First Aid Procedures The procedures outlined recognise that the Anti Discrimination Act 1991 prohibits discrimination on the basis of medical

Transcription

1 First Aid Procedures The procedures outlined recognise that the Anti Discrimination Act 1991 prohibits discrimination on the basis of medical impairment. First Aid Services - Determination a. The First Aid Officer should ensure that an assessment is conducted at regular intervals (at least annually, or more frequently where it is determined that changes at the workplace may impact on first aid needs) to determine the adequacy and appropriateness of existing first aid facilities in the college or workplace. b. As the requirements of this college/workplace may be different, a number of factors should be taken into account when determining adequate and appropriate first aid services for our college/workplace. These include: i. number and distribution of employees, students and regular visitors at the college or workplace; ii. iii. iv. location and/or isolation of the college or workplace; size and layout of the college or workplace; number of sites; v. availability of emergency services; vi. types of incident, illness, and injuries to which employees, students and visitors may be exposed; vii. any particular circumstance or activity that would increase or decrease the risk of injury of individuals at the college/workplace; and viii. the number of staff and students who have medical conditions which may require health services at regular intervals and for monitoring of illness and/or medical conditions while in the college or workplace. c. The factors listed in point six above may be determined by: i. conducting walk through surveys; ii. reviewing incident, accident and injury or illness data; iii. evaluating work processes, other activities and product information; and iv. consulting with employees. 3. First Aid Personnel a. Selection When selecting personnel for first aid training, the college may consider: i. the employee's personal skills, characteristics and physical capacity, including reliability and ability to remain calm in an emergency; ii. the employee's commitment to the role of first aid personnel; iii. the employee's availability to provide first aid services during regular client-service hours; and iv. the work areas that have been assessed as having a large number of hazardous activities (eg. physical education, sporting competition, manual arts, home economics). b. Responsibilities i. Provide initial care of ill or injured employees and others by rendering first aid

2 ii. treatment in accordance with their approved training, and where appropriate, recommending to principals or managers that additional medical advice is needed; Adequately supervise the casualty until no further treatment or assistance is required or until the casualty is handed over to ambulance or medical personnel or the parent or guardian; iii. Adhere to adequate and appropriate infection control procedures in the performance of their duties; iv. Arrange for regular checking of contents of first aid kits including USE BY dates, and for stocks to be replenished at regular intervals. This requires the First Aid Officer to: 1. record first aid treatment; and 2. report any hazard or incident to the college Workplace Health and Safety Officer, and the principal. First aid personnel must respect the confidential nature of any information provided during the course of any first aid treatment. Disclosure of personal information without that person's written consent is unethical. v. First aid personnel should remain in their role until: c. Training 1. expiry of person's current certification; 2. the person voluntarily relinquishes the role; or 3. advised by the principal that their services are no longer required. i. A variety of first aid accreditations are available from first aid training organisations approved under the Ambulance Service Act ii. The minimum level of training required for first aid personnel is a Senior First Aid Certificate. The minimum duration of a Senior First Aid Certificate course is 18 hours. iii. First aid certificates are only valid for a determined period, usually three years. The validity of some first aid certificates may also be subject to specific requirements (eg. refresher courses or evidence of proficiency in cardiopulmonary resuscitation). Therefore appropriate arrangements should be made to ensure certification is renewed prior to expiry. iv. The college should determine funding arrangements for accredited first aid training courses. d. Numbers i. A risk assessment of the provision of adequate first aid services will assist the principal to determine the minimum number of first aid personnel. This should be undertaken by, or in conjunction with the college Health and Safety Committee. ii. The number of first aid personnel for this college should be determined by the number of students enrolled in the college. iii. This college/workplace may choose to train a greater number of first aid personnel. It is the First Aid Officer's responsibility to act quickly, calmly and correctly in order to preserve life, prevent deterioration and promote recovery. First Aid Facilities 1. First Aid Kits a. The First Aid Officer may determine the first aid kit requirements by assessing at

3 regular intervals the first aid needs of the college or workplace. Number i. The college should keep a minimum of one main first aid kit on the premises in the first aid area, health room or equivalent. At least six smaller, portable first aid kits and two camp kits should be kept for college excursions and other variations of college routine. ii. iii. Contents Non-college locations should have a minimum of one main first aid kit/camp kit. First aid kits should be clearly identified by a suitable sign or label. i. The contents of first aid kits should match the types of injuries and illnesses likely to occur in the particular educational setting and the number of students and staff. The following table provides the minimum requirements for the main first aid kit. Smaller, portable first aid kit/s may be stocked according to the particular assessed needs. MINIMUM REQUIREMENTS FOR SCHOOL'S MAIN FIRST AID KIT Eye pads, sterile Sterile gauze pieces Disposable gloves Adhesive tape Burn dressings, dry, non adhesive, small Saline eye wash solution, 100ml single use Assorted bandages Burn dressings, dry, non adhesive, large Aluminium foil blanket, 1.3m x 2m Antiseptic solution Triangular bandages (cotton) Disposable drinking cups Inhaler (asthma) Elastic dressing strips Resuscitation mask Ice packs Adhesive dressing strips (bandaids) Spacer - for asthma medication (portable) Panadol Scissors, stainless, 12.5cm, sharp end, angle type Disposable Splinter removers Sanitary supplies Safety pins, assorted sizes Plastic bags (med size) for depositing waste Medicine cup Portable stretcher Anti-bacterial solution Tweezers Cotton tips Bite/sting cream Tissues Sterile combined pressure dressings Cotton balls Thermometer First aid pamphlet or booklet Vomit powder ii. Examples of circumstances where additional first aid kit contents should be considered. The following table provides a guide to additional contents needed to match the types of injuries and illnesses likely to occur in the particular educational setting. TYPE OF HAZARD ADDITIONAL CONTENTS COMMENTS BURN INJURIES Heat Flammable liquids Corrosive chemicals Non-ionising radiation (eg. ultraviolet light) EYE INJURIES All eye injuries Burns dressings (assorted sizes) eg. Science, Home Economics Technology Centre Sterile eye pads and non-stretch adhesive tape Cold water and clean sheeting should be available Injured eye should be covered prior to medical treatment Disposable eye wash (at least 100mls) MUSCULOSKELETAL INJURIES Sporting activities Ice packs For bruising or swelling

4 REMOTE LOCATIONS/CAMPS Distance from medical assistance/camp Broad crepe bandages Large burns sheet Thermal blanket Torch/Flashlight Note pad & pencil For snakebites For covering burn areas For treatment of shock (also for assisting portability) For night use, attracting attention For recording the injured or ill person's condition and treatment to be given iii. The First Aid Officer should arrange for: 1. shelf life of contents, where applicable, to be kept current; a. prescribed medication to be kept in a secure place and not in the first aid kit; and b. the contents of first aid kits to be used only for the rendering of first aid. 2. Officers should refer to current guidelines for the administration of medication as described in section 9 of this policy. 3. A list of contact telephone numbers for the nearest ambulance service, the Poisons Information Centre and other emergency services should be kept with the first aid kit. 2. First Aid Station and Sick Room a. Areas should be designated as the first aid station and the sick room which should be clearly identified. b. The sick room should have adequate lighting and ventilation and have sufficient space for a couch. c. All surfaces should be easy to clean, and be as close as possible to toilets and a telephone as well as hot and cold water. iii. Contents and/or Equipment The following provides a guide to requirements for furniture and other facilities in the first aid area/s. HEALTH ROOM AREAS - SUGGESTED CONTENTS 1 Bed, couch, plinth or examination table 2 Comfortable chair 3 Dust proof cabinet for first aid stores 4 Pillow 5 Clean bed linen 6 Work bench 7 Adequate cupboard space 8 First aid text 9 Main first aid kit 10 Identified refuse container (lined with disposable plastic bag 11 Stretcher 12 Ready access to sink with running water and soap dispenser 13 Ready access to a telephone 15 Stock of Accident Report Forms Provision of Information 1. The First Aid Officer should ensure: a. all employees are informed about first aid services and facilities on commencement of

5 employment at a particular work site; and b. all employees and students are instructed in the procedures to be followed when first aid is required. 2. Information should be provided through induction training. other avenues of information provision include newsletters, notice boards and college procedure manuals. 3. The requirements of people, whose language is other than English or with different communication skills, should be recognised when providing information on first aid. Disposal of First Aid Waste 1. The First Aid Officer should arrange on a daily basis for safe disposal of waste from first aid or health rooms. Regular waste should be placed into a plastic garbage bag that is tied off before disposal in the general waste. 2. Direct handling of contaminated waste (eg. bandages, bloodstained items) should be eliminated. All first aid waste should be considered as a potential source of infection. Waste should be secured in a plastic bag that is clearly identified as BIOHAZARD prior to disposal in the general waste. Appropriate personal protective equipment should be provided, used and maintained. Record Keeping 1. The First Aid Officer should ensure records of injuries and illnesses are maintained. 2. When an accident involving a student occurs, a Student Injury/Accident Report form must be filled out by the teacher reporting the accident. The First Aid Officer should fill out Section 2 of the form. The original Student Injury/Accident Report form will be held in the Business Manager s office, a copy is filed in the student administration office on the student s file. 3. When an accident occurs involving an employee, an Incident Record/Report (Workplace Health and Safety Qld Govt) should be completed in conjunction with the Workplace Health and Safety Officer. Employees, who wish to make a claim through WorkCover Queensland, must also complete WorkCover Queensland Application Forms (see Payroll Officer). 4. An official Register for the Administration of First Aid to students/staff must be maintained and must contain a record of all occasions when medication is administered to a student/staff member. a. Each entry in this Register should be completed by the authorised person administering the first aid, immediately after the first aid is dispensed. b. Each entry in the Register should contain the following: i. the date the first aid was administered; ii. the time taken for the dispensing; iii. the name of the student/staff member receiving the first aid; iv. a brief statement of the first aid dispensed; and v. the name of the person dispensing the first aid. c. For students who require the dispensing of medications on a regular/long term basis, an additional monthly record sheet showing: i. name of student; ii. year level (grade); iii. name of medication; iv. dose given; and v. dates and time of administration, should be completed and kept for a period of no less than two years. 5. The written request from the parent/legal guardian who requested the administration of medication must be held and kept with the Register. In the case of rectal medication, details of the arrangements entered into must also be held and kept with the Register 6. In effect, the documentation referred to in 6.5 above represents an agreement among the

6 parties as to the arrangements made in respect of the administration of medication. Medical Record Information 1. For students newly enrolled, the enrolment form will contain information, which may be necessary to pass onto teachers and others, so management of any special student medical conditions may be arranged satisfactorily. Depending on any special student medical conditions, preparations/training of staff may have to be undertaken, prior to the arrival of the student. The First Aid Officer should arrange any such preparations or training. 2. A Family Medical Record Information Form will be sent home to each continuing family at the start of each year. This form details: a. family name, parents Christian names; b. contact phone numbers; c. Medicare number; d. two emergency contact persons; h. permission by parents for Panadol to be administered by first aid personnel; i. children's names; j. details of illnesses/complaints or medication (eg. respiratory problems (Asthma), blood conditions (diabetes), allergies (food, medicines, stings); and k. date of last tetanus injection. 3. A Staff Medical Record Information Form should be completed by each employee (full-time, part-time, term-time, casual). The First Aid Officer should supervise this data collection at the commencement of each new school year and for each new employee. Referral to First Aid Officer 1. Students who need to attend the First Aid area should present an appropriate form completed by the teacher referring the student. Emergencies only, will be treated by the First Aid department without a form. Asthma medication The recommended procedure is as follows: a. Parents or legal guardians provide written permission for students to administer their own medication as deemed necessary by the students. b. Students are responsible for their inhalers at all times. It is not a requirement that inhalers be stored in a central location as required for other medications. c. Students should not be denied access to their inhalers. d. An inhaler for emergency situations should be included in college first aid kits for Prep Year 12. The inhaler should not be kept beyond the expiry date. It is expected that the parents/guardians of preschool children will have given permission for the use of asthma medication for their children, when necessary. The Chief Health Officer of Queensland Health has authorised the emergency use of Salbutamol and Terbutaline for school children in years Teachers should be familiar with the common signs and symptoms of asthma. As physical activity is a trigger factor in over 80 percent of children with asthma, some students may need to use medication as a preventative measure minutes before the activity commences. If an attack seems likely during activity, the student should be allowed to stop the activity and use the inhaler. 8. Receipt of the Medication Upon receipt of the medication the First Aid Officer should count the tablets in front of another employee. Both parties should verify the tablet count and if there is a discrepancy, the parent

7 should be advised. The First Aid Officer should initial the card upon each and every administration. When a child does not receive her/his medication, the medication card should be marked with 'D.N.A." (Did Not Appear). At the end of term, the First Aid Officer should attend to an S8 drug count in the presence of another employee or in the presence of the child's parent. The tablet count is reconciled against the total tablet count at the beginning of term and the total used during the term. 10. Queensland Poisons Schedule SCHEDULE 1 Poisons SCHEDULE 2 Poisons e.g. Panadol/ Sudafed SCHEDULE 3 Poisons e.g. Teldane/ Ventolin/ Phernergan SCHEDULE 4 Restricted Drugs e.g. Insulin/ Antibiotics/ Cortisone/ Steroids SCHEDULE 5 Domestic e.g. some agricultural & industrial poisons SCHEDULE 6 Industrial / Agricultural Poisons/ some Veterinary products Sales to persons under 18 years prohibited unless by qualified persons on prescription. Records of sale are to be kept. Storage out of public access. Special pacing and labelling provisions. Warning and first aid required. Labelling and packaging requirements including warnings and first aid directions (Reg. B1-B7 and NH & MRC recommendations). Storage: inaccessible to public (Reg.C1.02 (b). Supply to minors only by medical practitioners and pharmacists (script required) (Reg.A9.01). Licence/authorisation required to manufacture or sell (Reg.A10-A15.03). Labelling and packaging requirements including warnings and first aid directions (Reg.A7.06; B1-B7 and NH & MRC recommendations). Storage: inaccessible to public (Reg. C1.02 (b)). Licence/ authorisation required to manufacture or sell (Reg.A10-A15.03). OTC sale only by pharmacist and subject to special labelling (Reg.A7.06). Persons under 18 not to be supplied except on prescription. Labelling and packaging requirements (Reg. B1-B5.01); some must also comply with B8.03. Licence required to manufacture and sell wholesale (Reg.F1.01 and F2.01). Record of sale to be kept; records retained 2 years (Reg.F5). Prescription required, with provisions of emergency supply and recording of same (Reg.H1.01). Endorsement and disposal of scripts (Reg.H5). Storage inaccessible to public (Reg.K1.02). No restriction on sale. Storage to be out of reach of children (1.5m from floor) and apart from food for humans and animals; special packing and labelling provisions with warnings and first aid Sale to persons under 18 years prohibited unless by qualified persons on prescription. Storage out of reach of children (1.5m from floor) and apart from food for humans and animals; special packing and labelling provisions with warnings and first aid, sale of organochlorins except to licensed pest control operators for the destruction of termites prohibited, unless on Departmental authority. Appendix A Poisons Records of sale to be kept. Storage out of public access plus all of the other restrictions for Schedule 6 poison

8 SCHEDULE 7 Dangerous Poisons SCHEDULE 8 Dangerous Drugs e.g. Morphine/ Methadone SCHEDULE 9 Prohibited Poisons Contains some human therapeutic substances requiring special approval to prescribe; some substances require departmental authority to obtain, use or supply. Some substances have special packing restrictions to limit domestic use. Storage under lock and key. Sales to persons under 18 years prohibited unless by qualified persons on prescription. Records of sale to be kept. Labelling and packaging requirements (Reg.B1-B5), some must also comply with B8.03. Licence required to manufacture or sell wholesale (Reg.E1.01). Prescription required (Reg.H1.01). Script must specify intervals of time between repeats (if applicable). A prescription for a dangerous drug shall contain one item only. Records of dispensing to be kept; records retained 2 years (Reg.H6). Prescriptions to be cancelled and endorsed; to be forwarded to Director General within 14 days of dispensing (Reg.H5.01). Storage in approved receptacle under lock and key (Reg.K1.01). Prohibited from use or restricted to research purposes. Refer also Reg.A5.01. Emergency Procedures 2. If a patient is to receive treatment by the ambulance then the following procedures should occur: a. Ring ambulance; b. Try to contact parents; c. Take a copy of Family Medical Record Information Form (Form 6). Follow the ambulance if the parents are not able to be contacted and stay with the patient until the parents arrive; and d. Follow up with a call to the parents to ask how the child is progressing. CONDITION EXCLUSION PERIOD CONTACTS Chicken Pox (Varicella) Cold Sores (herpes simplex) Exclude until all blisters have dried. This is usually at least 5 days after the rash first appeared in unimmunised people and less in immunised people. Exclude young children unable to comply with good hygiene practices while sores are weeping (sores should be covered with a dressing where possible). Pregnant women and anyone with an immune deficiency (eg. leukaemia) or receiving chemotherapy or immunosuppressive therapy may require preventive immunoglobulin and/or exclusion for their own protection. Contact local public health unit for advice. Otherwise not excluded. Exclude young children unable to comply with good hygiene practices while sores are weeping (sores should be covered with a dressing where

9 possible). Conjunctiviti Exclude until discharge from eyes has ceased unless s non-infectious conjunctivitis. Diarrhoea Exclude until there has not been a loose bowel motion and or Vomiting for 24 hours. Exclude staff whose work involves food handling until they have not had any diarrhoea or vomiting for 48 hours. If there are more than 2 cases with loose bowel motions in the same centre or a single case in a food handler notify your nearest public health unit. Diphtheria Exclude according to public health unit requirements. Exclude according to public health unit requirements. Hepatitis A Exclude until at least 7 days after the onset of jaundice or illness. Written medical clearance from doctor or public health unit is required to return, confirming child is not infectious. Hepatitis B Exclusion is not necessary Hepatitis C Exclusion is not necessary Human Immunodefi ciency Virus Infection (HIV) Exclusion is not necessary unless the person has secondary infection requiring exclusion is its own right. Impetigo (School Sores) Measles Meningitis (Bacterial) Exclude case until has received appropriate antibiotics for at least 24 hours. Sores on exposed areas must be covered with a watertight dressing. Exclude until at least 4 days since the onset of rash. Written medical clearance from doctor or public health unit is required to return, confirming child is not infectious. Exclude until well and has received appropriate antibiotics. Immunised and immune contacts not excluded. Exclude unimmunised contacts of a case until 14 days after the first day of appearance of rash in the last case, unless they are immunised within 72 hours, or receive an immunoglobulin injection within 7 days, of first contact during the infectious period with the first case. Exclude all immunocompromised children and staff until 14 days after the first day of appearance of rash in the last case.

10 Meningococ cal Infection Exclude until child is well and has received appropriate antibiotics. Written medical clearance from doctor or public health unit is required to return, confirming child is not infectious. Mumps Exclude for 9 days after onset of swelling. Poliomyelitis Exclude for at least 14 days from onset of symptoms and case has recovered. Written medical clearance from doctor or public health unit is required to return, confirming child is not infectious. Ringworm/S cabies Rubella (German Measles) Streptococca l Infection (including Scarlet Fever) Exclude until the day after appropriate treatment has commenced. Exclude until fully recovered or for at least 4 days after the onset of the rash. Exclude until the person has received antibiotic treatment for at least 24 hours and the person feels well. Tuberculosis Written medical clearance is required from Queensland Tuberculosis Control Centre to return, confirming child is not infectious. Typhoid and Paratyphoid Fever Whooping Cough (Pertussis) Exclude from school/food handling workplaces until there is written medical clearance from doctor or public health unit confirming child is not infectious and has met public health unit requirements. Exclude until child has received 5 days of appropriate antibiotics or for 21 days from the onset of coughing. Written medical clearance from doctor or public health unit is required to return to school, confirming child is not infectious. unless considered necessary by public health unit. unless considered necessary by public health unit. Exclude unimmunised household contacts aged less than 7 years for 14 days after the last exposure to infection or until they have received 5 days of a 14 day course of antibiotics. General First Aid Instructions Some general first aid instructions when dealing with students who are referred to first aid personnel for assistance include: 1. When assessing the student's condition, a current First Aid Manual should be used where necessary. 2. Every effort should be made to treat the students at college and return to their class as soon as possible. When a student is treated/recovers sufficiently and returns to class, a Form 11 should be sent to parents/guardians giving details of sickness/injuries and details of the treatment given by first aid personnel. However when it is clear that a student is not well enough to return to class that day arrangements should be made for the student to be collected from the college without delay. 3. When parent arrives to collect the student, details need to be entered into the log book retained by the Receptionist at the main administration office. Where possible teachers should be informed that the student has been sent home. Infection Control

11 The purpose of these guidelines is to emphasise the importance of infection control in our college. 2. The responsibilities of the First Aid Officer are to: a. ensure the college personnel are informed of infection control guidelines; b. establish a college infection control protocol; c. monitor the implementation of this protocol; d. ensure that materials and equipment to protect all members of the college community from contact with body fluids are readily available; e. ensure that potential sources of infection such as needles and syringes are disposed of according to guidelines outlined; f. inform members of the college community of safe disposal methods for potentially infectious materials which may be found in college grounds, including syringes and needles, used condoms, bandages, bandaids and blood stained clothing; g. ensure that, in instances where students may be in risk situations such as cleaning up the college grounds, correct infection control precautions are undertaken; and h. educate parents/caregivers about their responsibility to protect their children from the spread of disease. Transmission of Disease/Route of Transmission Most infectious diseases are spread by: a. respiratory route - breathing, coughing, sneezing b. gastrointestinal route - faeces, oral c. direct route - through infected tissue/tissue fluid passing viruses or bacteria directly into another person through small breaks in the skin surface or lining membranes of various body cavities and orifices. Hepatitis B (serum hepatitis), herpes simplex (genital herpes virus or cold sore virus), Chlamydia and HIV are diseases that can be spread this way. Personal Hygiene Hand washing is an effective way to prevent the spread of disease because it dilutes and washes off organisms and contaminated matter. Hands should be washed with soap and water before providing first aid. Blood and Body Substance Precautions Because there is a risk of infection from blood and body fluids/matter, all blood and body fluids should be treated as potentially infectious. 7. Where possible, persons with cuts, burns, sores or other forms of open wounds must have the wounds covered. 8. Staff involved in supervision of students should: a. observe infection control procedures; b. remove as much of the spill as possible with paper towel, place it into a plastic bag, seal and discard in biohazard bin, located in the first-aid area; c. clean the area with water and detergent; and d. wipe all surfaces with bleach or sodium. Special care should be taken if spilt blood contains material such as broken glass etc. In such an event, the sharp material should be picked up with wadding, wrapped securely in several layers of newspaper and put into some form of puncture-resistant container before disposal. 9. Instruments Used in Treatment of Patients Thoroughly wash scissors/other instruments in cold tap water to remove matter. Sterilise all instruments in bleach/methylated spirits for at least 30 minutes. Freshly

12 prepared sterilising solution must always be used. Following cleaning, wash hands, arms and other contaminated body parts thoroughly with soap and water. Where students have given assistance they should wash their hands, lower arms and any other body parts contaminated, with soap and water.