RESPONDING TO MEDICAL EMERGENCIES

Effective Date: 
Fri, 07/29/2011
Reviewed: 
Sun, 08/21/2011
Revised: 
Tue, 11/07/2017

 

UCSC Student Health Center recognizes that prompt, skilled, and practiced response to emergency situations is critical.  Training on emergency responses is provided to the medical staff annually during Fall Orientation.  Periodic, emergency drills are conducted throughout the year.

Post emergency drill debrief sessions are done to provide constructive feedback and identify opportunities for improvement. Post emergency debriefing occurs after any emergency situation.

All career licensed primary care medical staff are CPR certified. 

Emergency supplies including oxygen, airways, anaphylaxis kits and glucagon are available on Floors 1 and 2 of the building. Oxygen and airways are available in the basement.  A Red Cart with Emergency medicines and advanced airway equipment is maintained in the trauma room and is brought to every emergency as needed.

The UCSC Student Health Center facility is not an emergency room and not a trauma center.  Emergency situations which occur off-site are managed by the 911 response system.  Emergency transport on campus by-passes the Student Health Center going directly to an appropriate emergency facility.

In house emergencies are handled by the clinical staff, with the DOC (doctor on call) as the team leader, coordinating the response and assisted by the responding clinical staff.

This policy addresses responding to medical emergencies within the Student Health Center.  Policies and procedures for disaster response are available under the heading Disaster Response.

Procedure: 

1. The person who identifies an emergency situation is the first responder and  summons help of other staff.

2. First responder either announces “code blue” and location three times on overhead page by dialing 44 or designates this task to another staff member. Remove headset when overhead paging.

3. First responder evaluates the safety of the setting and takes any necessary action to assure the safety of responders, patients, visitors and staff.

4. All available clinical staff will respond initially to the site of the emergency.

5. First Responder checks for responsiveness, pulse and and initiates BLS measures as appropriate.

6. The MA working in Same Day Clinic will respond to the location with the portable oxygen (detaching from secure location on the wall by unhooking the "S" hooks located at  1/3 and 2/3 of tank for earthquake security) and the Emergency Response Bag which includes BP cuff, stethoscope, airways, Ambu bag and mask, pulse oximeter and a hard copy of Emergency Response Incidence notes for recording the event.

7. A CLS in the laboratory, if in the building, is to respond to the emergency as soon as possible, with the glucometer. If there is no CLS, a staff member will be sent to retrieve the meter from the designated location in the laboratory and a trained licensed staff member will perform finger stick glucose testing if warranted.

8.  The Same Day Clinic  (SDC) Nurse brings the AED to the location. The Triage 2 Nurse takes over the role of Same Day Care nurse during  the SDC nurse absence.  The Charge Nurse continues to assess clinic staffing needs during this time.

9. On arrival, the DOC or senior clinician assumes direction of emergency response including:

  • specifically designating a person to call 911 if necessary if not already done.
  • deciding on optimal location of treatment and directing appropriate treatment process.
  • determines if Red Cart is needed at the location and assigns staff to bring it
  • designating a recorder of emergency interventions
  •  releasing staff not needed for emergency measures to return to regular duties.

9.  The recorder notes times, vital signs, participants, interventions, and any important incidental events

10. Contact with Emergency Room or Receiving Facility: As soon as possible, direct contact with the receiving physician at the Dominican Hospital ER will be made to advise of the transport and the patient’s status. The direct line is 462-7730.  Note: the Poison Control phone number is 1-800-222-1222 (and is listed on the UCSC SHS Confidential Phone List).

 Documentation
A. All observations and care should be documented preferably on an Emergency Response Record which is attached to the oxygen tank. This record is scanned into the patients chart and a summary note is entered into PNC concerning this event by the DOC.
B. A Transfer Summary Sheet will be completed for patients being transferred to the hospital.
C. A copy of that documentation, and other pertinent medical records will be provided to the transporting ambulance crew.
D. An Incident Report is filed after the event and reviewed by the Medical Director who reports to the Quality Management committee.

The Red Cart is maintained in the Treatment Room. The supplies and medications kept in the cart are checked monthly by the nursing staff.

Anaphylaxis kits are available in the Same Day Clinic and Floor 2 Nurses stations, the Allergy/Travel/Immunization room, all treatment rooms and on the Red Cart.

Post event debriefing occurs with those who responded and the Medical Director with a focus on constructive feedback and identifying opportunities for improvement in future situations.

Emergency response drills occur periodically during the year.  Once a year all staff are oriented to the location of all emergency supplies during the annual staff orientation emergency procedure review.  This annual review includes emergency response training.

Key Points: 

The ability to respond to emergencies promptly is critical.

All licensed career primary care medical staff are CPR certified.

Periodic emergency drills allow clinic staff to practice and prepare for timely and competent responses to emergency situations.

Emergency equipment including oxygen,  Red Cart, AEDs, glucometer, and Emergency Response Bags containing: airways, Ambu bag with masks, BP cuffs, stethoscope, and pulse oximeters are maintained and available in the event of an emergency.

Protocol determines the specific staff person responsible for bringing necessary equipment to the emergency location; MA will bring the oxygen tank & Emergency Response bag. The Same Day Clinic &/or Floor 2 Nurse will bring the AED Cart and the CLS will bring glucometer.

Post-emergency protocols assure that each situation is reviewed, evaluated, and used to improve clinical responses in the future.