2. PART TWO

3. What this is:  A quick guide for how to react to some common medical emergencies that arise in classrooms. What this isn’t:  Training for treating medical issues. (We encourage everyone to get CPR/AED or First Aid training.)

4. The most common medical emergencies in a classroom are: Seizures Anxiety attacks Respiratory difficulties *Loss of consciousness * Diabetic reactions * Heart Attacks

5. Emergency Phones: When unsure of how to handle an emergency, security should be notified. ext777 or 593-0777 - cell 911 is always an option. LOCATIONS of Emergency Phones: - Moore Building 3 rd & 4 th floors have 3 phones each located in the hallway center, North and South - Stafford Building has 3 phones; 1 per floor located opposite the elevator doors. - Forrence Building has 2 phones; 1 per floor located in the Hallways

6. Loss of Consciousness What to do: Assess Are they breathing? If not, follow the “ABCs” of CPR. Are they responsive to your questions? Most people who faint will “come to” fairly quickly. Place them in a position of comfort If they are not alert, place them on the floor, lying on their side, with the upper leg bent at the knee. This will facilitate drainage of fluids from the mouth. If they regain consciousness, allow them to assume the position that is most comfortable for them. Do insist that they remain at rest until they can be assessed by medical personnel. Provide good air circulation. Remove “onlooker” crowds from the area. Open a window, door, or provide a fan. Loosen restrictive clothing from around the neck (ie-buttoned shirt color, necktie). Applying a cool, moist cloth to face, neck, and head is soothing and sometimes helps increase alertness.

7. What to do: Talk to them calmly and try to get more information. What happened? What are they feeling? Has this happened before? If it has happened before, what caused it? What helped? Are they taking any medication? Did they forget to take their medication? Are they allergic to anything? When did they eat last, and what? DO NOT Give them anything to eat or drink until they have been cleared by medical personnel, unless they are diabetic. If the person is diabetic, go to that section. Loss of Consciousness

8. There are two types of abnormal diabetic reactions; hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Either one can cause a person to change behavior or exhibit an altered level of consciousness, though hypoglycemia is probably more common. Diabetic Reactions

9. Hypoglycemia occurs when the diabetic patient : Takes too much insulin or oral diabetic medication Forgets to eat or doesn’t eat enough after taking their medication Exerts more energy than usual. Energy exerted may be physical activity or emotional. Symptoms of hypoglycemia : Weak, shaky, trembling Cold, clammy, diaphoretic (sweaty) Dizziness Groggy, confused Headache Hunger Change in behavior An easy way to remember the symptoms is to memorize “cold and clammy, need some candy”.

10. Diabetic Reactions What to do: Assess Look for the signs mentioned above. Are they unconscious, or unable to talk? If so, call for help immediately. They need an injection of dextrose (sugar) or glucagon, which requires medical personnel.call for help If they are still able to talk, ask them if they are diabetic. – Did they take insulin today? – Did they take other diabetic medication today? – Did they eat like they were supposed to? If the diabetic is able to swallow, they need sugar in their system. “Need some candy” is actually incorrect. What they need is complex carbohydrates, such as milk or bread. However, those things are not usually readily available in a classroom. In a pinch, anything with sugar will do to help them temporarily. Soda, juice, candy are more likely to be available from another student or a nearby vending machine. Remember, diet soda has no sugar and will not help. Monitor them If they don’t feel better within 2-10 minutes, give them more sugar. Watch for difficulty breathing or decreased consciousness.

11. Diabetic Reactions Hyperglycemia occurs when the diabetic patient : A diabetic patient fails to take their insulin or oral diabetic medication A diabetic patient eats too much, or the wrong foods A diabetic patient experiences severe stress, trauma, or infection. A diabetic patient has too little or no exercise Symptoms of hyperglycemia : Hot, flushed, dry skin Reddened face Extreme thirst Frequent urination in large amounts Headache Fatigue Changes in behavior Difficulty concentrating May have fruity, acidic odor to breath (sometimes mistaken for alcohol odor). An easy way to remember the symptoms is to memorize “hot and dry, sugar high”.

12. Diabetic Reactions What to do: Assess Look for the signs mentioned above. Assess their breathing and respond accordingly. Are they responsive? If so, ask if they have insulin with them and allow them to administer the insulin if able. If not, wait for someone trained in administration of insulin. They need to follow up with medical personnel to determine the reason behind the hyperglycemia and to manage the symptoms/causes.

13. Symptoms/warning signs of a heart attack Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath. This feeling often comes along with chest discomfort. But it can occur before the chest discomfort. Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness. Heart Attack

14. What to do Call for help As mentioned earlier, it is a very good idea to know CPR. If you do not, call out to the class and ask for anyone who knows CPR to come forward immediately. Basic steps: 1. Look, listen and feel for breathing for no more than 10 seconds in the position you found the person. 2. If not breathing in the position you found them, place them face up on the floor and look, listen and feel for breathing again for no more than 10 seconds. 3. If not breathing face up, then open the airway and look, listen and feel for breathing for no more than 10 seconds. 4. If they are not breathing with an opened airway and you suspect it is a cardiac emergency, start CPR. Begin with 30 chest compressions, then 2 rescue breaths. Repeat for 5 cycles and then look, listen and feel for breathing again for no more than 10 seconds. If still not breathing, continue CPR. Continue with 5 cycles patterns until an AED is available, EMS arrives, they show signs of life, you become exhausted, or the scene becomes unsafe. Heart Attack

15. COMMON AND KEY POINTS Call 911 – better to have them here and not need them. Call Security – they will have access to an AED and radio. Clear the Classroom of unnecessary people, for comfort and privacy. Reassure the student – if you are calm it will help their mental state.

16. Sources http://www.4faculty.org/includes/digdeeper/L esson3/medemergency.htm http://www.4faculty.org/includes/digdeeper/L esson3/medemergency.htm http://www.cdc.gov/epilepsy/basics/first_aid. htm http://www.cdc.gov/epilepsy/basics/first_aid. htm