Blood Borne Pathogens, EPIPEN and First Aid Inservice

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Blood Borne Pathogens, EPI-PEN and First Aid
In-service

• Instructor
• Rhonda Sexton, RN
• School Nurse-Teacher

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INTRODUCTION

• Rhode Island State Law mandates annual training
  in the following
• Blood Borne Pathogens/Universal Precautions
• EPI-PEN administration
• One hour of Basic First Aid Training Provided
  for school personnel who might be involved in
  managing an injury or medical emergencies.

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Record Keeping

• After completing In-Service EVERYONE must fill
  out the pink form.
• After presentation, please return SIGNED forms
  to me.

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Blood Borne Pathogens Disease causing germs
found in the blood.

• The Occupational Safety and Health Administration
  (OSHA) has issued a standard that requires
  employers to protect their employees from
  exposure to blood borne pathogens.

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What types of pathogens are found in the blood?

• Hepatitis B Virus Can live on inanimate objects
  for at least 7 days.
• HIV--(Human Immunodeficiency Virus)
• Virus is unstable outside of the body.

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Workplace Transmission

• Blood borne pathogens can be transmitted by
  direct entry into your body through open cuts,
  abrasions, acne or skin rashes.
• Blood borne pathogens can also be transmitted
  indirectly when you have touched a contaminated
  object and transferred the pathogen to your
  mouth, eyes, nose, or open skin.

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UNIVERSAL PRECAUTIONS

• Defined as a method of infection control.
• It considers every individuals blood and body
  fluids as potentially infectious.
• Body fluids include blood, drainage from
  scrapes and cuts, feces, urine, vomit, semen,
  respiratory secretions and saliva.

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What precautions do you take to protect
yourself from disease transmission?

• Avoid Contact with Blood and Body Fluids!

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How do you protect yourself?

• Disposable gloves

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Use protective equipment when necessary.

• Masks
• Goggles
• Masks and goggles are available in the health
  room.

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Protective Equipment

• Breathing barriers (found in health room and in
  AED cases)

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Protect Yourself..

• Place barrier between you and blood/body fluids
• (Ex. Have person use their own hand,
  towel/clothing, etc.)
• Wash hands immediately after giving care using
  soap and warm water
• Use disinfectant wipe, if unable to wash hands.
  Then wash as soon as possible

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What else do you do?

• Disposable gloves and contaminated materials need
  to go in a red biohazard bag.
• Use sharps container for sharp objects (In
  nurses office).
• If you have a blood or body fluid spill, call
  maintenance to immediately clean the area.
• Keep students away from contaminated areaCall
  for administrative assistance if needed.
• If clothing becomes contaminated, it should be
  placed in a red biohazard bag.
• Refer all students to health room if their
  clothing becomes contaminated (ie. bloody nose,
  vomiting, etc.)

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What do you do if you are exposed to blood borne
pathogens while at work?

• Report incident to administrator. Incident
  report needs to be filled out by the school
  nurse. Follow-up care will be necessary.

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Hepatitis B Vaccine

• All Category I Employees are offered the vaccine
  free of charge.
• Category I Employees
• School Nurse Teacher
• Custodial Staff
• Self-Contained Special Education Teachers
• Teacher Aides

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Glove Demonstration
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EPI-Pen In-Service

• What is Anaphylaxis?
• What are the signs and symptoms of Anaphylaxis
• What are some common causes of Anaphylaxis?

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Peanut Policy RI Laws

• Law
• Policy
• Emergency Health Care Plans
• Changes for LHS Peanut/Tree Nut free table in
  cafeteria, Peanut/Tree Nut free desk/chair in
  classroom Designated Peanut/Tree Nut free
  classrooms.

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How to use an EPI-PEN

• If an EPI-Pen is given, what has to be done?
• Would you know how to do this?
• Demonstration

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Good Samaritan Laws

• The Good Samaritan is required to us common
  sense and a reasonable level of skill, not to
  exceed the scope of the individuals training in
  emergency situations.

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Questions?

• First year teachers will also need to view video.
  Please see me at your earliest convenience.
• My website has all of this information plus more!

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H1N1 (Swine Flu)

• General information
• Recommendations from CDC RIDOH
• What can you do?

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Basic First Aid

• Definition First aid is the temporary and
  immediate care of a person who is injured or ill.
• Purpose
• To save life
• Prevent further injury
• To relieve pain

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What you need to know.

• Before providing first aid to a victim, the
  victim must consent to the following
• Who you are, what you plan to do, what training
  you have.
• If victim is unconscious, you have implied
  consent
• If victim is a child (under 18) without parent
  present, you have implied consent

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What to do..

• Remember, any information discovered during first
  aid treatment is confidential.
• Check the scene for safety---Could there be
  invisible hazards? (ie. Electric, Gas, etc.)

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Recognizing Emergencies

• Use your senses.
• Hearing-Unusual noises
• Sight Unusual sights
• Smell-Unusual odors
• Is the student demonstrating unusual appearances
  or behaviors?
• FYI
• (If you suspect alcohol/drug use-the student
  needs to be evaluated by the nurse)let an
  administrator know immediately.
• http//www.nwnc-redcross.org/RecognizingEmergencie
  s.htm

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Activating the EMS system

• Do you know how to call for emergency services?
  (Important to know, especially on field trips)
• Any time an EPI-Pen is given 911 has to be
  called.
• Life threatening Emergencies Unconscious, No
  breathing or breathing in a strange way, No
  heartbeat, severe bleeding

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Minor Wounds

• If someone is bleeding, what do you do?
• Put on gloves if available.
• Small wounds are cleaned with soap and water
• Place a clean gauze pad over the wound and apply
  pressure. If the student is alert, have the
  student perform these steps. If you do not have
  gloves, have the injured person hold the gauze.

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Major Wounds

• What is a Major Wound?
• Punctures, gashes, loss of skin tissue, bleeding.
• Do not wash Major woundsCall for help
  immediately
• Apply direct pressure to wound, (Remember
  Universal Precautions) DO NOT USE TOURNAQUETTE!!!
• Penetrating woundsDo not remove object-Call for
  helpThis is an emergency.

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Burns

• Minor BurnsRun cool water over the burn, or soak
  in cool water for at least five minutes
• Send to health room for evaluation.
• Do not put lotion or ointment on the burn
• Chemical burn-flush skin with water-call for help.

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EYE INJURIES

• All Eye injuries need to be evaluated by the
  school nurse.
• Do not rub, touch or press the eye. (Explain
  this to student)
• Minor eye irritations can be treated by flushing
  the eye.
• Do not attempt to remove foreign body
• For chemical injuriesIrrigate eye-flush with
  water-call for nurse immediately.
• Penetrating eye injuries sudden acute eye pain
  sudden loss of vision Chemical burns---All
  require immediate attention and are considered
  emergencies!

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Seizures. What do you do?

• Call for help.
• Gently place student on floor, remove nearby
  objects.
• Loosen clothing around head and neck
• Place soft cloth/cushion under head.
• Do not try to prevent the child from shaking
• Do not put anything in the childs mouth
• Fluid/vomit in mouth-Roll the child onto his/her
  side.

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Head, Neck and Back Injuries.

• If a head/neck or back injury is suspected---
• DO NOT MOVE VICTIM!
• The only time that a victim is to be moved,
• is if a life is in danger. (Move using clothing
  drag)
• If a student falls
• Call for help.
• Have the victim remain in the position that you
  found him or her in.

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The Clothes Drag
American Red Cross
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Head Injuries

• All head injuries must be evaluated by the school
  nurse.
• Do not move student if he/she complains of neck
  pain or vision changes, or loss of consciousness.

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Signs of a concussion

• Nausea
• Vomiting
• Severe headache
• Lethargy, Increased sleepiness

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Diabetes

• What is diabetes?
• Diabetes is a chronic disease. In Type 1
  Diabetes (Insulin-dependent), the pancreas does
  not produce insulin, a hormone necessary to
  transport glucose into the bodys cells.
• Symptoms
• Frequent urination
• Increased hunger or thirst
• Unexpected weight loss
• Irritability
• Weakness and fatigue
• Treatment Insulin injections.

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Type 2 Diabetes

• Type 2 diabetes was previously called
  non-insulin-dependent diabetes mellitus (NIDDM)
  or adult-onset diabetes.
• Begins as insulin resistance, a disorder in which
  the cells do not use insulin properly. As the
  need for insulin rises, the pancreas gradually
  loses its ability to produce insulin. Type 2
  diabetes is associated with older age, obesity,
  family history of diabetes, history of
  gestational diabetes, impaired glucose
  metabolism, physical inactivity, and
  race/ethnicity.
• Type 2 diabetes is increasingly being diagnosed
  in children nd adolescents.

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A student in my class has diabetes..
What do I need to know?

• The emergency situation you may encounter is low
  blood sugar (Hypoglycemia), also known as an
  insulin reaction.
• Causes of Hypoglycemia Too little food, too
  much insulin, too much physical activity without
  eating.

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What are the symptoms of hypoglycemia?

• Headache
• Sweating
• Shakiness
• Pale, moist, cold and clammy
• skin
• Extreme hunger
• Weakness/dizziness
• Fatigue
• Rapid pulse rate
• Blurred vision
• Shallow breathing
• Inability to concentrate
• Loss of coordination
• Mental confusion
• Seizure
• Loss of consciousness

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Goal is to treat Symptoms early!

• Students with diabetes are generally able to
  detect changes in their blood sugars.
• If a student appears lethargic, not acting like
  his/herself call for nurse.
• If a student states they Feel Low-Allow to
  have juice/snack (If available) and send to nurse
  with escort.
• If juice/snack not available, send to nurse with
  escort.
• Safety is the number one priority.

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What else do I need to know?

• Students with diabetes may need to snack during
  the school day (especially before/after physical
  education classes).
• They also need to keep hydrated, and need to
  carry water with them if needed.
• No restrictions on activity.
• Please do not call attention to special
  accommodations.
• Treat the child normally.
• If blood sugars are low or high, the student may
  not perform well on tests.
• Students may test their blood sugar in class-
  They are instructed on proper disposal of
  sharps/precautions. There is minimal bleeding.
• Allow students to go to health room as needed
  delay in treatment can be dangerous.

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What is high blood sugar?

• Hyperglycemia---Blood sugar is elevated/
• Causes---Too much food, too little insulin,
  illness or stress.
• Onset is gradual.
• Symptoms Extreme thirst, frequent urination,
  dry skin, hunger, blurred vision, drowsiness,
  decreased healing.

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AEDAutomated External Defibrillator

• Locations
• Health Room
• North Wing
• Hallway outside of auditorium
• Across from Gymnasium doors
• Hallway between old and new cafeteria

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AED Policy

• Staff need to be aware of locations AED.
• If you are CPR/AED certified and wish to be on
  the building responders list, please see me. List
  of responders is located in communications
  center, main office, health room, and
  principal/vice principals office.
• First Responders
• Back up first Responders.
• Person to bring second AED

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Other Important Stuff

• CPR certificationforms need to be filled out.
  Available online.
• CPR class September 26, 2009, 11am-2pm (Date
  changed).
• Web sitehas all info and power point slides.
  Please check periodically. Good resources.
• Staff health concerns (forms availablesee me)
• Student health concernsI will let you know via
  email, when the health concerns will be ready.
• Proper disposal of old ones. Will collect at end
  of the year.
• Emergency cards and yellow medication
  sheets-Please return to health room
• Faculty Flu clinic September 21, 2009 fro 130
  pm-3pm.
• Community Flu Clinic October 24, 2009 9am-12pm at
  LHS
• Student Flu clinics-at LHS Date TBA
• 9th Grade Vision Screening--September 9, 2009
• Field Trip information

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Thank You!!!

• Have a great year!!