Medical Emergencies Policy For use in Sudden Emergency Situations (Including Anaphylactic Shock and Admissions to Hospital)

Transcription

1 Medical Emergencies Policy For use in Sudden Emergency Situations (Including Anaphylactic Shock and Admissions to Hospital) MEDICAL EMERGENCY (including Admissions to Hospital) Serious Injury Sudden Death (see Death of A Service User) Unexpected/unexplained loss of consciousness Unexpected/unexplained major haemorrhage (blood loss) or any other serious medical condition Shock or any other serious medical condition (For Epilepsy see Epilepsy Care Plan) YES Criterion Met NO Dial 999 State name, address and postcode of affected person and nature of emergency. Follow advice given by operator. Follow On Call Procedure Contact Operational Operational Network Manager or On Call Manager Operational Operational Network Manager/Local On Call Manager Responsibilities Attends house to support staff. Make staffing adjustments to enable staff to attend Hospital (within 2 hours). Inform relatives (unless they have stated that they do not want to be informed). Inform Purchasers/Duty Social Worker (if required by Contract Purchasers). Ensure all necessary paperwork is completed. Inform On Call Senior Manager or Operations Manager In the event of a sudden death the On Call Senior Manager or the Operations Manager will also attend 1

2 1. Purpose The purpose of this procedure is to provide support and guidance to Future Directions CIC Staff in regards to actions required and reporting mechanisms in the event of a medical emergency occurring; including anaphylactic shock and admissions to hospital. 2. Introduction A medical emergency can include: Serious injury. Sudden death (see also End of Life and Death of a Service User Policy). Unexpected/unexplained major haemorrhage (blood loss). Anaphylactic Shock (see Section 3). Unexpected/unexplained loss of consciousness, e.g. no known diagnosis of epilepsy, shock or any other serious medical condition. This is not an exhaustive list but it may act as a guide. 3. In the Event of a Medical Emergency or Sudden Death, the following steps must be followed by the staff on duty: Dial 999 for Ambulance Have a pen and paper ready for any instruction that may be given. State name, address and postcode of affected person clearly and state nature of emergency. Use the information on service user profile in personal files and also give own name. Listen and respond in a clear manner to questions asked by operator. If competent and following training staff administer appropriate first aid to preserve life and prevent deterioration in condition whilst waiting for response from Ambulance Service and/or On Call Manager. Follow any advice given by Control Room Operator. Contact Local On Call Manager/ Operational Network Manager (during office hours the Operational Network Manager should deal with the emergency unless unavailable). The On Call Manager/ Operational Network Manager will respond and attend to provide support. The On Call Manager/Operational Network Manager will make any necessary staffing adjustments to provide cover. Contact numbers are listed in the diary and/or red communication file. The On Call Manager/Operational Network Manager will if necessary cover the house him/herself. Adhere to any policies or procedures in regard to the nature of the emergency, e.g. Death of a Service User, Incident and Accident Reporting including Serious and Untoward Incidents. 2

3 The Local On Call Manager will inform the Senior On Call Manager who will attend in the event of sudden death.(see Procedure End of Life and Death of a Service User Notification of Death). 4. Definition of Anaphylactic Shock The term anaphylaxis may be defined as an unusual or severely exaggerated allergic reaction of an organism to foreign protein or other substances. It is a serious, potentially fatal condition, which may develop in susceptible individuals within a few seconds or a few minutes of, for example: The injection of a specific drug, e.g. Penicillin. The sting of a certain insect, e.g. a wasp or bee. The ingestion of a particular food, e.g. peanuts or shellfish. In this severe allergic reaction, chemical substances are released into the blood, which dilate blood vessels and constrict the trachea (air passages). Blood pressure falls dramatically and breathing is impeded. The amount of oxygen reaching the vital organs (brain, heart and lungs) is severely reduced and a service user suffering anaphylactic shock requires oxygen and adrenaline Recognition of Anaphylactic Shock Swelling of the face and neck, increasing the risk of asphyxiation. Widespread red, blotchy skin eruptions. Oedema (swollen tissue) around the eyes. Sneezing and discharge from the nasal passages. Increasing anxiety. Impaired breathing ranging from a tight chest to severe difficulty. A rapid pulse rate. NB: As with all signs and symptoms of any medical condition or illness, there are degrees of severity depending upon how critical the situation is. In anaphylactic shock the AIM is to ARRANGE URGENT REMOVAL TO AN ACCIDENT AND EMERGENCY DEPARTMENT AT A GENERAL HOSPITAL Treatment of Anaphylactic Shock Dial 999 for an ambulance. Make the service user as comfortable as possible by helping them into a sitting position to alleviate any difficulty with breathing. Monitor levels of responsiveness and respiration rates until the Paramedics arrive. If the service user loses consciousness, maintain their airway, and check for breathing. If the service user remains unconscious but is breathing, place in the recovery position. 3

4 If breathing and/or pulse rates cease, start resuscitation until either vital signs are reinstated or the Paramedics arrive. If another staff is available request that they go and check the service users Personal Profile, Electronic Record Alert section and/or MAR (medication administration record) for known allergies. Check MAR for any as required treatments that may have been prescribed. Where possible keep notes and pass on as much information to medical staff as possible regarding the possible cause of the allergic reaction. 5. Informing Relatives/Commissioner Where medical emergency arises it is the responsibility of the On Call Manager/Operational Network Manager to ensure that the relatives are informed (unless they have stated that they do not want to be informed). As soon as reasonably practical and at the earliest opportunity (next working day) a Senior Manager will inform a Care Manager, Social Worker or Commissioner. 6. Registration Under the Health and Social Care Act 2008 Under the Health and Social Care Act 2008, Community Service are registered with the Care Quality Commission to provide these services: Domiciliary Care, Supported Living and Registered Care Home without nursing and as such must comply with the Essential Standards of Quality and Safety which details what providers must do to comply with Section 20: Notification of other incidents, regulation of the Health and Social Care Act 2008 follow link to document which provides detail of reportable incidents: safety_march_2010_final.pdf Outcome 18 Notification of Death of Service User (Regulation 16) details the requirement to notify the Care Quality Commission without delay of ALL deaths of a person using the service where they die while receiving, or as a result of, the care, treatment or support provided by the service. The notifications will be completed by the Operation Manager, Registered or Responsible Person as soon as possible following the death. Notification of other incidents and of Death of Service User must be made using the appropriate form follow link below fro relevant reporting forms:- tifications.cfm 4

5 7. Recording Record relevant information via the Incident Reporting System (paper-based or PRISM as appropriate, see incident/accident reporting) unless the emergency is service user ill health. Record information on the 24 Hour Report and in the Service User s Records (paper-based or electronic as appropriate) Where a medical emergency is not incident reportable, a full written report will be submitted to the Operational Network Manager. 8. Admission to Hospital All service users will have a completed Hospitals Assessment Booklet taken with them. If admitted the Hospitals Assessment Booklet will be brought to the attention of the person admitting the service users. In the absence of a local agreed form Appendix B (available from Future Directions CIC Forms) will be used Completing Hospitals Assessment Booklet It is the responsibility of the Team Manager to ensure that there is a completed and up to date Hospitals Assessment Booklet kept on the service user s Record (paper-based or electronic). All sections of forms must be fully completed, if not the Team Manager by somebody who knows the service user well. It is the responsibility of the Team Manager to review at least once every 6 months, prior to a planned admission and/or as needs change. Reviews will be recorded on the front of the form. Any significant changes will necessitate the completion of a new form. It is the responsibility of the person accompanying an individual to Hospital to ensure that the form is made available to all relevant medical personnel at the time of the visit/admission. It is intended that the form is left with the service users during their stay and is visible, i.e. clipped to the service user s bed with their observation charts. The form must accompany the service user during any internal Hospital transfers, i.e. Accident and Emergency, Medical Assessment Unit, admission to a ward. On Discharge: It is the responsibility of the staff escorting the service user home to ensure the form is taken from the Hospital at the time of discharge and returned to the service user s file. NB: It is the Team Manager s responsibility to ensure that the form is updated with any lessons learned from the Hospital visit/admission. 5

6 8.2. Support In all instances of a Hospital attendance the service user must have staff support at the earliest opportunity once cover has been arranged (usually within 2 hours). This will ensure all relevant information is relayed to the appropriate professionals. Following Hospital admission, ongoing support requirements will be determined by the individual needs of the service user. NB: Learning Disability Hospital Liaison Nurse Where available this nurse will be consulted as soon as possible. (For planned admission engagement with the nurse must be carried out as soon as possible). If you are not sure who to contact then speak to your Operational Network Manager or the local Learning Disability Support Team. Support Costs: Where there are ongoing funding issues for staff support costs the Director of Operations will pursue the matter with the relevant Commissioners. 9. Medical Emergencies Aftercare and Counselling Where appropriate, risk assessments will be reviewed and amended where necessary to prevent likelihood of reoccurrence. The Health Action Plan (HAP) may need amending or an Enhanced HAP written (see Health Action Planning Procedure). Aftercare and counselling will be available to staff and service users after serious incidents and accidents and will be arranged by the Operational Network Manager Lessons Learned The staff team and the Operational Network Manager will reflect on how the emergency was managed (lessons learned) and decide if changes need to be made if something similar happens again. Lessons learned from this discussion will also be discussed at the Future Directions CIC Governance Meeting and where appropriate at the monthly Directors meeting. 6

7 Medical Emergencies Policy Appendix A AREAS WHERE HOSPITALS ADMISSION FORMS HAVE BEEN AGREED Manchester LDP East Lancashire PCP Stockport LDP Copies of forms are available from your Operational Network Manager. Areas not listed above are required to use Future Directions CIC s form (see Appendix B). 7

8 Medical Emergencies Policy Appendix B RED AMBER GREEN This assessment gives Hospital staff important information about you. Please take it with you if you have to go into Hospital. Ask the Hospital staff to hang it on the end of your bed. Please Note: Value judgements about quality of life including decisions on resuscitation must be made in consultation with you, your family, carers and other professionals. This is necessary to comply with the Mental Capacity Act Make sure that all the staff who look after you read this assessment. (Reproduced by kind permission of Gloucestershire NHS Primary Care Trust). NB: The Full Hospital Assessment Booklet is available from G:\Future Directions Forms\Service Users\Health 8