( PLUM BOROUGH SCHOOL DISTRICT

Transcription

1 No ( PLUM BOROUGH SCHOOL DISTRICT SECTION: PUPILS TITLE: FIRST AID STANDING ORDERS ADOPTED: March 27,1990 REVISED: February 27, FIRST AID STANDING ORDERS 1. Guidelines When a student comes to the health room, always check the medical problem list and the Emergency Care Card for allergies and/or medical problems. Skin Wounds For cuts, abrasions, scratches - cleanse the wound with soap and water to remove dirt, then apply dry dressing as needed. In deciding when a cut needs further medical attention, consider the following: 1. If cut is on the face, suturing more likely for better closing results, have checked by a physician. 2. If cut is on the hand, finger, elbow, knee, or any joint area where constant motion could tear it open, stitches more likely necessary. 3. If wound is gaping, bleeding actively, has fat visible or is greater than 112 inch long, it probably requires stitches. 4. If wounds involve a deep puncture or impacted debris, the wound should be checked. AL WAYS VERIFY DATE OF TETANUS BOOSTER WITH ANY SIGNIFICANT BREAK IN THE SKIN AND NOTIFY PARENT IF IMMUNIZATION IS CLOSE TO EXPIRATION. (DT IMMUNIZATION EFFECTIVE FOR 10 YEARS FOR CLEAN WOUNDS AND 5 YEARS FOR "DIRTY WOUNDS"). Burns 1. First degree burns - Apply cool water until pain is relieved. Dry area. Apply loose dressing if needed. Page 1 of 6

2 FIRST AID STANDING ORDERS - Pg Second and third degree burns - Cool all areas first with cool water. Dry area. Apply dry sterile dressing. Elevate extremity. Notify parent to arrange for further medical treatment. 3. Chemical Burns - Acid or Alkaline - Flush skin immediately with copious amounts of running water for minutes. If pain persists, continue to flush with water. Call poison center and parent. Eye Injuries 1. Foreign bodies in the eye may be removed with a cotton applicator soaked in water or the eye may be irrigated with tepid water for minutes. If child continues to complain of pain, sandy or scratchy sensation, notify parent to seek further treatment. 2. Chemicals in the eye - Irrigate immediately with tepid water for minutes. If there is still pain or visual disturbance following this, cover both eyes, call parent to arrange further care. 3. Penetrating eye injury - Do not attempt to remove impaled object from the eye. Cover both eyes, being careful to secure the impaled object and preventing its movement during transportation to a medical facility. Asthma Exacerbations 1. Use inhaler (betal agonist, such as Proventil, Ventolin, MaxAir, Rotacaps, or albuterol) as prescribed by private physician. Contact parent and send home if no relief from initial use of inhaler. 2. If no relief from initial use of inhaler and parent not yet arrived for student, use inhaler again 20 minutes after initial dose. This may be repeated again. No more than three doses given over one hour period. Muscle Sprains and Strains 1. RICE Therapy (REST - ICE - COMPRESSION {Nurses only to apply ACE bandage} - ELEVATION). Notify parent. 2. Minor neck muscle injury - Apply ice. Notify parent. Page 2 of6

3 FIRST AID STANDING ORDERS - Pg. 3 ( Fracture or Suspected Fracture 1. Immobilize with a splint. The joint above and below the fracture site must be immobilized before the person is transported to avoid further injury. If splint is unavailable, fashion one with magazines or rolled up newspaper. Nosebleed 1. Head forward, pressure to nostril for 8-10 minutes. If clot is present and bleeding continues, have student blow nose and reapply pressure. If bleeding continues, cannot be stopped, and is running down back of throat, call parent and arrange for further treatment. 2. If a head injury is suspected with a nosebleed, do not attempt to stop the bleeding and seek further medical help immediately. Bee Stings/Insect Bites/Allergic Reactions 1. Immediately check for known history of allergies and if EpiPen, or bee sting kit is prescribed for the student. Any symptom of systematic reaction, ADMINISTER EpiPen IMMEDIA TEL Y. Seek immediate medical attention and contact parent. 2. If student with unknown history of allergy presents with systematic or anaphylactic reaction, administer EpiPen and/or Benadryl as per package directions as indicated. Seek immediate medical attention, and contact parent. 3. If stinger is present, scrape off with gloved fingernail. 4. Wash with soap and water. 5. Apply ice to control pain. Headache or Discomfort 1. Check temperature. Check to see if student has a history of migraine or other related health problems. 2. If no fever is present, allow student to rest, apply ice pack to head if desired. 3. Administer medication as ordered by private physician. Page 3 of6

4 FIRST AID STANDING ORDERS - Pg SENIOR HIGH ONLY: Administer acetaminophen as per package directions with parental permission on Emergency Care Card. Skin Rashes 1. If itchy, apply RhuligellRhulcream, or Caladryl cream. 2. If impetigo, apply Bacitracin pm to wound. Cover with dressing. If area is oozing, contact parent and send student home. 3. If contagious disease apparent (scabies, lice, strep scarlatina, etc.) call parent and send student home. 4. If rash covers a large area of the body, call parent and send student home. Stomach/Sore ThroatlEarache 1. Always check medical history - First Aid Card - for pertinent background information. 2. Check temperature. If student has a fever 99.8 F or above, call parent and send home. If no fever is present, allow parent to make decision as to whether or not the student will remain in school. 3. NEVER apply heat for undiagnosed abdominal pain. May use heating pad for menstrual cramps. 4. With parental permission on the Emergency Care Card, administer: a. SORE THROAT/Cough - throat lozenges (lpm). Elementary students must remain in nurse's office while sucking on lozenges. b. STOMACH ACHE: antacid tablets 1 pm. 1. Elementary students: Temperature over F, with parental consent, give acetaminophen according to dosage chart, and send student home. 2. Secondary students: Temperature over 99.8 F, with parental consent, give acetaminophen 650 mg. for students over 100 pounds. Page 4 of6

5 FIRST AID STANDING ORDERS - Pg. 5 ( Mouth Injuries 1. Avulsed tooth - If the tooth is dirty, rinse it gently in running water. Do not scrub it. If student is old enough, place tooth between cheek and gum. If not, place the tooth in a "Save a Tooth" kit. Notify parent that student must go to the dentist immediately. 2. Fractured tooth - Clean injured area with warm water. Place cold compress to minimize swelling. Notify parent that student must go to the dentist immediately. 3. Injured tongue or lip - Apply direct pressure to the bleeding area with a clean gauze. Apply cold compress. 4. Suspected Fracture Jaw - Immobilize the jaw by any means. Apply cold compress. Notify parent and seek immediate medical attention. Poisoning 1. Conscious student: Attempt to identify nature and amount of substance consumed. Save vomit for analysis. Call Poison Control Center (412) Treat poison as directed by Poison Control Center. If Ipecac is ordered, use entire 1 ounce bottle and follow with 2 large glasses of water. 2. Unconscious student: Do not give Ipecac. Maintain airway, CPR. Seek immediate medical attention. Head Injuries 1. Observe for state of consciousness: unequal pupil size, nausea, pulse rate. 2. Suspected skull fracturelbrain injury: Do Not Move the Student. Seek medical attention immediately and notify parent. 3. Scalp laceration: Wash with soap and water. Direct pressure to the area. Apply ice compress. Use dry dressing. Seizures 1. Do not restrain student. Clear area and gently guide student to the floor. 2. Do not force anything between hislher teeth. 3. Tum hislher face to the side, and make sure breathing is not obstructed. Page 5 of 6

6 FIRST AID STANDING ORDERS - Pg Observe details of the event. 5. Allow student to rest. Notify parent. 6. Seizures lasting more than 10 minutes require immediate medical attention. Human Bites 1. Wash with soap and warm water. 2. Irrigate with saline solution. 3. Cover with antibacterial ointment (if not allergic) and a dry dressing. 4. Call parents of victims and perpetrator. Suggest that victim's parents consult PCP to consider oral antibiotics. AMBULANCE (412) PITTSBURGH POISON CENTER (412) Page 60f6