Medical issues training

MEDICAL ISSUES

Children on Campus

MEDICATION MANAGEMENTTraining Module – Medical Issues

Learning Objectives

When you complete this module you will understand:• How to manage medications.• How to prepare for medical emergencies.• What to do during a medical emergency.• How to report a medical incident.• What forms are required.

Medication Management

Safety Precautions• Keep in a secure area– Some medications require special handling (i.e.,

refrigeration). It is important to understand any special requirements and make appropriate provisions to ensure the requirements are met.

– Medication must be labeled, including the name of the medication, the name patient, dosage, the name and contact information for the prescriber.

– Medications must be kept in a restricted location that is not accessible to children.

Medication ManagementIf a child reports to a program with prescribed medication but without proper documentation:• Remove the medication and place it in a secure location.• Contact the parents/guardians to obtain proper documentation.

• Faxed or email authorization is acceptable.

• If parents/guardians cannot be reached, attempt to contact treating physician for instructions regarding immediacy of need or complications or risks associated with not administering medication.

• Take the child to a licensed medical facility (e.g., campus health center) to dispense medication if:– The prescribing medication cannot be identified.– The physician feels medication is necessary, but parental consent cannot be

obtained.• Costs for medical treatment are the responsibility of the parent/guardian.

Medication ManagementAdministering Prescription Medication• Program staff may only give medications to children with written

authorization by parents/guardians.– Required to ensure that Program staff can properly plan to meet the needs of

each child– Provides clear guidance and instructions for dosages– Important to have on hand in case of emergency

• State law requires a written emergency care plan prepared by a licensed physician

Requirements:– Signed by a licensed physician.– Update at three month intervals, each time dosage changes or as necessary for

other circumstances.– New form required for each Program attended by the child.

Medication Management

Administering Over-the Counter (OTC) Medications• OTC medication may be administered with

written permission from the parents/guardians• Medications must be given in accordance with

dosage instructions• Without written permission, no OTC medications

may be administered or provided to children unless necessary as part of general first-aid treatment

Medication ManagementDispensing Medication• Proper storage and distribution of medication is vitally

important to the safety of children. • Medication must be given in compliance with prescribing

physician’s instructions as outlined in the emergency care plan.• Parent, guardians or treating physician must be contacted if additional

instruction is needed. • Keep a log of medication distribution including dates, times,

name of medication, dosage administered and by whom it was administered. – Retain record for a minimum of three years.

Medication Management

Self-Administration of Medications• Subject to Program safety review– The decision about whether or not to allow self-

administration of medications is up to the Program.• Consider: – Age of children involved.– Type of medication (OTC vs Controlled Substance).– Nature of activities.– Immediacy of need for self-administration (epi pens,

inhalers, insulin, etc.).

Medication Management TEST YOUR KNOWLEDGE

A child reports for your program with insulin and indicates that she knows how to monitor her blood sugar, calculate the appropriate dosage and wants to keep the medication in her room. Her parent has authorized self-medication, but dosage instructions are left open due to the nature of the illness.

You should: Confiscate the medication, it

needs to be refrigerated. Instruct the child to request it when needed.

Contact the parent and/or treating physician for more instructions.

Authorization is received, allow the child to keep the medication and self-administer as needed.

Medication Management TEST YOUR KNOWLEDGE

It is the fourth month of a six-month-long program. You are responsible for administering medication to a child at regular intervals. The parents and treating physician have provided clear instructions, the medication is clearly marked and an emergency plan has been developed.

You should: Administer the medication as

directed and log dispensation.

Contact the parent to obtain updated written instructions.

Contact the parent to obtain verbal assurance that the medication regimen remains unchanged.

PREPARING FOR MEDICAL EMERGENCIES

Training Module – Medical Issues

Emergency Preparedness• Program Administrations should must prepare and plan in

advance for situations that may require an emergency response.

Be Aware:• Children and adults might experience medical emergency

situations due to:– Injuries– Complications of chronic health conditions– Unexpected major illnesses

• Children with special health care needs may have an additional risk of medical emergencies

Emergency PreparednessPreparing a Plan• Decide about the roles for all Authorized Adults in advance, ensure

everyone understands their role and is comfortable with them. • Recommended that at least one adult be certified in CPR/First Aid.• Identify a key person to develop and implement the emergency plan.• Maintain a list of names, locations and contact information of trained

professional resources to provide guidance during emergency.• Develop policies that are flexible to accommodate age-appropriate

responses. (Younger children will require close supervision during an emergency situation while older children/teens may be able to provide assistance).

• Consult with medical professionals as needed.• Identify who should be notified if an emergency occurs.

Emergency PreparednessHealth Treatment Centers• Identify the nearest health center to the location of off-campus

program activities and provide that information to program staff as part of training materials.

• If the program is on campus, be sure that all authorized adults and program staff have contact information for the campus health centers:

– Ann Arbor:– Dearborn:– Flint:

Emergency Preparedness

Minor illnesses or injuries require much different responses than those that require EMS activation.• Identify triggers for determining levels of emergencies

– Is first aid treatment sufficient?– Head trauma?– Choking?– Loss of consciousness?– Difficulty breathing?– Severe injury or bleeding?– Are there complicating medical factors that increase risk?– When in doubt – Call 911

Preparing a Plan• Create an emergency

medical kit• Identify what supplies

should be kept available– Keep in secure area– Organized and monitored– Accessible

• If an AED is on site, ensure it is properly maintained

• Absorbent cotton• Alcohol/swabs• Antibacterial soap• Antibiotic ointment• Adhesive strips (assorted)• Butterfly bandages (large, small)• Cotton tipped swabs• CPR mask• Dental rolls (nose packing)• Disposable gloves• Elastic bandage• Eye pads• Gauze pads and rolls• Insect sting kit• Instant cold pack• Medications (Epi-pens, pain relievers, antihistamines, individual participant

medications)• Moleskin• Non-stick pads• Roll of adhesive tape• Safety pins• Scissors• Sealable plastic bags• Splints• Steri-strips• Sterile dressing (4x4, 2x2)• Thermometer• Tongue blades • Tweezers• Zinc oxide• *Knowledge of location of nearest AED

Emergency Preparedness

Preparing a Plan• Maintain Authorization to Treat and Medical

Information forms in a central location.• Recommended that at least one adult is

certified in CPR/First Aid. • Develop policies, procedures and protocols for

responding to life-threatening allergic reactions (especially related to food triggers).

Emergency Preparedness

Preparing a PlanChildren with chronic medical conditions or other special health care needs are more susceptible to medical emergencies and require a heightened sense of readiness• Work with medical professionals to develop

individual emergency care plans if needed.– These should be copied and made available to medical

personnel if hospital treatment is necessary.• Special training of staff may be necessary

Emergency Preparedness

Preparing a Plan• Use of CPR and AEDs is a valuable addition to

emergency response. Many national agencies provide certified training programs.

• Communicable disease emergencies involve exposures for which there needs to be contact tracking and management. Contact OSEH for guidance.

Emergency Preparedness

Required Documentation• Medical Authorization to

Treat• Medication Distribution

Record• Over-the-Counter Medical

Authorization• Self-Administration of

Prescription Medication

Description• Required for all participants

in U-M programs. • Required if children require

medication during program.• Required if program staff

wish to make OTC available• Required if program

chooses to allow children to self-medicate

Emergency Preparedness TEST YOUR KNOWLEDGE

A parent contacts you to advise that their 11 year old child wishes to participate in your residential program. She has a severe peanut allergy. You should:

You should: Apologize, but decline to accept her

into the program because you cannot guarantee there will be no exposure to peanuts.

Request documentation and written instructions about how to respond to an emergency. Work with medical resources to develop training for staff and an emergency response protocol.

Confirm that child is aware of what to do in case of emergency and obtain Authorization to self-administer medications if needed.

Emergency Preparedness TEST YOUR KNOWLEDGE

A child comes to the program, but forgot to bring a signed Authorization for Medical Treatment.

You should: Contact the child’s parents/guardians

to obtain verbal authorization. Refuse admittance to the child. Contact the child’s parents/guardians

to ask that the form be provided in person, via fax or email.

Since the child is able to provide you with medical information, obtain the information and allow the child to participate until you have a chance to follow-up with parents/guardians.

EMERGENCY RESPONSETraining Module – Medical Issues

Emergency Response

• Assess the situation using established criteria• Determine whether EMS is necessary.• When EMS is needed, dial 911. Know the

street location for program activities.• If possible, remove other children and

unnecessary adults from area • Document all emergency interventions and

inform first responders

Emergency Response

• Provide copies of Medical Authorization to Treat Form.

• One adult should accompany the child to the hospital.

• Notify parents/guardians or designated emergency contact persons as soon as possible.

• Stay with child until responsible adult arrives.

Emergency Response

• Record/document all emergency response interventions including:– First aid rendered– CPR – Use of AED– Other responses

• Notify Program Administrator and any other previously identified persons about incident

• Call734-764-2200 to notify Risk Management about incident.

Emergency Response TEST YOUR KNOWLEDGE

A child falls and suffers a severe injury that is not life threatening.

You should: Identify a key person to consult with

medical professionals as needed. Assess the situation and activate the

appropriate protocol(s) and determine if EMS needs to be activated.

An Authorized Adult should accompany a child to a medical facility and bring the Authorization to Treat form for presentation to medical personnel.

All of the above

Emergency Response TEST YOUR KNOWLEDGE

A child comes to the program and appears to be slightly dizzy and disoriented. It make you wonder if there are medical issues of concern. You are unable to reach the parents/guardians.

You should: Contact the treating physician

to obtain more information. Since the child does not appear

to be in any immediate distress, keep an eye on the child while you continue to attempt to contact the parents/guardians.

Take the child to a medical facility for assessment and guidance.

AFTER THE EMERGENCYTraining Module – Medical Issues

After the Emergency

• Review the response and provide feedback to staff

• Identify areas in need of improvement• Design changes in procedures as needed• Restock equipment and medications• Follow-up with Risk Management Services to

determine if additional information is needed.