KNOW SICK WHEN YOU SEE IT, AND ACT

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KNOW SICK WHEN YOU SEE IT, AND ACT IF IT DOESN T SEEM RIGHT, IT PROBABLY ISN T WHEN IN DOUBT, TRANSFER OUT Screen clients at check-in time: Do you have a sore throat or a cough and fevers? Do you have any spots or a rash on your body? Shortness of breath? Severe vomiting? If a client s behavior or health does not seem normal to you, that s a good enough reason to look for medical care for that person. Help arrange for clients to see a Medical Provider as soon as possible if you think they are sick. Don t hesitate to call 911 if your gut tells you to. Clients may refuse to go in the ambulance, but they can t refuse your decision make the call.

GET CLIENTS THE CARE THEY NEED HEALTH CARE IS A RIGHT, NOT A PRIVILEGE CHECK THIS OUT In the US, the average age of death is 77 years. For someone homeless in SF it s age 43. There are many clinics in SF that serve homeless and uninsured clients. YOU can save a life by getting a client into Primary Care (a place where they can get their own regular doctor). If they are sick today but don t need an ambulance, send them to an Urgent Care Clinic (a drop in clinic where they can be seen the same day). Your Shelter should have a Referral Folder for Primary and Urgent Care Clinics that you can send clients to. These include maps and hours of operation. Ask your supervisor if you don t have one handy.

WASH YOUR HANDS OFTEN AND HIT THAT HAND SANITIZER! REMIND OTHERS TO WASH THEIR HANDS AND TO HIT THAT HAND SANITIZER TOO! Washing your hands a lot prevents you and everyone around you from getting sick. HERE S HOW TO WASH YOUR HANDS: 1. Lather your hands and rub them together for at least 20 seconds (that means singing the Happy Birthday song twice). 2. Dry them with a paper towel and use the paper towel to turn off the water and to open the door on the way out. Hand sanitizer is a very good substitute for soap and water, unless you can see dirt on your hands. Use it every time you walk in and out of the shelter.

USE PERSONAL PROTECTIVE EQUIPMENT THAT MEANS GOWNS AND GLOVES Gloves and gowns are personal protective equipment, and are available for your use. If you are handling the 3 P s: PEE, PUKE or POOP and of course BLOOD, gown and glove up. If you are handling a clients belongings or bedding, you should wear gloves too. And remember!! Wash your hands after removing gloves. Review that hand-washing page again, ok? HELP OTHERS USE IT TOO

BUGS (AND GERMS) YOU NEED TO KNOW THE FOLLOWING PAGES BREAK IT DOWN FOR YOU Many bugs and germs can spread from person to person. Washing hands Covering coughs Treating every client the same Using gloves and gowns Cleaning or bagging clothes and belongings Will prevent the spread of bugs and germs.

A RASH IS NOT A REASON TO BAR A CLIENT FROM SHELTER IF YOU SUSPECT THE CLIENT HAS BUGS (It can be kinda freaky) but, DON T BUG OUT! The following pages will help you chill out and get clients the help they need PEOPLE NEED SHELTER TO GET RID OF BUGS Have a doctor check it out within 36 hours. Sharing Is Not Caring: Help clients contain their stuff and not share clothes, hats or bedding. Have clients wash everything they can and bag everything they can t. Prevent the spread by avoiding skin contact. Make showers available especially during medical treatment.

BUGS YOU SHOULD KNOW HEAD LICE & BODY LICE HEAD AND PUBIC LICE DON T CARRY DISEASES. BODY LICE CAN MAKE YOU SICK (BUT VERY RARELY). PEOPLE NEED SHELTER TO GET RID OF BUGS. THE ILLNESSES: HEAD LICE AND BODY LICE THE BUG: Head lice live on hair. Body lice live on clothes. Pubic lice live on pubic hair. HOW THE BUG SPREADS: Sharing clothes, headgear, brushes, unwashed linens. Pubic lice spread through sexual contact. HOW TO PREVENT SPREAD: Gloves and Gowns when changing bed linens. Bag belongings. Wash belongings and dry in a hot dryer for 1 2 hr. Make showers, laundry and plastic bags available to people undergoing treatment for lice. MEDICATION: Creams or shampoos prescribed by a doctor. EXTRA HELP: Let clients with head lice have a private space with a mirror to comb out lice nits between treatments. Especially families!

BUGS YOU SHOULD KNOW SCABIES ITCH LIKE CRAZY PEOPLE NEED SHELTER TO GET RID OF BUGS. THE ILLNESSES: SCABIES THE BUG: A tiny bug you can t see that infests the skin. It can live for 24 to 36 hours off of skin. HOW THE BUG SPREADS: Skin-to-skin contact. It s possible but uncommon to get scabies from heavily infested clothing or linens. HOW TO PREVENT SPREAD: Avoid skin-to-skin contact with a person who is itching. Bag belongings. Wash belongings and dry in a hot dryer for 1 2 hour. Use gowns and gloves when changing bed linens. Make showers, laundry and plastic bags available to people undergoing treatment for scabies. MEDICATION: Creams to kill them and pills to stop the itching, prescribed by a doctor. You can still itch for a while even after treatment.

BUGS YOU SHOULD KNOW BEDBUGS DON T CARRY DISEASES THEY JUST BUG YOU THE ILLNESSES: BEDBUG BITES THE BUG: A tan/brown bug about the size of a sesame seed that lives in cracks and crevices in a room. It tends to bite at night. HOW THE BUG SPREADS: Bugs hitchhike into the shelter in client s belongings (not on their bodies). Encourage clients to self inspect their belongings/luggage upon entering shelter. HOW TO PREVENT SPREAD: Bag belongings. Wash belongings and dry in a hot dryer for 1 2 hr. Bedbugs must be exterminated by a licensed pest control operator. Get educated on what bugs look like and where they live. Report any concerns to a supervisor. NEVER LET CLIENTS BRING FURNITURE INTO THE SHELTER. MEDICATION: Creams or pills to control itching from bites.

BUGS YOU SHOULD KNOW M.R.S.A. (pronounced MERSA ) METHICILLIN RESISTANT STAPH AUREUS ANOTHER REASON NOT A REASON TO BAR SOMEONE FROM SHELTER THE ILLNESSES: MRSA THE SYMPTOMS: Painful red sores with puss in them, possibly fevers THE GERM: A bacteria that many of us carry on our skin already, and can cause problems if it gets under our skin SPREAD: Unwashed hands HOW TO PREVENT SPREAD: Wash hands! Refer clients to a medical provider if they have cuts or a rash or oozing sores. If a client has open cuts or sores they should be covered. Always cover your own cuts and yes, once again, WASH YOUR HANDS OFTEN. MEDICATION: Specially prescribed antibiotics MRSA is treatable...

COVER YOUR COUGHS AND SNEEZES WITH YOUR ARM OR ELBOW Get in the habit of coughing and sneezing into your arm or elbow. It s like wearing a seat belt; you will soon do it naturally. Coughing or sneezing into your hands is grosser than spitting on them. Airborne Illnesses are germs that spray into the air. If they hit a hard surface like your arm they will probably die. REMIND OTHERS TO DO THE SAME

BUGS YOU SHOULD KNOW COLD & FLU FLU SHOTS PREVENT THE FLU. REALLY. THE ILLNESSES: Cold, Flu THE SYMPTOMS: Coughing, sneezing, fevers, feeling tired THE GERMS: Viruses that infect the nose and lungs SPREAD: Coughs, sneezes, and unwashed hands HOW TO PREVENT SPREAD: Cover coughs and sneezes, wash hands MEDICATION: Usually none, unless it s very serious. Antibiotics won t help! If you notice a lot of people in one area that are sick, contact your supervisor who can refer to the ATD Guidelines for Shelters.

BUGS YOU SHOULD KNOW TB TUBERCULOSIS THE ILLNESSES: TUBERCULOSIS (TB) THE SYMPTOMS: Coughing, fevers, feeling tired, losing weight, soaking sweats at night THE GERM: A bacteria that can infect any part of the body, but usually likes the lungs SPREAD: Cough HOW TO PREVENT SPREAD: Keep client s TB clearance up to date (that s yearly) Get a TB test for yourself every year And... cover coughs! MEDICATION: Specially prescribed antibiotics taken over months

KINDNESS SPREADS AND THAT S THE GOOD KIND OF CONTAGIOUS Living in a shelter isn t easy. Working in one isn t either. When you treat people with respect, genuine concern and a little good humor you have not only created a better environment for the client but also for yourself and other staff. But you already knew that. If you re feeling stressed at work, talk to your supervisor.