSONNEL
Managing Allergies and Anaphylaxis at School EPI-PEN TRAINING FOR SCHOOL PERSONNEL Objective: Attendees will be able to: Increase their knowledge about allergies to food and other allergens. Describe the
More information9220 Haven Avenue, Suite 101 Rancho Cucamonga, CA Tel: (909) Fax: (909) ALLERGY HISTORY
Name: Date of Birth: Date of Visit: Briefly describe the reason for your visit: How long have you had these problems? How frequently do you have them? NASAL SYMPTOMS ALLERGY HISTORY 1. I have the following
More informationAllergy Management Policy
Allergy Management Policy Food Allergy People with allergies have over-reactive immune systems that target otherwise harmless elements of our diet and environment. During an allergic reaction to food,
More informationYou need to know that we will administer the epi-pen if your child is experiencing ANY of the following symptoms:
MEDICATION ADMINISTRATION AND FOOD ALLERGY POLICY We want to make you aware of the steps Silver Spring Day School (SSDS) is taking to assure the safety of children with serious allergies or a medical condition.
More informationAustralian insects: bites and stings guide.
Australian insects: bites and stings guide www.healthdirect.gov.au Biters Stingers Biters use their mouths to suck blood. They can infect you with diseases. Stingers inject you with venom, which can trigger
More information7. Study instruments for 13/14 year olds
7. Study instruments for 13/14 year olds 7.1 Instructions for completing questionnaire and demographic questions Examples of instructions for completing questionnaires and demographic questions are given
More informationLesson 17: Allergies & Anaphylaxis. Emergency Reference Guide p
Lesson 17: Allergies & Anaphylaxis Emergency Reference Guide p. 25-30 Objectives Describe basics of allergic reactions & treatment Define anaphylaxis List signs & symptoms of anaphylaxis Describe conditions
More informationEnvironmental Injury and Illnesses. Dc. Anna Toplaghaltsyan
Environmental Injury and Illnesses Dc. Anna Toplaghaltsyan Yerevan 2018 BITES AND STINGS Insect bites and stings are a common and an annoying occurrence. Most bites are minor but the potential for a serious
More informationA Sweet Stinger. READTHEORY Name Date. Buzz! Buzz! Buzz!
READTHEORY Name Date A Sweet Stinger Buzz! Buzz! Buzz! If you hear that sound, it means that there could be a honey bee nearby. Honey bees are very important insects. As they fly from one flower to another,
More informationAppendix. Contents A-1. Knowledge Reviews A-2. Knowledge Reviews Answer Keys A-9. Primary Care Final Exam A-11. Secondary Care Final Exam A-17
Appendix Appendix Contents Knowledge Reviews A-2 Knowledge Reviews Answer Keys A-9 Primary Care Final Exam A-11 Secondary Care Final Exam A-17 Primary Care Final Exam Answer Sheet A-23 Secondary Care Final
More informationTerms What is Anaphylaxis? Causes Signs & Symptoms Management Education Pictures Citations. Anaphylaxis; LBodak
Leslie Bodak, EMT-P Terms What is Anaphylaxis? Causes Signs & Symptoms Management Education Pictures Citations Allergic Reaction: an abnormal immune response the body develops when a person has been previously
More informationEnjoy the Countryside SAFELY
Enjoy the Countryside SAFELY Buzzers and Stingers worksheet 2 LESSON PLAN / TEACHERS' NOTES TOPIC: This lesson plan covers UK creatures that can sting; bees and wasps, caterpillars and ants. AIMS: For
More informationALLERGY AWARENESS POLICY
ALLERGY AWARENESS POLICY 1. RATIONALE Allergies are very common and increasing in Australia and New Zealand, affecting around 1 in 5 people at some time in their lives. There are many different causes
More informationSTEPS. How to Get Well When You re Sick or Hurt. Nancy Lobb illustrated by David Strauch. Third Edition
STEPS To Independent Living Third Edition How to Get Well When You re Sick or Hurt Nancy Lobb illustrated by David Strauch WALCH EDUCATION 1 2 3 4 5 6 7 8 9 10 ISBN 978-0-8251-6489-7 Copyright 1986, 1995,
More informationAn allergic reaction is an exaggerated response by the immune system to a foreign substance
ALLERGIC REACTION An allergic reaction is an exaggerated response by the immune system to a foreign substance Anaphylaxis is an unusual or exaggerated allergic reaction; is a life threatening emergency
More informationSTAYTON FIRE DISTRICT PROTOCOL QUIZ
STAYTON FIRE DISTRICT PROTOCOL QUIZ Name 1. Please list the appropriate EMS Level for each of the Scope of Practice items below EMR Emergency Medical Responder B Basic Conduct primary and secondary patient
More informationSCHOOL DISTRICT NO. 51 (BOUNDARY) P O L I C Y
SCHOOL DISTRICT NO. 51 (BOUNDARY) P O L I C Y SECTION TITLE NO. 4020 HEALTH/SAFETY Anaphylaxis (Severe Allergic Reaction) DATE ADOPTED: May 13, 2008 DATE AMENDED: Anaphylaxis is a sudden and severe allergic
More informationFirst Aid Information
ISSUED May 2018 First Aid Information First Aid Kits Are Located: First Aid Kits Are Managed By: First Aid Kits Are Accessible By: Church Staff Ministry Volunteer Leaders Ministry Volunteer Team Members
More informationYour Anaesthetic Explained
Your Anaesthetic Explained Patient Information Sheet Pre Admission Assessment Clinic Tel: 4920307 What is anaesthesia? The word anaesthesia means loss of sensation. If you have ever had a dental injection
More informationSEVERE ALLERGY/ANAPHYLAXIS ACTION PLAN & TREATMENT AUTHORIZATION Appendix F-4A
PART I - TO BE COMPLETED BY PARENT Student Date of Birth Teacher/Grade Allergy Route of Exposure Contact Ingestion Weight lbs. Inhalation Sting Asthmatic Yes* No *Higher risk for severe reaction Parent
More informationREQUIREMENTS FOR DEVELOPING AN INDIVIDUALIZED HEALTHCARE PLAN FOR STUDENTS WITH FOOD AND LIFE THREATENING ALLERGIES
REQUIREMENTS FOR DEVELOPING AN INDIVIDUALIZED HEALTHCARE PLAN FOR STUDENTS WITH FOOD AND LIFE THREATENING ALLERGIES Parent/ Guardian: Notify the appropriate school personnel of all student allergies and
More informationEczema: also called atopic dermatitis; a chronic, itchy, scaly rash not due to a particular substance exposure
Allergy is a condition in which the immune system causes sneezing, itching, rashes, and wheezing, or sometimes even life-threatening allergic reactions. The more you know about allergies, the better prepared
More informationCCSD School Nurses. Support of Students with Life Threatening Allergies
CCSD School Nurses Support of Students with Life Threatening Allergies The Clark County School District is committed to provide a safe, supportive environment in which all students can learn and achieve.
More informationللأدوية الأليرجياي ي الارتكاس = medication Allergic reaction to
1 / 6 Allergic reaction to medication An allergic reaction to a medication is an unintended immune response to the medication. Symptoms can vary from a mild rash to shortness of breath to death. It is
More informationWest Houston Allergy & Asthma, P.A.
Consent to Receive Immunotherapy (ALLERGY SHOTS) Procedure Allergy injections are usually started at a very low dose. This dose is gradually increased on a regular (usually 1-2 times per week) basis until
More informationSTUDENT HEALTH FORM. Name of Student Birth Date Sex (MM/DD/YY) Entrance Date (MM/DD/YY) Siblings in the School (names and grades)
STUDENT HEALTH FORM If you are a new student enrolling at AISC, please attach a copy of the immunization records & proof of physical exam in the last 12 months & submit the complete form to: Sanja Ilic,
More informationQueen City Independent School District Stock Epinephrine Policy/Protocol
Queen City Independent School District Stock Epinephrine Policy/Protocol In accordance with Texas SB 66 as well as Chapter 38 of the Education Code Subchapter E, and the NASN guidelines for stock Epinephrine
More informationLEARN ABOUT ANOTHER WAY TO TREAT YOUR ALLERGIES
LEARN ABOUT ANOTHER WAY TO TREAT YOUR ALLERGIES WHAT ARE ALLERGIES? It s probably not something that you think about, but every time you open your mouth or inhale, tiny particles from the environment that
More informationFaith Lutheran College, Redlands Faith in Christ prepared for life A I ANAPHYLAXIS POLICY T H. Last updated June 2017
F Faith Lutheran College, Redlands Faith in Christ prepared for life A I ANAPHYLAXIS POLICY T H Last updated June 2017 Food Allergy Policy and Procedures Rationale: Within the general community, there
More informationEmergency Care Progress Log
Emergency Care Progress Log For further details on the National Occupational Competencies for EMRs, please visit www.paramedic.ca. Check off each skill once successfully demonstrated the Instructor. All
More informationSt. Andrew Apostle Family Handbook Acknowledgement
11602 Silver Spring, MD 20902 (301) 649-3555 fax (301) 649 2352 www.standrewapostle.org 2018-2019 Apostle Family Handbook Acknowledgement *The Principal reserves the right to amend the Family Handbook
More informationSESSION PLAN FAA LEVEL 3 AWARD IN FIRST AID AT WORK (RQF) AWARD IN FIRST AID AT WORK AT SCQF LEVEL 6 REQUALIFICATION COURSE.
FAA LEVEL 3 AWARD IN FIRST AID AT WORK (RQF) AWARD IN FIRST AID AT WORK AT SCQF LEVEL 6 REQUALIFICATION COURSE Unit 1 : Emergency First Aid in the Workplace : 6 hour duration Full qualification requires
More informationSAN JOAQUIN COUNTY EMERGENCY MEDICAL SERVICES AGENCY. Administration of Epinephrine Auto-Injector Training
SAN JOAQUIN COUNTY EMERGENCY MEDICAL SERVICES AGENCY Administration of Epinephrine Auto-Injector Training Disclaimer: Authorization - EMT Optional Skills Only authorized Emergency Medical Technicians (EMT)
More informationPackage leaflet: Information for the user. Pharmalgen Bee Venom Pharmalgen Wasp Venom. 100μg/ml. powder and solvent for solution for injection
Package leaflet: Information for the user Pharmalgen Bee Venom Pharmalgen Wasp Venom 100μg/ml powder and solvent for solution for injection Read all of this leaflet carefully before you start using this
More informationUWSP Medical History Form
UWSP Medical History Form 2017-2018 Student: Please complete the first 6 pages prior to your appointment with your medical provider. The medical provider must sign off on the medical history form. Student
More informationEpinephrine Auto Injector Self-Administration Authorization Packet for Anaphylaxis (A new packet must be completed yearly)
Epinephrine Auto Injector Self-Administration Authorization Packet for Anaphylaxis (A new packet must be completed yearly) Packet Contents: 1. Anaphylaxis Medication Self-Administration Form (requires
More informationS:\Admin Staff\100 Administration\2010\109 Policy\Operational Plans\Anaphylaxis Policy.doc
Growing Together Principal: Mr Paul Andrijich Deputy Principal: Mr Paul Westcott Registrar: Mrs Kerry Vine 65 Coast Road West Swan WA 6055 Telephone: 9250 2711 Mobile: 0434734390 Fax: 9250 2416 EDUCATE
More informationHOW TO HANDLE BASIC MEDICAL EMERGENCIES
HOW TO HANDLE BASIC MEDICAL EMERGENCIES INTRODUCTION At some point in your career as a Certified Nursing Assistant (CNA) you may be the first person on the scene at a medical emergency. You may witness
More informationPATIENT INFORMATION. Address: Street City State Zip Home phone: Work phone: Cell phone: address: Patient s or parent s employer: Occupation:
Date: PATIENT INFORMATION Name: Birth date: First Last Address: Street City State Zip Home phone: Work phone: Cell phone: E-mail address: How would you prefer to be contacted? Home Cell Text E-mail Are
More informationWELCOME Patient Registration Date:
Patient Information WELCOME Patient Registration Date: Mr. Mrs. Ms. Dr. Name: Last First MI Address: Street Apt. # City State Zip Code Home Tel #: Work #: Cell #: Sex: Female Male Birth Date: Married Single
More informationALLERGY CLINIC JOHN V. BOSSO, MD, FAAAAI, FACAAI, DIRECTOR
ALLERGY CLINIC JOHN V. BOSSO, MD, FAAAAI, FACAAI, DIRECTOR Name D.O.B. Date Reason for your visit today: Please put a check and complete the blanks which apply to your symptoms: Present Problem Past Problem
More informationEvergreen Speech & Hearing Clinic, Inc. Transforming Lives Through Improved Communication Since 1979
Audiology Hearing Testing VRA VNG/VEMP OAE BAER/ECochG Hearing Aids Cochlear/Bone Implants Tinnitus CAPD EHDDI Speech-Language Pathology Language Voice Accent Modification Autism Evaluation & Treatment
More informationMEDICAL JEOPARDY. Q. This is the first thing you check when you find an unconscious victim
MEDICAL JEOPARDY This is a Medical Jeopardy game with rules similar to Jeopardy on television. Use 3x5 cards with a hole punched in one end on a bulletin board for the game board. Each contestant will
More informationPARENT/ GUARDIAN ANAPHYLAXIS PACKAGE ELEMENTARY/SECONDARY
PARENT/ GUARDIAN ANAPHYLAXIS PACKAGE ELEMENTARY/SECONDARY 2006 PARENT/GUARDIAN INFORMATION & RESPONSIBILITIES: The Board and its schools endeavor to provide a safe environment for children with life threatening
More informationHLTAID003 PROVIDE FIRST AID WORK BOOK
1 HLTAID003 PROVIDE FIRST AID WORK BOOK To be used in conjunction with the E M E R G N E C Y H A N D B O O K FIFTH EDITION READY HEALTH NURSING COLLEGE HLTAID003 PROVIDE FIRST AID WORKBOOK Student s Name:
More informationBradford Beekeepers Association Certificate of Competence as a Beekeeper Continuing Learning
Certificate of Competence as a Beekeeper Continuing Learning This learning guide will help you meet the requirements of the activity: BfdGL2 Carry out a risk assessment for beekeeping activity In this
More informationTREATMENT OF ANAPHYLACTIC REACTION WITH EPINEPHRINE
TREATMENT OF ANAPHYLACTIC REACTION WITH EPINEPHRINE FILE: JGCDC Background: The Bibb County School System recognizes the growing concern with severe life-threatening allergic reactions to food items, latex,
More information1960 FP CENTER FOR SLEEP DISORDERS
1960 FP CENTER FOR SLEEP DISORDERS Sleep Questionnaire Name: Date: Date of Birth: / / Age: Gender: Height: Weight: lbs. Referring Physician: Occupation: Please give a brief description of your sleep problem
More informationGET TRAINED. What Would You Do? You have moments to react. Bianca 1/15/2014 GET TRAINED
GET TRAINED It s time to GET TRAINED to administer an epinephrine auto-injector in an emergency! What Would You Do? Bianca has a bee sting allergy She is playing in the garden at her friends house She
More informationSECONDARY INSURANCE Insurance Name Guarantor* *List person or insured name responsible to ensure
DATE: Sec. Initials: PATIENT NAME: (Last) (First) Cell: Home: Work: Email: ADDRESS: (Street) (City) (State) (Zip) Date of Birth: Sex: Male Female Race\Ethnicity: Emergency Contact Name: Phone No.: Family
More informationPoisoning KNOWLEDGE OBJECTIVES SKILL OBJECTIVES. 1. List the four ways poisons enter the body.
KNOWLEDGE OBJECTIVES Poisoning 1. List the four ways poisons enter the body. 2. List at least six signs and symptoms of poisoning. 3. Describe the role of a poison centre. 4. Identify the general principles
More informationSchool Year SEVERE ALLERGY Medical Action Plan (MAP) Student s Name. Date of Birth CONTACT INFORMATION ALLERGIC HISTORY
Bus Transportation Office Use ONLY if Needed Bus # Driver Route # Medical File 9758 E Highland Rd. Howell, MI 48843 810-632-2200 phone 810-632-2201 fax School Year SEVERE ALLERGY Medical Action Plan (MAP)
More informationEvergreen Speech & Hearing Clinic, Inc. Transforming Lives Through Improved Communication Since 1979
Audiology Hearing Testing VRA VNG/VEMP OAE BAER/ECochG Hearing Aids Cochlear/Bone Implants Tinnitus CAPD EHDDI Speech-Language Pathology Language Voice Accent Modification Autism Evaluation & Treatment
More informationREGISTRATION FORM. 1. Full Name. 2. Date of Birth. 3. Gender. 4. Round Square. 5. Do you have any dietary restrictions? 6. School:
REGISTRATION FORM Personal Details 1. Full Name 2. Date of Birth 3. Gender Female Male 4. Round Square Rep Staff Student 5. Do you have any dietary restrictions? 5 6. School: 6 7. Parent/Guardian details
More informationAllergy to: NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction. USE EPINEPHRINE.
Name: D.O.B.: Allergy to: PLACE PICTURE HERE Weight: lbs. Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe
More informationREPORT OF MEDICAL HISTORY Form A Complete History for Pre-Hire or Job Transfer
MEDICAL RECORD REPORT OF MEDICAL HISTORY Form A Complete History for Pre-Hire or Job Transfer Pre-Hire Job Transfer PERSONAL INFORMATION Last name, First name, Middle Initial Social Security Number Today
More informationNew Patient Information & Consents
New Patient Information & Consents Name: DOB: SSN: Gender: Address: City: State: Zip: Home #: Cell #: Other#: Employment Status: Occupation: Email Address: Marital Status: S M D W How did you hear about
More informationCHIROPRACTIC ASSOCIATES CLINIC
CHIROPRACTIC ASSOCIATES CLINIC 1127 LAKEWOOD COURT NORTH, REGINA, SK S4X 3S3 PH: (306) 924-5300 FAX: (306) 924-5252 EMAIL: cac.north@accesscomm.ca CHIROPRACTIC INITIAL HEALTH FORM PATIENT INFORMATION Last
More informationLinton Hall School Allergy Action Plan
Linton Hall School Allergy Action Plan Dear Parent or Guardian, Please provide the information requested below to help us care for your child s life-threatening allergy while at school. Instructions for
More informationOverview and Useful Contacts (Bees EBD) The scheme of work and resources within this zone cover the theme of Beekeeping.
Theme/Zone Identified Overview and Useful Contacts (Bees EBD) The scheme of work and resources within this zone cover the theme of Beekeeping. Key Stage This zone is applicable to Key Stage 4. Ability/NC
More informationEMERGENCY SCREENING PLEASE PROVIDE US THE REASON FOR YOUR VISIT TODAY. Date of Birth: Is today s visit related to work place injury?
EMERGENCY SCREENING Welcome to MedStar PromptCare. In order to provide the very best care for you and also protect your privacy, we ask that you complete this form immediately upon presentation to the
More informationRecognize Anaphylaxis Symptoms
Recognize Anaphylaxis Symptoms File: JHCD-F1 Recognize the Common Anaphylaxis Symptoms Sudden difficulty breathing, wheezing Hives, generalized flushing, itching, or redness of the skin, Swelling of the
More informationANAPHYLAXIS POLICY & PROCEDURES
PHOENIX P-12 COMMUNITY COLLEGE ANAPHYLAXIS POLICY & PROCEDURES Policy Statement Anaphylaxis is a severe, rapidly progressive allergic reaction that involves various areas of the body simultaneously and
More informationGET TRAINED. A program for school nurses to train school staff to administer epinephrine using an auto-injector
GET TRAINED 2015 A program for school nurses to train school staff to administer epinephrine using an auto-injector Get Trained 2016 Updates Information in this presentation was reviewed and updated in
More informationMedical Advisory Committee. Run Review
Nor Cal EMS Medical Advisory Committee Run Review September 2014 Eric M. Rudnick, MD, FACEP, FAAEM Medical Director Northern California EMS September 9, 2014 1 Case #1 Dispatched for a male with chest
More informationALLERGY QUESTIONNAIRE
ALLERGY QUESTIONNAIRE CLIENT INFORMATION Today s Date: Date of Birth Name: Address City State Zip Home Phone: Work Phone Cell /Pager: Age Male Female Email address Marital Status: Married Single Divorced
More informationPackage leaflet: Information for the patient. Vertigon 8 mg Tablets Vertigon 16 mg Tablets (betahistine dihydrochloride)
Package leaflet: Information for the patient Vertigon 8 mg Tablets Vertigon 16 mg Tablets (betahistine dihydrochloride) Read all of this leaflet carefully before you start taking this medicine because
More informationMonthly Safety Meeting. 25 September 2014 Please sign roster
Monthly Safety Meeting 25 September 2014 Please sign roster Before we begin Please sign the safety meeting roster Used to log safety currency in eservices Safety currency necessary for participation in
More informationMedical Questionnaire
MEDICIS Health Testing Center Avenue de Tervueren 236 115 Bruxelles Tel : 2/762.5.44 Medical Questionnaire Name :. Maiden name : First name :. Sex :. Address :...... Phone (private) : Office :. Date of
More informationAlka-Seltzer Plus Multi-Symptom Cold Day & Night Effervescent Tablets
Do not take these products at the same time. Alka-Seltzer Plus Multi-Symptom Cold Day Effervescent Tablets Drug Facts Active ingredients (in each tablet) Purposes Aspirin 325 mg (NSAID)*...Pain reliever/fever
More informationNOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction. USE EPINEPHRINE.
Name: Allergy to: Weight: D.O.B.: lbs. Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No PICTURE NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction.
More informationNew Patient Questionnaire. Today s Date: Date of Birth: Name: Home Address: City: State: Zip: Home Phone: Work Phone: address: Referred by:
Pamela A. Pappas MD, MD(H) Classical Homeopathy for Mind, Body, and Soul 8114 E. Cactus Rd., Suite #240 Scottsdale, Arizona 85260 Phone: 480.656.9218 Fax: 602.626.3695 E-mail drpam@drpampappas.com New
More information