Trainer Resource Guide - dds.ca.gov · Changes observed by the DSP or reported by the ... problems...
Transcript of Trainer Resource Guide - dds.ca.gov · Changes observed by the DSP or reported by the ... problems...
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8. Signs & Symptoms of Illness or Injury
Trainer Resource Guide
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T-1
T r a i n e r G u i d e : S E S S I O N 8
Materials• LCDprojectorandcomputer• FlashDrive• Seizurevideo• Chartpaper• Coloredmarkers• Maskingtape
Show Slide #1: Signs and Symptoms of Illness or Injury
Show Slide #2: Practice and Share, Session 7 • Reviewtheassignment.• Askforvolunteerswhowouldliketosharetheirexperience.• Inthelastsession,youlearnedaboutsupportingindividualsto
maintaingooddentalandoralhealth.• Inthissession,youwilllearnaboutchangesyoumayobserve
thatmighttellyouofanillnessorinjuryofanindividualyouaresupporting.
Show Slides #3 and #4: Outcomes• Reviewoutcomesforthesession.
Show Slide #5: Key Words• Reviewkeywordsforthesession.• Givestudents5minutestothinkaboutandrewritedefinitionsin
theirownwordsinthespacesprovided.
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SignsandSymptomsofIllnessorInjuryO U T C O M E S
Whenyoufinishthissession,youwillbeableto:
K E Y W O R D S
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Key Word Meaning In My Own WordsMedical Emergency
Anunexpectedevent,illnessorinjurycallingforfirstaidfollowedbyimmediatemedicalattentiontoprotectanindividual’slifeorsafety.
Routine Treatment
Givingsimplefirstaidorfollowingdoctor’sordersinresponsetosignsofinjuryorillness.
Seizure Anunusualrushofelectricalenergyinthebrain.
Signs and Symptoms
ChangesobservedbytheDSPorreportedbytheindividualthatmayindicatedisease,illness,orinjury.
• Identifychangesthatmaybesignsandsymptomsofillnessorinjury.
• Identifytheappropriatelevelofresponsebasedonanindividual’ssignsandsymptoms.
• Makea911callandprovidenecessaryinformation.
• Followtheguidelinesforreportinganddocumentingchangesthatmaybesignsandsymptomsofillnessorinjury.
• Takeanindividual’svitalsignsincludingpulseandtemperature.
• Describehowtoprovidefirstaidforanindividualhavingaseizure.
• Identifywaystopreventhealthproblemsforindividualsatrisk.
• Describehealthproblemsassociatedwithaging.
Urgent Call to Doctor
Aphonecallmadeassoonaspossibletotheindividual’sdoctortoreportserioussignsorsymptomsofillnessorinjury.
Student Resource Guide: Session 8
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ACTIVITY: What Do You Want to Know?• Readdirectionsaloud.• Askforstudentvolunteerstoshareanswers.• Makenoteofstudentanswersandlinkbacktostudentknowledge
andinterestsasappropriateasyoureviewsessioncontent.• Attheendofthissession,youwillreturntothisactivitytogive
studentsanopportunitytoanswerthethirdquestion.
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A C T I V I T Y
What Do You Want to Know?
Directions: Think about the topic of this training session. Answer the first two questions in the space provided below. You will come back to this page at the end of the session to answer the last question.
Whatdoyoualready knowaboutrecognizingsignsandsymptomsofillnessorinjury?
Whatdoyouwant to knowaboutrecognizingsignsandsymptomsofillnessorinjury?
Tobeansweredattheendofthesession,duringreview:Whathave you learnedaboutrecognizingsignsandsymptomsofillnessorinjury?
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T-3
Recognizing Changes
Show Slide #6: Recognizing Changes• Sessions3and4addressedhowtomitigateandrespondtorisks
tothehealthandsafetyofindividuals.Thissessionwillfocusonidentifyingsignsandsymptomsthatmayhelpidentifyillnessandinjuryforearlytreatmentandthepreventionofmoreseriousconditions.Prevention is the Number One Priority.
• Earlyidentificationofchangesinanindividualcansavehisorherlife.
• Yougettoknowapersonbyspendingtimewithhimorherandlearningwhatisusualforthem.
• Ifyoudon’tknowwhatisnormalforaperson,youwon’tknowwhensomethinghaschanged.
• Youalsoneedtoknowaperson’shealthhistory.• InSession7,welearnedaboutplacestogetinformationabout
individuals’healthhistories.Whatarethoseplaces?Physician’s Report, Health History, and the Individual Program Plan (IPP).
Observation and Communication
Show Slide #7: Tools that the DSP Must Use• Define“observation”
— Usingallofyoursenses:sight,hearing,touchandsmell.— ReviewhowDSPsmightusetheirsensestorecognize
change.• Define“communication”
— Includesaskingquestionsandlisteningtoanswers.— ReviewhowDSPsmightusecommunicatingtorecognize
change.• Agoodlistenerattendstowordsaswellasotherwaysof
communicating,includingbehavior.• Otherwaystocollectinformationaboutanindividualareto:
— Talktootherstaffatshiftchangeandattheindividual’sdayprogram.
— Readdocumentationkeptatthefacility.• Theindividualsyousupportrelyonyoutoidentifychangesthatmay
bethesignsandsymptomsofanillnessorinjuryandtoensurethattheyreceivetreatment.
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Recognizing Changes
InthissessionwewilltalkabouthowtousetheDSP’stoolsofobservationandcommunicationwhenlookingfor
signs and symptoms,orchangesthatmaytellyouofanillnessorinjury.Earlyidentificationofanillnessorinjurycansaveanindividual’slife.
AsaDSPyougettoknowanindividualbyspendingtimewithhimorherandlearningwhatisusualforthatindividual,suchashisorherdailyroutines,behavior,wayofcommunicating,
appearance,usualmood,andphysicalhealth.Ifyouknowwhatisnormalforanindividual,youwillknowwhensomethinghaschangedorisdifferent.
Youalsoneedtoknowanindividual’shealthhistory.Thiswillhelpyoutonoticeachangeinhisorherhealthandtodecidewhattodo.Youwillknowifthechangeissomethingthathashappenedbeforeandwhatwasdone,andyouwillhavesomecluesastowhatyouneedtodonext.
Observation and Communication
Toidentifychangesandgatherinformationthatwillhelpyoudecidewhatyoushoulddo,youwilluseyourtoolsofobservationandcommunication.
Observationmeansusingallofyoursenses:sight,hearing,touch,andsmell.Youmay seeaphysicalchange,suchastears,
rednessorswellingoftheskin,orcloudyurine.Youmayhearnoisybreathing,crying,moaning,coughing,orscreaming.Youmayfeelhot,moist,orcoldskin.Youmaysmellanunusualorunpleasantodorcomingfromtheindividual’smouth,body,clothing,orbodyfluids.
Communicationincludesaskingquestionsandlisteningtoanswersfromtheindividualandothers.Agooddetective
asksalotofquestions.Forexample,ifanindividualtellsyouthatherstomachhurts,youmightask,“Whendiditstarthurting?”or“Canyoushowmewhereithurts?”Ifyouseeanindividualholdingherstomach,frowning,andcrying,youmightasktheindividual,“Doesyourstomachhurt?”
Iftheindividualisunabletousewordstotellyou,yourdetectiveskills—observation,andcommunication—becomeevenmoreimportant.Theindividualintheexampleaboveisholdingherstomach,frowning,andcrying.Thesebehaviorsprovidecluesthatsomethingiswrong.Agoodobservernoticesbothwordsandotherwaysofcommunicating,includingbehavior.
Youmayalsowanttoaskothers.Talkingtootherstaffwhoknowtheindividual,readingthedocumentationkeptatyourfacility,suchasthefacilitylog,individuallogs,ormedicationrecords,aregoodwaysofcollectinginformation.
Itmaybechallengingtodetectachange.Manyindividualswithintellectual/developmentaldisabilitieshavedifficultycommunicating.Somemay“tell”youthattheyareinpainbycrying,withdrawing,pointing,orscreaming,whileothersmaysay,“Ihurt,”or“Mystomachhurts.”Thecluesmaynotalwaysbesoobviousandeasytodetect.Theindividualsyousupportrelyonyoutoidentifychangesthatmaybethesignsandsymptomsofanillnessorinjuryandtoseethattheyreceiveappropriatetreatment.
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T-4
Learning More About Changes
Show Slide #8: ACTIVITY: Observation and Communication• Readthescenarioaloudandposethequestionstothelarge
group.• Assurethatstudentsperceivethatthereappearstobeachange
inbehavior,manner,ormood.• Askthestudentshowtheycanlearnmoreaboutwhatisgoingon
withRachel.Studentsmaysuggest:— LooktoseeifRachelhasanyscratchesorbruises.— ListentoRachel.— AskRachelavarietyofquestionstoseeifyoucanfindout
whysheiscrying.— AskthestaffatRachel’sschoolandthebusdriverifanything
unusualhappened.— ObserveRachelforanyotherpossiblechanges.— Readthelogatthefacilitytofindoutwhathappenedinthe
morningandpreviousevening.
ACTIVITY: The Good DSP Detective
Show Slide #9: The Good DSP Detective• Groupings:smallgroupsofnomorethanfourstudents.• Readdirectionsaloudandgivesmallgroupstimetocompletethe
activity.• Askforstudentvolunteerstoshareachangethattheynoticedand
howtheyidentifiedit.• Informationonidentifyingchangesrelatestoasessionoutcome
andmayappearonthequiz. Outcome: Identify changes that may be signs and symptoms of
illness or injury.
Show Slide #10: What Kind of Changes Should the DSP Look For?
• ReferstudentstopagesS-4throughS-6.• TherearedifferenttypesofchangesthatDSPsmayobserve• Reviewtypesandgiveexamples:
— Dailyroutine
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A C T I V I T Y
The Good DSP Detective
Directions: Get into groups of no more than four. Think about a time that you had to use your observation skills to figure out why there was a sudden change in an individual you support. Tell your group about that time:
• Whatwasthechangethatyounoticed?• Howdidyouidentifyit?Shareoneexamplefromyourgroupwiththeclass.
Learning More About Changes
Sonowyouknowthatyouidentifychangesbyusingyourobservation(see,hear,feel,andsmell)andcommunication(listenandquestion)skills.Let’slearnsomemoreaboutthetypesofchangesyoumayobserveorlearnabout.What Kind of Changes Should the DSP Look For?
Remember,changesmaybeinanindividual’sdailyroutine,behavior,wayofcommunicating,appearance,usualmood,andphysicalhealth.Thefollowingaresomeexamplesofchangesthatyoumayobserveineachoftheseareasandsomequestionsthatmayhelpyouthinkaboutthereasonsforthechanges.
Daily routine:anindividualrefusestogetoutofbed;getsupatadifferenttime;sleepsmoreorless;eatsmoreorless;changesfoodpreferences(startseatingsaltyfoods);changesgroominghabits(likestobrushhis/herteethbutonedayrefuses);hasnewtoiletingaccidents;hastroublefeedinganddressinghimself/herself.• Youmaywanttoask,“Istheindividual
behavingdifferentlythanyesterday?”“Whyistheindividualrefusingtoeathis/herfavoritefoods?”“Whatiscausingtheindividualtohavetroublesleeping?”
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A C T I V I T Y
Observation and Communication
Directions: As a class, discuss the scenario below.
Scenario: Rachelusuallycomeshomefromschoolinagoodmood,humming,andhappilygoestoherroomtoplaywithhertoys.Today,shecamehomefromschoolcryingand,whenofferedafavoritetoy,ignoresit.• Doyourecognizeachange?Ifso,what?• HowelsecouldyoufindoutwhatisbotheringRachel?
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Learning More About Changes (cont.)
Show Slide #10: What Kind of Changes Should the DSP Look For? (cont.)• ReferstudentstopagesS-4throughS-6.• TherearedifferenttypesofchangesthatDSPsmayobserve• Reviewtypesandgiveexamples:
— Behavior— WaysofCommunicating— Appearance—Generalmannerofmood— PhysicalHealth
Show Slide #11: Physical Health• ReviewsignsandsymptomslistedonpageS-5thatmayindicateillnessorinjuryin
differentareasofthebody.
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Behavior:anindividualwhoisusuallycalmstartshittingandkicking;appearsmoreorlessactivethanusual.• Youmaywanttoask,“Whyisthe
individualactingaggressivelytohimselfortoothers?”“Whatistheindividualtryingtotelluswiththisnewbehavior?”
Ways of communicating:anindividualwhousuallytalksalotstopstalking;speechbecomesgarbledorunclear.• Youmayask,“Hastheindividual’s
abilitytotalkorcommunicatechangedlikethisbefore?”
Appearance: anindividualwhoisusuallyveryneatinappearancehasuncombedhairandiswearingadirty,wrinkledshirt;changesincolororappearanceofskin,(asuddenrednessonthehandsoranashytoneandclammyfeeltotheskin);anychangesinweight,upordown.• Youmayask,“Doesitseemlikethe
individualhaslostinterestinthings?”“Istheindividualtakinglesscareinhisorherpersonalappearance?”
General manner or mood:Someonewhoisusuallyverytalkativeandfriendlybecomesquietandunfriendly;anindividualwhousuallyspendstimewithotherssuddenlywithdrawsandwantstobealone.• Youmayask,“Whyhastheindividual’s
moodchanged?”“Doestheindividualwanttobealoneallthetimeorataspecifictime?”
Physical HealthChangesinphysicalhealthofteninvolveaparticularpartofthebody.Somearechangesyoumayobserve,andothersarechangesanindividualmaytellyouabout.Forexample,youmayobservethatanindividualispullinghis/herearoranindividualmaytellyouthatithurts.
• Youmaywanttoask,“Isthereanyapparentchangetotheindividual’sskin,eyes,ears,nose,oranyotherpartofthebody?”
Somephysicalchangestopayattentiontoinclude:
• Skin: Bleeding,swelling,spotsorbumps,changesofskincolor(blue,gray,red).Theindividualmayscratchorrubtheirskin.
• Eyes: Redness,yelloworgreendrainage,swellingoftheeyelid,excessivetearing.Theindividualmaysaythattheireyesburnorhurt;theymayrubtheireyes.
• Ears: Redness,fever,drainagefromtheear.Theindividualmaysaytheyaredizzyortheirearhurts.Theymayhearringingintheirears.
• Nose: Clear,cloudy,coloredfluidrunningfromthenose.Theindividualmayrubthenose.
• Mouth and throat: Rednessorwhitepatchesatthebackofthethroat,hoarsevoice,feverorskinrasharoundmouth,facialorgumswelling,gumbleeding.Individualmaysaytheyhavepaininatoothorwhenswallow-ingortheymayrefusetoeat.
• Muscles and bones: Inabilityordifficultymovingalegoranarmthattheindividualcouldpreviouslymove,stiffness,swelling.Individualmaysaytheyhavepaininthearms,legs,back.
• Breathing (lungs): Cough,phlegmormucous(fluid)inthelungs,shortnessofbreath,wheezing,stuffynose.Individualmaysaytheyhavepaininnoseorchest,dizziness.
• Heart and blood vessels:Coldorbluehandsorfeet,swellingofankles.Individualmaysaytheyhavechestpainorshortnessofbreathorthattheirhandsorfeetarenumb.
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Learning More About Changes (cont.)
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Learning More About Changes (cont.)
• Review:— Changeisanythingthatisdifferentaboutanindividual’sdailyroutine,
behavior,wayofcommunicating,appearance,generalmannerormoodandphysicalhealth.
— TheDSPmustknowwhat“normal”isfortheindividual.— Identifychangesbyusingyourobservationandcommunicationskills.— Thepeopleyousupportrelyuponyoutoidentifychangesandto
respondtothosechangesappropriately.
Show Slide #12: DSP TV, Scene 18: Observing and Responding to Changes
• Clickontheicontoshowthevideo.• DiscussandanswerquestionsatendofScene18.
Answers— Whatsignsandsymptomsdidyouobserve?Bestamor was breathing
heavily, clutching her chest and moaning in apparent pain.— DidtheDSPrespondappropriately?No. The DSP did not use
observation to notice the signs and symptoms, and did not use communication to listen to Bestamor and ask her questions about how she feels. The DSP put off taking action until it may have been too late for Bestamor.
— WhatarepossibleconsequencesoftheDSP’sactions?Bestamor could sustain serious physical damage or even die.
Assessing What To Do When You Learn About A Change
Show Slide #13: Levels of Emergency Response• ManychangestheDSPobservesinanindividualrequiretheDSPto
takeaction.• AftertheDSPhasidentifiedachangeheorshemustassesswhether
thechangeisapotentialsignorsymptomofillnessorinjuryanddecidetheappropriatelevelofresponserequired.
• ShowLevelsofEmergencyResponse• Review:
— 911call— Urgentcalltoadoctor— Routinetreatment
911 Call • A911callinvolvesmedicalemergenciesthatrequireimmediateattention.• ReadtheboldedstatementatthebottomofpageS-6aloudandensurethat
studentsunderstand.• Thisinformationrelatestoasessionoutcomeandmayappearonthequiz. Outcome: Make a 911 call and provide necessary information.
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Assessing What to Do When You Learn About a Change
Manychangesinanindividual’sdailyroutine,behavior,wayofcommunicating,appearance,mood,and/orphysicalhealth,
requiretheDSPtotakeaction.Thefollowinginformationwillhelpyoutoassess,orthinkaboutanddecide,theappropriateactionineachsituation.
Afteryouhaveidentifiedachange,youmustdecidewhetherthechangeisapotentialsignorsymptomofillnessorinjury.Makingtherightdecisioninvolvesthinkingabouttheinformationthatyouhaveandmakingajudgment.Knowledgeofthepersonandhisorherhealthhistory,includingcurrentmedicationsanddoctor’sorders,areessential.
Differentsignsandsymptomsofillnessorinjurywillrequiredifferentlevelsofresponse,including:
Levels of Emergency Response:• 911 Call:Medicalemergenciesthat
requireimmediatemedicalattention.
• Urgent Call to Doctor:Serioussignsorsymptomsthatrequireaphonecalltotheindividual’sdoctorassoonaspossible.
• Routine Treatment:SignsorsymptomsthatareaddressedbysimpleFirstAidorwrittendoctor’sorders.
911 CallA911callinvolvesa medical
emergencythatrequiresimmediatemedicalattention.
If you think you need to call 911, do it! Don’t call someone to ask if you should. If you have any question in your mind, make the call. Quick action in recognizing signs and symptoms that require emergency medical treatmentcanbethedifferencebetween life and death.
• Abdomen, bowel, and bladder (stomach, intestines, liver, gallbladder, pancreas, urinary tract): Swollen,hardstomach;vomiting;loosebowelmovementordiarrhea;constipation;bloodinvomitorbowelmovement;fruitysmellingbreathorurine;difficult,painfuland/orburningurination;changesinurinecolor(cleartocloudyorlighttodarkyellow).Individualmaysaytheyhavepainononeorbothsidesofthemid-backorstomach;chillsorafever.
• Women’s reproductive organs: Vaginaldischarge,itching,unusualodor,burning,changesinmenstrualcycle,suchashowoftenaperiodoccurs,howlongitlasts,andhowheavytheflowofbloodis.
• Men’s reproductive organs: Dischargefrompenis,pain,itching,redness,increasedfrequencyofurination,difficultyurinating,burning.Toreview,achangeisanythingthat
isdifferentaboutanindividual’sdailyroutine,behavior,wayofcommunicating,appearance,usualmood,andphysicalhealth.Inordertorecognizeachange,youmustfirstknowtheindividualandwhatis“normal”forthatindividual.Youidentifychangesbyusingyourobservationandcommunicationskills.Theindividualsyousupportrelyuponyoutoidentifychangesandtorespondtothosechangesappropriately.
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Learning More About Changes (cont.)
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T-7
Assessing What To Do When You Learn About A Change (cont.)
Show Slide #14: Always Call 911 If an Individual… • Reviewthetimesitisnecessarytocall911.• Ifanindividualappearstohavebeenpoisoned,callPoisonControl
firstandthencall911.
Show Slide #15: When you call 911, tell them… • Reviewwhattotellthe911dispatcherwhenyoucall:
— Whoyouare— Whereyouare— Whathashappened— Whenithappened
Show Slide #16: Urgent Call to a Doctor • Review.
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Always call 911 if an individual:• Hasbleedingthatcan’tbecontrolled• Isorbecomesunconscious(not
relatedtoaseizure,seizureswillbeexplainedlaterinthissession)
• Hasnopulse• Hastroublebreathingorisbreathing in
astrangeway• Haschestpainorpressure• Hassevereinjuriessuchasbroken
bonesasaresultofanaccident• Ischoking(notbreathingandnot
coughing)• Hasinjuriestothehead,neck,orback• Hasgoneintoshock(alife-threatening
conditionwherethebodydoesn’thaveenoughbloodflow)
• Hasaseizurelastingfiveminutesorhascontinuousseizures
• Hassufferedelectricalshock• Isdrowningorneardrowning• Experiencesparalysis(theinability
tomoveallorpartofthebody),numbness,confusion
• Sufferssevereburns(burnsthatcovermorethanonepartofthebodyoronhead,neck,hands,feet,orgenitals)
•If an individual appears to have
beenpoisoned,firstcallthePoisonControl Center at 1-800-222-1222 to get advice and then call 911.
When you call 911, tell them:• Whoyouare• Whereyouare• Whathashappened• Whenithappened
Stayonthephoneuntilthe911dispatchertellsyoutohangup.
Whilewaitingformedicalhelptoarrive,staycalmandhelptheindividualstaycalm,staywithhimorher,anddonecessaryfirstaidand/orCPR.Ifpossible,sendanotherpersontowatchforandguidetheemergencypersonnel
tothescene.Whentheemergencypersonnelarrive,providethemwithadditionalinformationincludingallmedications,allergies,insuranceinformation,andthenameandphonenumberoftheindividual’sprimarydoctor,thatis,thedoctorwhousuallyprovidescareforthisindividual.Itisagoodideatoalsocalltheprimarydoctorassoonasyoucan.
Urgent Call to Doctor Anurgent call to a doctorisneeded
whenserioussignsorsymptomsrequireareportbemadetotheindividual’sdoctorassoonaspossible.
Somesignsandsymptomsindicateaneedforimmediatemedicalcare.Inthesesituations,theDSPshouldcalltheindividual’sdoctorandreportthesignsandsymptomssothatthedoctorcanassesstheperson’sconditionanddecidewhatshouldbedonenext.Whiletheperson’slifemaynotbeinimmediatedanger,thesignsandsymptomslistedbelowareserious,andtheDSPmustreportthemtotheindividual’sdoctorassoonastheyareidentified.Thefollowingareexamplesofchangesthatmaybesignsandsymptomsofillnessorinjuryandthatrequireanurgentcalltothedoctor:• Rapidchangeinbehaviororan
increaseinchallengingbehaviorsuchasaggressionorself-injuriousbehavior
• Sleepingmostoftheday;unusualdifficultyinwaking;beingunusuallytired
• Scratchingorholdingoneorbothears• Holdingabdomen,orstomacharea• Noticeablechangeinfacialexpression
orbehavior• Evidenceofpainordiscomfortthatis
noteasilyexplained• Neworsuddenincontinence(inability
tocontrolurination)
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T-8
Assessing What To Do When You Learn About A Change (cont.)
Urgent Call to a Doctor (cont.)Show Slide #17: When you call the doctor, tell them… • Reviewwhattotellthedoctorwhenyoucall:
— Whatsymptomstheindividualhasreportedtoyou.— Whatsignsyouhaveobserved.— Whatsignsothershaveobserved.— Whenthechangefirstbeganorwasnoticed.— Anyrecenthistoryofsimilarsignsandsymptoms.— Currentmedications.— Knownallergies.
• Alwaysreportthesechangestothedoctorassoonaspossible.• Ifyouthinkthedoctordidnotunderstandhowseriousthesituationis,orifitgets
worse,call911.
ACTIVITY: Who Do I Call?
Show Slide #18: ACTIVITY: Who do I call?• Groupings:individual,pairs,smallgroup,largegroup.• Readdirectionsaloudandinstructstudentstowritetheinformationinthespaces
provided.• Askforvolunteerstosharewhattheywrote.• Thisactivityrelatestoasessionoutcome. Outcome: Identify the appropriate level of response.
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• Feverof101degreesorhigher• Diarrheaorvomitinglastingmorethan
fourhours• Rashlastingseveraldaysorgetting
worse• Increaseinseizureactivity• Suddenlimping,inabilitytowalk,or
difficultyinmovementofanybodypart• Severesorethroat/difficultyswallowing• Infectionofaninjurysuchasacut.• Swelling
• Monitortemperaturebelow101degrees
Always report these changes to the doctor as soon as possible. When in doubt, call the doctor. When you call the doctor, stay on the phone until you get assistance. If you think the doctor did not understand how serious the situation is, or if the individual gets worse, call 911. Your actions can save a life.
A C T I V I T Y
Who Do I Call?
Directions: Using the following scenario, decide whom you would call and what you would say.
Youareinthekitchencookinglunch.YouhaveyourbacktoMargaret.MargaretsaysthatsheisgoingintothefamilyroomtowatchTV.Youhearherfallandstarttoscream.Youimmediatelyruntoherside.Youfindherlyingonthefloorinthefamilyroom,clutchingherleg,andscreaming.Margaretisunabletogetupfromthefloor.
• Whowouldyoucall:• Whoyouare:• Whereyouare:• Whathashappened:• Whenithappened:• Whatyousee:
When you call the doctor, tell them:• Whoyouareandhowyouknowtheir
patient• Whatsymptomstheindividualhas
reportedtoyou• Whatsignsyouhaveobserved• Whatsignsothershaveobserved• Whenthechangefirstbeganorwas
noticed• Anyrecenthistoryofsimilarsignsand
symptoms• Currentmedications• Knownallergies
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Assessing What to Do When You Learn About a Change (cont.)
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Assessing What To Do When You Learn About A Change (cont.)
Routine Treatment• SignsandsymptomsthatcanbeaddressedbysimpleFirstAidorwrittendoctor’s
ordersareconsideredroutineandcanbetreatedinthehome.Forexample,a minor scratch on the finger may be treated in the home.
• DSPsmustbefamiliarwiththeindividual,hisorherhealthhistory,medications,andanywrittendoctor’sordersbeforedecidingwhattodo.
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Routine Treatment Signsorsymptomsthatmaybe
addressedwithsimpleFirstAidorforwhichtherearewrittendoctor’sordersareconsideredtoberoutine treatmentandcanbetreatedinthehome.Forexample,aDSPmayprovideminorFirstAidinthehomeforasmallscratchonthefinger.Somesymptomsreportedby
theindividual,suchasaheadacheorswellingoftheankles,maybetreatedinthehomeiftherearewrittendoctor’sordersthatspecifywhattodo.TheDSPmustbefamiliarwiththeindividual,hisorherhealthhistory,medications,andanywrittendoctors’ordersbeforedecidingwhattodo.
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Assessing What to Do When You Learn About a Change (cont.)
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T-10
ACTIVITY: What Would You Do?
Show Slide #19: ACTIVITY: What Would You Do?• Groupings:individual,pairs,smallgroup,largegroup.• Readdirectionsaloud.• Reviewanswerswithlargegroup.
Answers: — Onsetoffeverof101degreesorhigher:Urgent Doctor Call— Neworsuddenonsetofincontinence:Urgent Doctor Call— Rashlastingseveraldaysorgettingworse:Urgent Doctor Call— Bleedingthatcannotbecontrolled:911— Severesorethroat/difficultyswallowing:Urgent Doctor Call— Infectionatinjurysite:Urgent Doctor Call— Sleepingmostoftheday;unusualdifficultyinarousing;unusual
fatigue:Urgent Doctor Call— Scratching/holdingoneorbothears:Urgent Doctor Call— Holdingabdomen:Urgent Doctor Call— Diarrheaorvomitinglastingmorethanfourhours:Urgent Doctor Call— Hasaseizurelasting5minutesorcontinuousseizures,paralysis,
numbness,confusion:911— Suddeninabilitytomove,numbness,confusion:911— Onsetoflimping,inabilitytowalk,ordifficultyinmovement:Urgent
Doctor Call— Mosquitobite:Routine Treatment— Hastroublebreathingorisbreathinginastrangeway:911— Visibleswellingwithdoctor’sorderstoelevateleg:Routine
Treatment— Minorcut:Routine Treatment— Isorbecomesunconsciousnotrelatedtoseizure:911— Hasnopulse:911— Anyevidenceofpainordiscomfort:Urgent Doctor Call— Haschestpainorpressure:911— Severeinjuriesasaresultofaccidentssuchasbrokenbones:911— Choking(notbreathingandnotcoughing):911— Hasinjuriestothehead,neck,orback:911— Hasgoneintoshock:911
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A C T I V I T YWhat Would You Do?
Directions: For each sign or symptom listed in the left column, decide if you should respond by calling 911, placing an urgent call to the doctor, or providing routine treatment at home. Check the appropriate box on the right columns.
Your Response
Sign or SymptomFeverof101degreesorhigher □□□
Neworsuddenincontinence(inabilitytocontrolurination)□□□
Rashlastingseveraldaysorgettingworse □□□
Bleedingthatcan’tbecontrolled □□□
Severesorethroat/difficultyswallowing □□□
Infectionofaninjury □□□
Sleepingmostoftheday;unusualdifficultyinwaking;□□□unusuallytired
Scratching/holdingoneorbothears □□□
Holdingabdomen(orstomacharea) □□□
Diarrheaorvomitinglastingmorethanfourhours □□□
Aseizurelastingfiveminutesorcontinuousseizures □□□
Suddeninabilitytomove,numbness,confusion □□□
Minorcut□□□
Mosquitobite □□□
Troublebreathingorisbreathing inastrangeway □□□
Visibleswellingwithdoctor’sordertoelevatetheleg □□□
Sudenlimping,inabilitytowalk,ordifficultyinmovement□□□
Isorbecomesunconsciousnotrelatedtoaseizure □□□
Nopulse □□□
Anyevidenceofpainordiscomfort □□□
Chestpainorpressure □□□
Severeinjuriesasaresultofanaccident,suchasbrokenbones□□□
Choking(notbreathingandnotcoughing) □□□
Injuriestothehead,neck,orback □□□
Hasgoneintoshock □□□
Urgent Routine 911 Doctor Call Treatment
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Measuring Vital Signs
Show Slide #20: Vital Signs: Temperature and Pulse• Thefourvitalsignsaretheperson’stemperature,pulse,respiration,
andbloodpressure.
Temperature• Temperatureistheamountofheatinone’sbodyandisnormally98.6• Totakeaperson’stemperaturewithadigitaloralthermometer:
— Useaplasticsliptocoverthethermometer.— Pressthebuttontosetthethermometer.— Placethethermometerunderthetongue,withmouthclosed
(breathingthroughthenose)forseveralminutes.— Takethethermometeroutoftheperson’smouthtoreadwhen
thetemperatureindicatorlights.• Ifapersonisunabletokeepthethermometerunderthetongue,
taketheirtemperatureundertheirarmpit,waitingfiveminutes.• Donottakeatemperaturebymouthforanindividualwhohas
ahistoryofseizures,breathesthroughmouth,hasjusthadoralsurgery,orisunconscious.
Pulse• Thepulseisthebeatoftheheartfeltatanartery.• Theeasiestandmostcommonplacetotakeapulse(heartbeats
perminute)isontheinsideofthethumbsideofthewrist,usingyourfirsttwofingerspressedagainsttheskin(notyourthumb).Countthenumberofbeatsovera15secondperiodandmultiplybyfour.
Show Slide #21: Activity: Taking a Pulse• Groupings:pairs.• Instructstudentstogetintopairsandpracticetakingeachother’s
pulseandtocomparetheirreadingswithotherpairs.• Ensurethatstudentsknowtocountthepulseandwatchtheclockat
thesametime.• Thisactivityrelatestoasessionoutcome. Outcome: Take an individual’s vital signs, including pulse and
temperature.
RespirationShow Slide #22: Respiration• Define“respiration.”
— Theactofbreathingairintothelungsandoutofthelungs.• Onerespirationisaninhale(takingbreathintothelungs)andan
exhale(lettingthebreathout).
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Measuring Vital Signs
Youmaybecalledupontotakeanindividual’svitalsigns. Thefourvitalsignsaretheindividual’s
temperature,pulse,respiration,andbloodpressure.TemperatureandpulsearevitalsignsthatyouwillmostcommonlyuseasaDSP.
Temperature Temperatureistheamountofheat
inthebody.Normaltemperatureis98.6degreesF.Anythingwithinonedegreelowerorhigher(97.6to99.6)isconsiderednormal.
Therearevariouswaysoftakingaperson’stemperature.Determinewhichmethodispreferredbytheindividualyouaresupporting: 1) Digital-mouth,earorarmpit 2) Temperaturesensitive“tongue
strips”Digitalthermometersareeasytoread
andhardtobreak.Totakeanindividual’stemperaturebymouthusingadigitalthermometer:• Useaplasticsliptocoverthe
thermometer.• Pressthebuttontosetthe
thermometer.• Placethethermometerunderthe
individual’stongue;haveindividualclosetheirmouth(breathingthroughthenose),forseveralminutes.
• Takethethermometeroutoftheindividual’smouth;readthetemperaturewhentheindicatorlights.
Iftheindividualisunabletokeepthethermometerundertheirtongue,youmaytakeatemperatureunderthearmpit(withtipofthethermometeragainstdryskinandheldinplacebythearm),waitingfiveminutes(notfour).Exerciseraisesanindividual’stemperature,sotemperatureshouldbetakenatrest.
Do not take a temperature by mouth for an individual who has a history of seizures, breathes through his or her mouth, has just had oral surgery, or is unconscious.
PulseArteriescarrybloodfromtheheartto
allpartsofthebody.Apulseisthebeatoftheheartfeltatanarteryasawaveofbloodpassesthroughtheartery.Youcanfeelapulseeverytimetheheartbeats.Theeasiestandmostcommonplacetotakeapulseisontheinsideofthethumbsideofthewrist,usingthefirsttwofingerspressedagainsttheskin.Countthenumberofbeatsovera15-secondperiodandmultiplybyfour—thiswillprovideapulsereading(beatsperminute).Repeattheprocesstochecktoseeiftheresultisthesame.Don’tuseyourthumbbecauseyoucouldendup“counting”yourownheartbeatswhenyoufeelyourpulsethroughyourthumb.Anormalpulsewillbeabout70beatsperminute.Anythingfrom50to90iswithinnormalrangeforanadult.
Taking a pulse:• Insidethumbsideofwrist.• Usefirsttwofingerspressedagainst
theskin.• Countthenumberofbeatsovera
15-secondperiodandmultiplybyfour.
Respiration Respirationistheactofbreathingair
intoandoutofthelungs.Whencountingrespiration,paycloseattentionnotonlytothebreathingrate,butalsotowheezing,othersounds,andeaseordifficultybreathing.
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Measuring Vital Signs (cont.)
Respiration (cont.)• Normalrespirationforindividual’sabovetheageof7willbe12to
24breathsperminute.
Show Slide #23: Blood Pressure• Define“bloodpressure.”
— Theamountofforcepushingagainstthewallsofanarterybytheblood.
• Reviewwhatisconsiderednormal,high-normal,andhighforadultsover18.— Normal–Below120/80— High-Normal–120-139/80-89— High–140/90orhigher
• ThefirstnumberiscalledtheSystolicmeasure.• ThesecondnumberistheDiastolicmeasure.• Bloodpressureisaffectedby:
— Timeofday— Emotions— Weight— Activity— Excesssodium(salt)intake— Excessalcoholconsumption
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Respirationisbestcountedwithouttellingtheindividualwhatyouaredoing.Iftheindividualknowsyouarecountingherbreath,itmaychangehowshebreathes.Counttheriseorthefallofthechestforoneminute.Onerespirationisaninhaleandanexhale.Rememberrespirationisaninhaleandexhale.Normalrespirationrateis12to24breathsperminuteforindividualsabovetheageof7.
Blood Pressure Bloodpressureistheforceorpushof
thebloodagainstthewallsofanartery.Abloodpressuredevicemeasuresbloodpressurebytighteningabandonthearm(orleg)andthendetectingwhenbloodbeginstoflowagainthroughthearteriesinthatarm(orleg).Themeasureofbloodpressureisshownusingtwonumbersseparatedbyaslashmark,likethis:120/80.Thefirstnumberisthesystolicmeasure,wherethedeviceusedtomeasurepressureshowsbloodflowingthroughthetightenedbloodvessels.Thelowernumberisthediastolicmeasurethatrecordswhenthebloodisnolongerheard.Bloodpressureforadults18yearsofageandolderfallsinthefollowingcategories:
• Normal: Lessthan120/lessthan80• High-normal:120–139/80–89—
pre-hypertension(highbloodpressure)
• High:140/90orhigher—hypertension*
Bloodpressureisaffectedbytimeofday(lowatnight;peakabouteighthoursafterawakening);emotions(stressincreasesbloodpressure);weight(obesitytypicallyincreasesbloodpressure);activitylevel;excesssodium(salt)intake;excessalcoholconsumption;anduseofcertaindrugs,includingbirthcontrolpills,steroids,decongestants,andanti-inflammatorymedications.
Highbloodpressure(hypertension) isoftencalleda“silentkiller” becausesymptomsofanykindarerare.Ifuntreated,highbloodpressurecanhardenarteriesandresultinseriousheartproblems.Ifhighbloodpressureissuspectedorhasbeendiagnosed,thedoctormayasktheDSPtomonitortheindividual’sbloodpressure.Thismeansthebloodpressureshouldbemeasuredwiththesamedevice,atthesametimeofday,onthesamearm(orleg),andwiththeindividualinthesameposition(forexample,sittingup)overaperiodoftime.Anythingthatmighthaveaffectedthebloodpressure,suchasexercise(forexample,theindividualcamein10minutesafterridingabike)shouldbenoted.Inthesesituations,theDSPwillfollowthedoctorsinstructionsfortakingbloodpressureanddocumentingbloodpressurereadings.
S-12
Measuring Vital Signs (cont.)
*Source:AmericanHeartAssociation,Inc.,2012,http://www.heart.org/HEARTORG/
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T-13
Reporting and Documenting Changes
• Alltypesofchangesmustbereportedanddocumentedinsomeway.
• Reviewreportingand/ordocumentationrequirementsformedicalemergencies,callstothedoctor,andtreatmentsprovided.
• RemindstudentsthatSpecialIncidentReportingwascoveredinSession3.
• SometimestheDSPwillsimplydocumentachangeheorshehasidentified.ThisisimportantbecausemanychangesoccurslowlyovertimeandwillonlybeidentifiedifDSP’sconsistentlydocumentandshareobservations.
• Signsorsymptomsofchangesreportedtoothers(doctors,dentists,theregionalcenterservicecoordinator)mustalsobedocumented.
• SignsorsymptomsmaybeanindicationofpossibleabuseorneglectwhichyouaremandatedtoreporttotheappropriateprotectiveserviceagencyaswasdiscussedinSession3.
Show Slide #24: Reporting and Documenting Changes• Reviewdocumentationguidelinespresentedasbulleted
statementsonpageS-13.• Thisinformationrelatestoasessionoutcomeandmaybecovered
onthequiz. Outcome: Follow the guidelines for reporting and documenting
changes that may be signs and symptoms of illness or injury.
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Reporting and Documenting Changes
Regardlessofwhatactionyou,astheDSPtake,youmust report (tellit)and document (writeabout
it)insomeway.• Medicalemergenciesmustbe(1)
documentedintheindividual’srecordand(2)reportedtotheregionalcenter,CommunityCareLicensingandotherprotectiveservicesagencies.
• Urgentcallstothedoctormustbe(1)documentedintheindividual’srecordand(2)mayrequireaspecialincidentreport.
• Routinetreatmentprovidedinaccordancewithawrittendoctor’sorderorsimplefirstaidmustbe(1)documentedintheindividual’srecordand(2)completedinaccordancewithawrittendoctor’sorder.Sometimesthecorrectresponseis
simplytodocumentthechangethatyouhaveidentified.Thisisimportantas,overtime,youandotherDSPsmayidentifyapatternortrendandprovidevaluableinformationinthediagnosingofahealthproblem.Forexample,throughcontinuousdocumentationofyourobservations,youmaydiscoverthatanindividualislosinginterestinactivities,whichmaybeasignorsymptomofillnessorinjury.ManychangesoccurslowlyovertimeandwillonlybeidentifiedifyouandotherDSPsconsistentlydocumentandshareobservations.
Youmaybereportingchanges(orsignsandsymptoms)toanumberofdifferentpeople,includingadoctor,dentist,regionalcenterservicecoordinator,behaviorspecialist,andyouradministrator.Allofthesecontactsmustbedocumented.Also,rememberthatsignsandsymptomsmaybeanindicationofpossibleabuseorneglectthatyouaremandatedtoreporttotheappropriateprotectiveserviceagency.
Alwaysreportanddocumentchangesassoonaspossible.Sometypesofdocumentation,suchasspecialincidentreporting,haveregulatoryandstatutorytime-linesthatmustbefollowed.Forexample,specialincidentsmustbereportedbyphonetotheregionalcenterwithin24hoursandinwritingwithin48hours.
HerearesomeguidelinestoaddtoyourDSPtoolboxandtousewhenreportinganddocumentingchangesthatmaybesignsorsymptomsofillnessorinjury:
• Writedownwhattheindividualsaidordidtocommunicatethechange.Forexample,Billsaid,“Mystomachhurts,”or“Fredwalkeduptomeandpointedtohisstomach,frowningandmoaning.”
• Donottrytomakeadiagnosis.TheDSPisnotahealthcareprofessional.Describeidentifiedchangesonly.
• Donotdocumentyourpersonalopinion;forexample,“Billsaidhisarmhurt,butIdon’tthinkthereisanythingreallywrong.”
• Bespecificwhenreportinganddocumentingobservedchanges.Forexample,“IheardJanescreaming.Shewassittingonthecouchinthelivingroom.Thescreaminglastedforabouttwominutes.”
• Whenreportinganddocumentinganswerstoquestions,reportanddocumentboththequestionandtheresponse.Forexample,“Billtoldme‘mystomachhurts.’Iaskedhim,‘howlonghasithurt?’Billsaid,‘Sincebreakfast,anditreallyhurtsbad.’”Inthecasewhereanindividualdoesnotverballyrespond,theDSPshouldreportanddocumenttheindividual’sresponse;forexample,“IheardJanescreaming.WhenIaskedJane,‘What’swrong?’sheputherhandsonherheadandbeganrocking.”
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T-14
ACTIVITY - Signs and Symptoms
Show Slide #25: ACTIVITY: Signs and Symptoms• Groupings:individual,pairs,smallgroups,largegroup.• Readthedirectionsaloudandremindthestudentstousethe
guidelinesdiscussedonpageS-14whendocumentingthechanges.
• Reviewanswerswiththelargegroup.
Answers:— WhatareJohn’ssignsandsymptoms?John complained of
chest pain and pressure, only ate part of his lunch, had a pale complexion, was sweating, and was short of breath.Notetoinstructor:Ifthestudentsanswer“heartattack,”thisisanopportunitytoremindthemthattheyarenottodiagnose,buttoidentifychangesbyobservingandcommunicating.
— WhatshouldZacdonext?Call 911 immediately.— Inthisscenario,didZacdotherightthing?No. Zac should
have called 911 immediately when John first complained of chest pain.
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Signs and Symptoms
Directions: Read the following scenario and answer the questions.
John,57,complainedofchestpaintoZac,theDSPonshift.ZacadvisedJohnto“takeiteasy.”Tobesafe,Zacobservedhimmorecloselythanusualthroughoutthemorning.HealsolookedatJohn’srecordandsawthathehadahistoryofobesityandhighcholesterol.Hehadbeentothedoctorthreetimesinthelastsixmonthsfor“achesandpains,”andnoproblemswerefound.
AfterJohnhadeatenonlypartofhislunch,heagaincomplainedofpainandpressureinhischest.JohnwenttowatchTVinthelivingroom.Zacwentwithhimtomakesurehewasokay.Afterabout15minutes,ZacobservedthatJohnwaspale,sweating,andshortofbreath.
What are John’s signs and symptoms?
What should Zac do next?
In this scenario, did Zac do the right thing?
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Managing Chronic Health Care Conditions
Show Slide #26: Managing Chronic Health Care Conditions• ThebestpossiblesupportDSPscanprovidetoindividualswith
chronichealthconditionsistotalktotheiradministrator,theindividual’sdoctor,andplanningteam,andreviewtheindividual’shealthrecords.
• “Protocols”orhealthcareguidelinesformostchronichealthconditionsrequiringspecializedcarecanbeobtainedfromregionalcenternurses.
Diabetes
Show Slide #27: Diabetes• Diabetesisachronicdiseasewithnocure.Peoplewithdiabetes
needtomanagetheirdiseasetostayhealthy.• Reviewthetwotypesofdiabetes.
— TypeI:Noknownwaytoprevent.Mustinjectinsulineveryday.— TypeII:Preventable.Cancontrolbloodsugarthroughweight
control,regularexercise,andasensiblediet.• TypeIIdiabetescanbepreventedwithregularexerciseand
maintainingahealthybodyweight.
Show Slide #28: Who Is At Risk for Diabetes • Reviewriskfactors.
— Overweight,don’texerciseandoverage40.— Familyhistoryofdiabetes.— African-American,Latino,AsianAmerican,PacificIslander,
andNativeAmerican.
Show Slide #29: Common Symptoms of Diabetes• Review
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Managing Chronic Health Care Conditions
Inthissectionyouwilllearnguidelinesforsupportingindividualswithcertainlonglasting,orchronic,health
conditions.Sincethiscurriculumisdesignedforall DSPs,itisimpossibletoreviewpropercareandmanagementguidelinesforallthechronichealthconditionsthatDSPsmayseeintheindividualstheysupport.DSPsareencouragedtotalktotheiradministrator,theindividual’sdoctor,andtheservice
coordinator,andreviewhealthrecordstolearnhowtoprovidethebestpossiblesupporttoindividualswithanychronichealthconditions.Theregionalcenternursemayalsobehelpfulandshouldhavehealthcareguidelines,calledprotocols, formostchronichealthconditionsrequiringspecializedcare.Eachindividualisunique,andcareplanscanbeverydifferentforindividualswiththesamechronichealthcondition.
Diabetes
Diabetesisadiseaseinwhichthebodydoesnotproduceorproperlyuseinsulin.Insulinisahormonethatisneededtoconvertsugar,starchesandotherfoodintoenergyneededfordailylife.Diabetesoccurswhen:• Thebodydoesnotproduceanyinsulin
(TypeIdiabetes),or• Thebodyproducesverylittleinsulin
(TypeIIdiabetes).Diabetesisachronicdiseasewithno
cure.Individualswithdiabetesneedtotakemedicationandmonitortheirdiseasetostayhealthy.
Type I diabetes,orinsulindependentdiabetes,isusuallydiagnosedinchildhoodoradolescencebutcandevelopatanyage.PeoplewithTypeIdiabetesmustmonitortheirbloodsugar(alsoknownasglucose)levelsandinjectinsulineveryday.ThereisnoknownwaytopreventTypeIdiabetes.
Type II diabetes,ornon-insulindependentdiabetes,isthemostcommonformofdiabetes.PeoplewithTypeIIdiabetescanoftencontroltheirbloodsugarthroughweightloss,exercise,andcarefulmealplanning.Somemayneedinsulininjectionsororalmedicationtolowerbloodsugar.
Prevention of Type II DiabetesFactorssuchasage,familyhistory
andethnicitycannotbechanged.However,alifestylethatincludesahealthydiet,regularexercise,maintainingandmonitoringahealthybodyweight,andyearlyphysicalexamscanreducetheriskofTypeIIDiabetes.
Who Is at Risk• Peoplewhoareoverweight,don’t
exercise,andareovertheageof40.• Peoplewithafamilyhistoryofdiabetes.• African-Americans,Latinos,Native
Americans,AsianAmericansandPacificIslanders.
Common Symptoms of DiabetesThesymptomsofdiabetesoften
seemharmlessandmaybemistakenforsymptomsofotherillnesses.TheDSPshouldobservetheindividualcarefullyandreportthesesymptomstothedoctor.Diabetescanbediagnosedwithasimplebloodglucosetest.TheDSPshouldobserveallindividualscarefullyandreportthefollowingsymptomstothedoctor:• Excessivethirst• Frequenturination• Extremehunger
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Diabetes (cont.)
Show Slide #30: When to Get Urgent Care for an Individual Who Is Diabetic
• ReviewusingthebulletsonpageS-16.
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• Unexplainedweightloss• Increasedfatigue• Itchyskin• Yeastinfections• Slow-healingwounds• Drymouth• Blurredvision• Irritability• Legpain
Problems that May Come with DiabetesHyperglycemiaandhypoglycemia
mayhappentoindividualswhohavediabetes.Hyperglycemiameans‘highbloodglucose’(ahighlevelofsugarintheblood);hypoglycemiameans‘lowbloodglucose’(alowlevelofsugarintheblood).Ifhyperglycemiaisnottreated,adiabeticcomacouldoccur.
Signsandsymptomsofhyperglycemiainclude:
•Highlevelsofsugarintheurine•Frequenturination•Increasedthirst•HighbloodglucoseIndividualswithdiabetesmustcheck
theirbloodglucoseoften.Theindividual’sdoctorwilltellthemhowoftentheyshouldcheckandwhattheirbloodglucoselevelsshouldbe.TheDSPshouldchecktheindividual’smedicalprofileandtalktotheindividual’sdoctortofindthesafestwaytolowertheindividual’sbloodglucoselevel.Thedoctormayrecommendexercise,changesindiet,orchangestotheamountortimingofmedication.Diabeticcomaislife-threateningandneedsimmediatetreatment.
When to Get Urgent Care for an Individual who is Diabetic
Geturgentcareifanindividualwithdiabetes:• Losesconsciousness.• Showssignsofhighbloodsugar:
•Frequenturination• Intensethirst•Blurredvision•Rapidbreathing•Fruitysmellingbreath
• Showssignsoflowbloodsugarthatcontinueafterthepersonhaseatensomethingcontainingsugar:•Fatigue•Weakness•Nausea•Hunger•Doubleorblurredvision•Poundingheart•Confusion• Irritability•Appearanceofdrunkenness
Preventing ProblemsOnceagain,Prevention is the
Number One Priority:Topreventhyperglycemiaandhypoglycemia,supportindividualswithdiabetestopracticegooddiabetescare.Theideaistowatchforandtreatproblemsearly--beforetheycangetworse.
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Epilepsy or Seizure Disorders
Show Slide #31: Epilepsy or Seizure Disorders• Aseizureisanunusualrushofelectricalenergyinthebrain.• Therearetwomajorcategoriesofseizures:
— Partial:occurslocally(inaspecificpart)inthebrain.Usedtobecalledpetitmalseizures.
— Generalized:encompassestheentirebrain.Usedtobecalledgrandmalseizures.
• StatusEpilepticusisrepetitivetonic-clonicconvulsions(withoutrecovery)orasingle,prolongedseizure.Thistypeofseizurecanbelifethreatening.
• Whenaseizureoccurs,observetheeventcarefullyanddocumentwhatoccurred,includinghowlongthepersonwasunconscious.
• Ifitistheindividual’sfirstseizure,anditlastsforfiveminutesormore,call911.
• Ifapersonhasahistoryofseizures,consultwithhisorherneurologist.
Show Slides #32 and #33: Top 10 First Aid Rules for Seizures • Review.
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Epilepsy or Seizure Disorders
Oftheover300,000peoplecurrentlybeingservedbyregionalcenters,about16percentareidentifiedashavingepilepsy.
Epilepsyisamedicalconditionthatproducesseizures.Aseizureisanunusualrushofelectricalenergyinthebrain.Therearetwomajortypesofseizures,partialandgeneralized,referringtothepartofthebrainwheretheseizurehappens.Ifaseizurebeginslocallyinthebrain,itispartial.Ifaseizurehappenstotheentirebrain,itisgeneralized.Knowinggeneraltypesofseizuresisimportantforthephysiciantochoosetherightmedicationtoprescribe.
Status Epilepticuscomingfromeitherapartialorgeneralizedseizure canbelifethreatening.Itisdefinedaseitherrepetitiveseizuresorasingle,prolongedseizure.Braindamagecanoccurafterabout20minutesofcontinuousseizureactivity.
Whenaseizureoccurs,observecarefullyanddocument whathappened,includinghowlongthepersonwasunconscious(iflossofconsciousnessoccurred).TheDSP’sdocumentationofaseizureiscriticaltotheindividual’sdoctor,especiallyifthereissomethingnewtoreport.Detailsarehelpfulinmakingaproperdiagnosisandchoosingatreatment,forexample,aparticularmedicationorclassofmedications.
Ifitistheindividual’sfirst(known)seizure,theDSPshouldplaceanurgentcalltothedoctor.Ifaseizurelastsforfiveminutesormore,call911.
Theindividual’sdoctormaywanttoexaminespinalfluidtoruleoutinfectionordoothertests.Ifapersonhasahistoryofseizures,thedoctormayconsultwithaneurologist.Thedoctormayprescribean“asneeded”medicationforrepetitiveseizuresonagivendayorongoingmedicationforseizurecontrol.Remembertochecktheindividualforanysignsorsymptomsofinjury;documentanyinjuriesthatmayhaveoccurredduringtheseizure.
Top 10 First Aid Rules for Seizures1.Keepcalm!Theindividualisusuallynotsufferingorindanger.2.Protecttheindividualfrominjurybyclearingtheareaofhardorsharpobjects.
Preventionisthenumberonepriority!3.Loosentightclothing.Donotrestrainmovements.4.Turntheindividualonhis/hersidewithhis/herfaceturnedgentlysidewaysor
slightlydown.5.Donotputanythingintotheindividual’smouth.6.Donotgivetheindividualanythingtodrink.7.Reassuretheindividual.8.Staywiththeindividualuntilconsciousnessreturnsandconfusiongoesaway.9.Allowarestperiod(10–30minutesformostpeople).10.Documenttheseizureintheindividual’slog.Includetheamountoftimethe
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ACTIVITY: Understand Seizures and Seizure First Aid
Show Slide #34: ACTIVITY: Understand Seizures and Seizure First Aid• Groupings:individual,pairs,smallgroups,largegroups.• Informthemthatavideowillbeshownandthatfollowingthevideo,
theyaretoanswerthequestionsabouttheinformationinthevideo.• ClickontheicontoshowtheSeizurevideo.• Allowstudentstimetoanswerthequestionsanddiscusstheanswers
inclass.• Informationdiscussedinthisactivityrelatestoasessionoutcomeand
maybecoveredonthequiz. Outcome: Describe how to provide first aid for an individual having a
seizure.• NotetoTrainer:ThisvideoisfairlynewtotheDSPTcurriculum.It
doesnotdirectlyaddressquestion#3.Discusstheanswerwiththestudents,clarifyingthatfirstaidisessentiallythesame:Staycalm,reassuretheindividual,makesuretheyaresafefromharm,andstaywiththemuntiltheyrecover.
Answers:1. Whenaseizureoccurs,whatishappeninginsidetheperson’s
brain? A part or all of the brain is experiencing a surge in electrical energy.
2. Toassistapersonhavingageneralizedseizure,whatshouldyoudo?Notdo?Why?Keep calm and reassure the individual. If the individual is falling, ease him or her to the ground. Protect the individual’s head by removing objects and putting something soft under his or her head. Turn the individual on his or her side, if possible, to avoid choking on saliva or prevent the tongue from blocking his or her airway. Do not restrain the individual’s movements and do not put anything in his or her mouth.
3. Toassistapersonhavingapartialseizurethatdoesn’tgeneralize,whatshouldyoudo?Notdo?Why?Keep calm and reassure the individual. Minimize physical interaction with the individual. Head off any danger (for example, walking into traffic). Stay with the individual until he or she recovers.
4. Underwhatcircumstanceswoulditbeappropriatetoseekmedicalcarerightaway?If it is the first seizure and/or the person is unconscious for 5 minutes of longer and/or the seizure is the result of injury.
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A C T I V I T Y
Understand Seizures and Seizure First Aid
Directions: Answer the following questions about the information in the video.
1.Whenaseizureoccurs,whatishappeninginsidetheindividual’sbrain?
2.Toassistanindividualhavingageneralizedseizure,whatshouldyoudo?Notdo?Why?
3.Toassistanindividualhavingapartialseizurethatdoesn’tgeneralize,whatshouldyoudo?Notdo?Why?
4.Underwhatcircumstancesisitappropriatetoseekmedicalcarerightaway?
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This video about seizures (You Can Do This: Seizure First Aid) is used with the generous permission of its producers: Finding a Cure for Epilepsy and Seizures (faces) at New York University Medical Center. For more information, visit their Website at http://faces.med.nyu.edu.
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High Risk Health Problems
Show Slide #35: High Risk Health Problems• Peoplewithdevelopmentaldisabilitieshaveahigherriskofserious
healthproblemssuchasskinbreakdown,constipation,choking,sunandheat-relatedillness,andtheearlyonsetofage-relatedhealthconditions.
• DSPsneedtoknowwhatpreventativeactionstotakeandtoidentifychangesthatmaybesignsandsymptomsoftheseconditions.
• Thisinformationrelatestoasessionoutcomeandmaybecoveredonthequiz.
Outcome: Identify ways to prevent health problems for individuals at risk.
Skin Breakdown
Show Slide #36: Skin Breakdown• Skinbreakdownisaseriousandconstantconcernforpeoplewhouse
wheelchairsand/ordonotmoveaboutorchangepositions.• Askthemhowmanyofthemsupportpeoplewithmobilitychallenges?
Whatdotheydotopreventand/ortreatskinbreakdown?• Reviewhowtopreventskinbreakdown.
— Frequentmovingaboutand/orchangingpositions.— Keepingtheskindryandclean.
• Ifskinbreakdownoccursorisexpected,makesurethepersonisexaminedbyadoctorimmediately.
• ReviewcommonfungalinfectionslikeJockItchandAthlete’sFootandwaystopreventthem.
• Reviewhowskinproblemscanbepreventedoratleastminimized.
Constipation
Show Slide #37: Constipation• Untreatedconstipationcanleadtoseriousconsequences.• Reviewlistofbulletedlistofriskfactorsforconstipation(pagesS-19
throughS-20).• Askstudentstosaywhattheythinkanindividualcandotoprevent
constipationgiventheaboveriskfactors?Liststudents’answersonaflipchart.Possibleanswersinclude:healthy diet with lots of fiber (fruits, vegetables and whole grains), regular exercise (people with mobility challenges can often participate in many modified types of exercise), and drink plenty of fluids especially water (eight glasses per day).
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High-Risk Health Problems
Individualswithintellectual/developmentaldisabilitieshaveahigherriskforserioushealthproblems.
Theymaybepronetoskinbreakdown,constipation,choking,sunandheat-relatedillness.Alsoage-relatedhealth
Skin Breakdown
conditionsmaybeginearlyduetospecificdevelopmentaldisabilitiesorthetreatmentofcertainconditions.DSPsneedtoknowwhatpreventiveactionstotakeandhowtoidentifychangesthatmaybesignsandsymptomsofserioushealthproblems.
Oftheover300,000peoplecurrentlybeingservedbyregionalcenters,17percentareidentifiedasusingwheelchairsorneedingassistancetowalk.Skin breakdownisaseriousandconstantconcernforindividualswhousewheelchairsand/ordonotchangepositions.Skinbreakdowndescribeschangestoanindividual’sskin,includingscrapesandsoresoverbonyspotssuchastailboneandhips.
Individuals who are at High Risk for Skin Breakdown
Individualswhousewheelchairsand/orindividualswhodonotmovearoundorchangepositions.
How to Prevent Skin Breakdown• Assistindividualtomoveand/or
changepositionseveryhour.• Keeptheskindryandclean.
What to Do If Skin Breakdown Occurs Makesuretheindividualisseenbya
doctorimmediately.
Athlete’sfoot(tinea pedia)andjockitch(tinea cruris) areverycommon fungalinfectionsthatcancauseskinbreakdown.Fungusgrowsbestinwarm,moistareasoftheskin,suchasbetweenthetoesorinthegroinarea.Fungusproblemscanbepreventedbydryingoffskinwellafterwashing,wearingsandalsorshoesthatallowairtomovearoundthefeet,wearingcottonunderclothesandsocks,andusingtalcumpowder.DSPsshouldassistindividualstocleananddryfootandgroinareas.
Someskinproblemsareveryserious. Othersareuncomfortableandpassing.Someskinproblemscanbepreventedoratleastminimizedthroughdiet,properclothing,andotheractions.Someskinproblemsmaybespreadbycontact,soremembertousehandwashingandotherinfectioncontroltechniques.Alwaysseekadviceandtreatmentfromtheindividual’sdoctorwhennewproblemsariseortheexistingproblemcontinues.
Constipation
Untreatedconstipationcanleadtoseriousconsequencesincludingtheneedforsurgery,tearingofthebowel,andevendeath.
Individualswhoareatahigherriskforconstipation:• Usewheelchairsorsitforlongperiods• Getverylittlephysicalactivity
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Constipation (cont.)
Show Slide #37: Constipation (cont.)• Reviewwaysthatconstipationcanbeprevented.
— Healthydietwithfiber.— Regularexercise.— Plentyoffluids.
• DSPsshouldbeawareofindividual’snormalpatternofbowelmovementssothattheycanobserveforchanges.
• ReviewchangesthatareoftensignsandsymptomsofconstipationonpageS-20.
• IfDSPsidentifyanyofthesechangestheyshouldcalltheindividual’sdoctortoseekmedicalassistance.
Risks from Exposure to Sun and Heat
Show Slide #38: Exposure to Sun and Heat• Overexposuretothesunandheatcanleadtomanyproblems–
anythingfrommildsunburntofatalsunstroke.• Overexposureandprolongedphysicalactivityintemperaturesas
lowas80degreescanplacepeopleatriskforheat-relatedillness.• CommunityCareLicensingrequiresthatfacilitiesbekeptata
comfortabletemperaturebetween65and85degreesatalltimes.
Individuals Who Are At Higher Risk• Children,theelderly,andindividualswithdevelopmental
disabilitiesareatthegreatestriskforsunburnandheat-relatedillness.
• Increasedriskisalsoassociatedwithtakingcertainmedicationsandhavingcertaincharacteristics.ReviewthelistonpageS-20.
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Risks from Exposure to Sun and Heat
Overexposuretosunandheatcancausemanyproblems—anythingfrommildsunburntofatalsunstroke.Individualsareatriskofheat-relatedillnessstartingattemperaturesaslowas80degrees,dependinguponlengthofexposureandlevelofphysicallyactivity.
CommunityCareLicensingrequiresallhomestomaintainacomfortabletemperaturebetween65and85degreesatalltimes.Inareasthatareextremelyhot,themaximumtemperaturemustbe30degreeslessthantheoutsidetemperature.(ReferencedTitle22,80088.)
Individuals Who Are at Higher Risk from Exposure to Sun and Heat
Ingeneral,children,theelderly,andindividualswithdevelopmentaldisabilitiesareatthegreatestriskforsunburnandheat-relatedillness.Individualswithfairhairorskinareathigherriskaswell.Increasedriskisalsoassociatedwithtakingcertainmedications,includingbutnotlimitedto:• Antihistaminesusedincoldand
allergymedications• Antibiotics(sulfadrugs,tetracyclines)• Antidepressants• Antipsychotics• Cardiovasculardrugs• Oralmedicationsfordiabetes• Non-steroidal,anti-inflammatorydrugs
usedtocontrolpainandinflammation• Anti-dandruffshampoos
• Drinksmallamountsoffluids• Don’teatenoughfiberintheirdiet• Takecertainmedications Preventing Constipation• Eatahealthydietwithlotsoffiber
(fruits,vegetables,andwholegrains)• Exerciseregularly• Drinkplentyoffluids,especiallywater
(eightglassesperday)
Eachindividualhasapatternofbowelmovementsthatis“normal”forhimorher.Oncethenormalpatternofbowelmovementsisknown,theDSPshouldlookforchangesthatmaybesignsofconstipation.Ifanindividualisnotabletotellyouthathehadabowelmovement,orifthedoctororotherhealthcareprofessionalfindsthattheindividualisatriskforproblemsinthisarea,the
individualprogramplan(IPP)forthatindividualmayincludekeepingarecordofbowelmovements.
Changesthatareoftensignsandsymptomsofconstipationare:• Achangeinthenormalpatternof
bowelmovements(smalleramountsofstool,waterystoolordiarrhea,unusualaccidents).
• Lossofappetite• Increaseinsleepiness• Abdominalbloating• Abdominalpain• Irritability
Constipation can have serious consequences. If you identify any of these changes, call the individual’s doctor to seek medical assistance.
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Constipation (cont.)
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Risks from Exposure to Sun and Heat (cont.)
Show Slide #39: Sunburn• Define“sunburn:”redness,painandinflammationcausedby
exposuretoradiationfromthesun.• UseSunscreenwithanSPFor15ormore.• Peoplewithfairhairorskinwhoburneasilyshoulduseasunscreen
withanSPFof30.• Useofsunscreenshouldbedocumentedintheindividual’srecord.• Askthestudentstoidentifywaystopreventsunburnandheat-
relatedillnesses.Reviewtheclasslistandmakesureitincludesallofthewaysidentifiedinthelistofthingstodowhentemperaturesrise.
• Reviewtreatmenttipsforsunburn.
Show Slide #40: Heat Cramps• Neverleaveachild,apersonwithadisability,anelderlyperson,or
ananimalinacaronahotday.Inaslittleas10minutesthecarcanbecomeafatalfurnace.
• Define“heatcramps:”painfulmusclespasmsusuallyinthelegsorabdomen.Thepersonusuallyexperiencesheavyperspirationorsweating.
• Reviewtreatmenttipsforheatcramps.
Show Slide #41: Heat Exhaustion• Define“heatexhaustion:”seriousillnesscausedbyexcessiveheat
anddehydration.— Causesapersontobeweakandsweatheavily.Othersymptoms
include:– Cold,paleandclammyskin– Weakandshallowpulse– Fatigue,confusion,nausea,faintingandvomitingmayalso
occur• Reviewtreatmenttipsforheatexhaustion.
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Preventing SunburnSunburn isredness,painandinflammationcausedbyexposuretothesun’sultravioletrays.Anindividualcanburnwithin15minutesanydayoftheyearinCalifornia.Sunburnscanoccurevenonanovercastday.Peopleofcolorcanalsoburnveryeasily.Thedegreetowhichsomeoneburnsor“tans”dependsontheintensityofthesun’sraysandtheperson’suniqueresponsetotheexposure.Typicalsymptomsofsunburnarerednessandpainintheskin.Inseverecasesthereisalsoswelling,blisters,fever,andheadaches.
Inadditiontosunburn,individualswithfrequentexposuretothesun’sultra-violetrayshaveahighriskofdevelopingskincancer.SkincanceristhemostcommonformofcancerintheUnitedStates.
Topreventsunburn,usesunscreenwithasunprotectionfactor(SPF)of15 ormore.Individualswithfairhairorskinwhoburneasilyshoulduseasunscreenwith SPF30.Applysunscreentoallexposedskinsurfaces20minutespriortogoingoutinthesun.Reapplythroughoutthedayandaftertheskincomesincontactwithwater.Useofsunscreenshouldbedocumentedintheindividual’srecord.
Treatment Tips:Havetheindividualdrinklotsofwater.AloeveragelandcertainothertopicalOver-the-Counter(OTC)moisturizershelpreducethepain.Contactthedoctorimmediatelyifsevereblisteringoccurs,theindividualfeelsveryill,ortheindividual’stemperatureis102degreesormore.Preventing Heat-Related Illness
Whentemperaturesrise:• Wearahatwithawidebrimorusean
umbrella.• Wearlight-weight,light-colored,loose
fittingcottonclothing.• Drink8to10glassesofwateraday.
Drinkevenmoreifyouareworkingorexercisinginhotweather.Avoidsugary,caffeinatedoralcoholicbeverages.
• Takeiteasy!Limitphysicalactivityduringthehottestpartsoftheday.
• Stayinsideifpossible.• Ifyoumustbeoutdoorsforlongperiods
oftime,stayinashadyspotorbringasunshadewithyou.
• Forindividualswithimpairedmovement,avoidtemperaturesabove95degreesifatallpossible.
• Intheeventofapoweroutage,considergoingtoacoolbuildingorairconditionedcar.Neverleaveachild,anindividualwith
adisability,anelderlyperson,orananimalinacaronahotday.Inaslittleas10minutes,thetemperatureinthecarcanrisealmost20degrees;anyoneleftinthecarcoulddie.
Heat cramps are painfulmusclespasms,usuallyinthelegsorabdomen,causedbyover-exposuretoheat.Theindividualusuallyexperiencesheavyperspirationorsweating.
Treatment Tips: Havetheindividualmovetoacoolerplaceandrestinacomfortableposition.Givehimaglassofcoolwaterevery15minutes,butdon’tlethimdrinktooquickly.Removeorloosentightclothingandapplycoolwetclothstotheskin.Donotgivesalttablets.Calladoctorifthesymptomspersistmorethantwohours.
Heat exhaustion,aseriousillnessbroughtonbyexcessiveheatanddehydration,causesanindividualtobeweakandsweatheavily.Atthesametimetheskiniscold,pale,andclammy.Theindividual’spulseisweakandshallow.Fatigue,confusion,nausea,fainting,andvomitingmayalsooccur.
Treatment Tips: Call911orgototheEmergencyRoomif:• Theindividual’sskinisdryevenunder
thearmpitsandbrightredorflushed.• Bodytemperaturereaches102degrees. S-21
Risks from Exposure to Sun and Heat (cont.)
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Risks from Exposure to Sun and Heat (cont.)
Show Slide #42: Heat Stroke• Define“heatstroke:”severeillnessthatoccurswhenaperson’s
temperaturecontrolsystemhasstoppedproducingsweat,whichcoolsthebody.Signsandsymptomsinclude:
– Highbodytemperature(102degreesandup)– Hot,dryskin– Strong,rapidpulse– Personmaybecomeunconscious
• Reviewtreatmenttipsforheatstroke.
Choking
Show Slide #43: Choking• Chokingisablockageoftheairwaythatpreventsapersonfrom
breathing.• Chokingwillresultindeathunlesstheairwayisclearedimmediately.• Chokingisafrequentsafetyhazardfor:
— Peoplewithdevelopmentaldisabilities.— Individualswithchronichealthconditionsandthosewithcerebral
palsywhohavedifficultywithswallowingareathighestriskandneedtobeobservedcloselywheneating.
— Otherpersonsmayhavetroublewithfoodsofdifferenttextures.— Peopletakingcertainmedicationsmayhavedrymouthandhave
ahardtimeswallowing.— Peoplewhoeatordrinktoofast,talkandlaughwhileeating,or
eatwhilelyingdown.— Peoplewhotakefoodfromothersandmayputtoomuchfoodin
theirmouthstoavoidbeingcaught.• Askstudentstoidentifycommoncausesofchoking.Liststudent
answersonaflipchart.Makesurethelistincludesthecommoncausesofchoking.
• ReviewSignsofChoking.
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• Theindividualisconfused,seemstobeimaginingunrealthings,orbecomesunconscious. Otherwise,gettheindividualtoa
coolerplaceandinacomfortableposition.Givehalfaglassofcoolwaterevery15minutes,butdon’tlettheindividualdrinktooquickly.Removeorloosentightclothingandapplycoolwetclothstotheskin,orspongethebodyinabathwithcoolwater.
Heat stroke, alsoknownassunstroke,issevereillnessthatoccurswhenthe
Choking
Chokingisablockageoftheairwaythatpreventsanindividualfrombreathing.Chokingwillresultindeathunlesstheairwayisclearedquickly.Chokingisafrequentsafetyhazardforindividualswithdevelopmentaldisabilities.
Individuals Who Are at Higher RiskManyindividualswithdevelopmental
disabilitiesexperiencechokingrelatedtootherchronichealthconditions.Forinstance,individualswithcerebralpalsymayhaveahardtimewithchewingandswallowing.Theseindividualsneedcloseobservationtohelpavoidchoking.Individualswithotherconditionsmayhavetroublewithfoodsofdifferenttextures.Individualstakingcertainmedicationsmayhavedrymouth,whichmakesithardertoswallow.Beawareofindividualswhoeatordrinktoofast.Individualsshouldberemindednottotalkorlaughwithfoodintheirmouthsortoeatlyingdown.Individualswhofrequentlyputtoomuchfoodintheirmouthsmayneedtobeprovidedwithsmalleramountsoffood.
Itisespeciallyimportanttocloselymonitorindividualswhotakefoodfromothers.Theseindividualsoftenputtoomuchfoodintheirmouthtoavoidbeingcaught.
Common Causes of Choking • Tryingtoswallowlargeportionsof
poorlychewedfood• Eatingwhiletalkingorlaughing• Eatingtoofast• Walking,playing,orrunningwithfood
orobjectsinthemouth• Certainfoodslikehotdogs,whole
grapes,andhardcandies• Medicationsthatdecreasealertness
andmuscletoneorcausedrymouth• Poororalmotor(mouthmovement)
skills• Difficultyswallowing• Eatingobjectsthataren’tsupposedto
beeaten• Vomiting• Aspiration(inhalingvomit,saliva,food,
orasmallobject)
Signs of Choking• Clutchingthethroatwithoneorboth
hands• Inabilitytospeak,coughforcefully,or
breathe• Turningblueintheface• High-pitchedwheeze
individual’sbodyhasstoppedproducingsweat,whichcoolsthebody.Signsandsymptomsofheatstrokeareahighbodytemperature(102andabove),hotdryskin,andastrongrapidpulse.Theindividualmaybecomeunconscious.
Treatment Tips:Call911immediately.Movetheindividualtoacoolerplaceandquicklycoolthebodybywrappingitinawetsheetandfanningit.Puticepacksontheindividual’sankles,wrists,andarmpitstocoolthelargebloodvessels.Keeptheindividuallyingdownandcheckhisorherbreathing.
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Risks from Exposure to Sun and Heat (cont.)
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Choking (cont.)
• Reviewtreatmenttipsforchoking.Thoroughlyexplain“five-and-five”techniqueforassistingsomeonewhoischoking.
Health Problems Associated with Aging
Show Slide #44: Aging• Agingisthenormalprocessoftime-relatedchangesthatoccur
throughoutlife.• Manyindividualswithdevelopmentaldisabilitiesexperienceage-
relatedchangesearlierthatthegeneralpopulation.Giveexamplesfromthetext.
• ItistheresponsibilityoftheDSPtoidentifychangesthatmayindicateanearlyonsetofanage-relatedhealthconditionandtoreportthesechangestotheindividual’sdoctor.
• Thisinformationrelatestoasessionoutcomeandmaybecoveredonthequiz.
Outcome: Describe health problems associated with aging.
Symptoms and Signs of Age-Related Health Conditions • Askstudentstoidentifysignsandsymptomsthattheythinkmight
berelatedtoaging.Liststudentanswersonaflipchart.Makesurethelistincludesallofthesignsandsymptomsofage-relatedhealthconditionslistedinStudentGuide.
Physical Health Changes of Aging• Reviewthephysicalhealthchangesofaging.
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Treatment Tips: It is strongly recommended that every DSP take a Cardio Pulmonary Resuscitation (CPR) class to learn the abdominal thrusts, an emergency procedure used to clear the airway when choking occurs. Classes are widely available. Check with your local Red Cross or Fire Department. By doing so, you may save a life.
Ifsomeoneischoking,remember“five-and-five”.First,leanthepersonforwardandgivethemfivequickhitson
Health Problems Associated with Aging
Agingisthenormalprocessoftime-relatedchangesthatoccurthroughoutlife.Manyindividuals
withdevelopmentaldisabilitiesexperienceage-relatedchangesearly,especiallythoseindividualswithcerebralpalsy,Downsyndromeandmetabolicdiseasesandsomeindividualswhohaveamentalillnessinadditiontoadevelopmentaldisability.ItistheresponsibilityoftheDSPtowatchforchangesthatmaybesignsofanearlyage-relatedhealthconditionandtoreportthesechangestotheindividual’sdoctor.Earlydetectionpermitsearlytreatmentthatoftenaddstotheindividual’slengthandqualityoflife.
Signs and Symptoms of Age-Related Health Conditions
Again,DSPsshouldusetheirtoolsofobservationandcommunicationtoidentifychangesin:• Daily routines:Memoryloss,inability
toperformself-careandotheractivitiestheycouldperformbefore.
• Behavior:Confusion,weakness,unsteadiness,orfatigue.
• Communication: Changeinabilitytorespondorinitiatecommunication.
• Appearance: Suddenorprogressiveweightgainorloss.
• General manner or mood:Moodchange,lossofinterestindailyactivities.
Physical Health Changes of AgingSkin:Dry,flakyskinthatbruisesor
tearseasily,abnormalhardness,orvisiblelumponbody.
Eyes:Dryeyes,squinting,holdingthingsclosetothefaceorothersignsofvisionloss.
Ears:Notseemingtopayattention,notrespondingtoquestions,orothersignsofahearingloss.
Throat and mouth:Difficultyswallowing,chokingorcoughingwithmeals,crackedorlooseteeth,troublechewing,mouthsoresorothersignsofdecreasedoralhealth.
Muscles and bones:Lossofmotorcontrol;slownessofmovement;unsteadywalking;falling;curvingofspine;inabilitytostandupstraight;painwithoutvisibleinjury,especiallyinjoints.
Lungs (breathing):Frequentcolds,slowrecoveryfromillness.
Heart and blood vessels:Numborcoldhandsorfeet,swellingofankles,chestpain,shortnessofbreath.
Abdomen, bowel, and bladder (stomach, intestines, liver, gallbladder, pancreas, urinary tract):Constipation,“gassy”orblackstools,bleeding,frequentordifficulturination.
thebackbetweentheshoulderblades.Iftheobjectdoesnotcomeout,standbehindthemandreachyourarmsaroundtheirwaist.Placeyourfist,thumbsidein,justabovetheirnavelandgrabthefisttightlywithyourotherhand.Pullyourfistquicklyupwardandinwardtoincreaseairwaypressurebehindtheobjectandforceitfromthewindpipe.Dothese‘abdominalthrusts’fivetimes,quickly.Continuethebackhitsandabdominalthrustsuntilthepersoncanbreatheorcoughforcefully,theobjectcomesout,orthepersonbecomesunconscious.Ifthepersonbecomesunconscious,call9-1-1.
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Choking (cont.)
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Summary• Askstudentstoturnbacktothe“What Do You Want To Know?”
activityatthebeginningofthesession.Givestudents5minutestothinkaboutwhattheylearnedandanswerthethirdquestion.
• Askforvolunteerstosharetheiranswers.• ReviewsummaryinboxonpageS-24.
Show Slide #45: Practice and Share• DirectStudentstoPracticeandSharedirections.• Readthedirectionsandmakesurestudentsunderstandthe
assignment.
T r a i n e r G u i d e : S E S S I O N 8
Year 1, Session 8: SIGN
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S U M M A R Y
Insummary,theDSPlearnsaboutchangesthroughobservation(usingallofhisorhersenses)andcommunicationwiththeindividualandothers.Knowinghowtoidentifychangesinanindividual’sdailyroutines,behavior,waysofcommunicating,appearance,mood,andphysicalhealthandknowingwhattodowhenyouhaveidentifiedachangeenablesyoutoprotectindividualhealthandsafetyandmaysavealife.
P R A C T I C E A N D S H A R E
Ifthereisanindividualwithaseizuredisorderlivinginthehomewhereyouwork,findout:
1.What,ifany,seizuremedicationistheindividualtaking?Whatarethesideeffects?
2.Doestheindividualhaveanemergencyalertbraceletornecklace?
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Year 1, Session 8: SIGN
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Quiz: Signs and Symptoms of Illness or Injury
Show Slide #46: Quiz Time• Givestudents20minutestotakethequiz.
Show Slide #47: Quiz Answers• Discussquestionsandanswersasaclass.• Remindstudentstomarkthecorrectanswerssotheycanusethe
correctedquizzesasastudyguideforthetestaftertraining.
Answers 1. A2. D3. D4. A5. C6. B7. C8. A9. B10.C
End of Session 8
T r a i n e r G u i d e : S E S S I O N 8
Year 1, Session 8: SIGN
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Signs and Symptoms of Illness or Injury
1. An example of a change in a person’s daily routine is:A)SleepingmuchlaterthanusualB)BeingaggressivetootherpeopleC)SpeakinglessthanusualD)Beingmadaboutsomething
2. In order to recognize a change that may be a sign of illness, the DSP must:A)Taketheindividual’stemperatureB)Knowifthereareanyothersick
individualsinthehomeC)Taketheindividual’sbloodpressureD)Knowtheindividualandwhatis
normalforthem
3. Which one of the following would be most likely to require an urgent call to the individual’s doctor?A) ChokingB)UncontrolledbleedingC)MinorcutD)Infectionofaninjury
4. Which one of the following may be treated at home, using routine treatment?A)AminorcutB)AninfectionofaninjuryC)ChokingonfoodD)Uncontrolledbleeding
5. Why should you not try to feel for an individual’s pulse using your thumb?A)Yourthumbisn’tsensitiveenoughto
feelapulseB)Yourthumbcouldhurttheindividual’s
wristC)Youwillfeelyourownpulsethrough
yourthumbD)Youwillneedyourthumbtocountthe
pulsebeats
6. When reporting and documenting changes that may be signs of illness or injury, the DSP must record:A)Thediagnosis,asyouseeit.B)Whattheindividualsaidordidthat
communicatedthechangeC)Youropinionabouttheindividual’s
behaviorD)Whatalltheindividualsandstaffwere
doingwhenthechangewasnoticed
7. Who is at risk for skin breakdown?A)Individualswhodon’tbatheveryoften.B)Individualswhoareveryactivein
recreationalsportsC)Individualswhousewheelchairsor
whodon’tchangepositionsoften.D)Individualswhoeatunhealthyfood
8. To assist an individual who is having a generalized seizure, you should:A)Placetheindividualontheirsideto
preventchokingB)Restraintheindividual’smovementsC)Placesomethingintheindividual’s
mouthtopreventthetonguefrombeingbitten
D)Leavetheroomtogivetheindividualtheirprivacy
9. A high body temperature (102 degrees and above), hot dry skin, and a strong rapid pulse are symptoms of what heat-related condition?A)SunburnB)HeatstrokeC)HeatexhaustionD)Heatcramps
10. Why is it important for DSPs to watch for early signs of aging?A)Treatmentofage-relatedconditionsis
notusuallyincludedintheIPPB)Individualswithdevelopmental
disabilitiesdon’tusuallyhaveage-relatedconditions
C)Earlytreatmentmayaddtotheindividual’slengthandqualityoflife
D)Individualswithdevelopmentaldisabilitiesdon’tknowtheyaregettingolder
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Session 8 Quiz