Management of a Client Emergency During/ Following a Sputum Induction Procedure

Policy

Category: Control of Infectious Diseases
Subject: Management of a Client Emergency During/ Following a Sputum Induction Procedure
Division: Health Protection
Policy Number: CA.82.01.211
Effective Date: August 8, 2016

POLICY STATEMENT

It is the policy of Wellington-Dufferin-Guelph Public Health (WDGPH) to manage an emergency event for a client who is receiving public health services or procedures within the nursing scope of practice and training until the responsibility is taken over by Emergency Services (fire/ambulance). If an emergency event occurs during or following a sputum induction, the response will be managed by the responsible physician who is, and must be, present on site as per this policy and procedure until the client has been safely discharged. Registered nurses (Public Health Nurses) will be responsible for following the direction and individual client orders from the physician for administration of onsite medications and oxygen until Emergency Services arrive on scene to take over the management of the client. 

SCOPE

This policy applies to all WDGPH staff that perform sputum induction procedures in tuberculosis (TB) Clinic, as well as any staff that may direct Emergency Services to the clinic room.

DEFINITIONS

Emergency Event – Any client event which requires nursing or medical intervention to support airway, breathing, and/or circulation.

REFERENCES AND RELATED FORMS, POLICIES AND PROCEDURES

Corresponding Procedure:  CA.82.02.211 Management of a Client Emergency During/Following a Sputum Induction Procedure
CA.82.02.210 and CA.82.02.210 Sputum Induction

CONTACT FOR INQUIRIES

Manager, Control of Infectious Diseases

APPROVED BY

Director, Health Protection  

Procedure


Category: Control of Infectious Diseases
Subject: Management of a Client Emergency During/ Following a Sputum Induction
Division: Health Protection
Procedure Number: CA.82.02.211
Effective Date: August 8, 2016

PROCEDURE

  1. Obtain the security pendant from reception and sign out as per policy CA.56.01.114 and procedure CA.56.02.114 Safety Pendants.
  2. Advise front desk that sputum induction procedure is being performed in clinic room 6.
  3. TB clinic nurse 1 (with client during procedure) will activate safety pendant (fob) for assistance and alert clinic nurse 2 by calling out for assistance. Ideally, if TB clinic nurse 1 notes that client is experiencing difficulty breathing or chest pain, the request for assistance can be made as soon as a deteriorating status is noted.
  4. Clinic nurse 2 will find and notify the onsite physician (respirologist) of client’s symptoms/distress/ difficulty breathing, chest pain, or loss of consciousness.
  5. Clinic nurse 2 will ensure physician is immediately brought to the client to begin directing individual client orders using emergency equipment/oxygen and medications available on site.
  6. Clinic nurse 2 will call 911 (“9” must be dialed first to get an outside line) and advise the physician that 911 has been called. The first internal responder must be directed to return and wait at the front desk to direct first responders (ambulance/fire) and advise all internal and external first responders that an N95 mask must be worn.
  7. Clinic nurse 2 will document all emergency orders given by the attending physician and administered by clinic nurse 1. All actions, oxygen orders, medication orders, and/or the initiation of CPR must be documented in chronological order and noted by whom the action was ordered/administered (noting exact time).
  8. The client’s emergency care will be turned over to first responders upon arrival. Final documentation will be made of the turnover of care and the record of emergency response will be scanned into client’s file. The Manager/Supervisor and Medical Officer of Health will be notified immediately following takeover of client’s management by first responders if it has not already been done.
  9. An Accident/Near Miss Report form (CA.30.01.606) must be completed.

RESPONSIBILITIES

Management will ensure that:
  • Staff are trained on this policy and procedure, as well as CA.56.01.114 and procedure CA.56.02.114 Safety Pendants;
  • Security pendant is supplied and maintained in working order;
  • TB clinic staff are certified in CPR;
  • Emergency kit is available in clinic and stocked with medications designated by the physician responsible for ordering the sputum induction procedure; and
  • New employees will be trained on emergency kit and use of safety pendants.
Employees will:
  • Review this policy and procedure, as well as CA.56.01.114 and procedure CA.56.02.114 Safety Pendants;
  • Remain certified in CPR;
  • Use safety pendant during sputum induction procedures; and
  • Check oxygen and emergency kit at beginning of each clinic.

REFERENCES AND RELATED FORMS, POLICIES AND PROCEDURES

Corresponding Policy CA.82.01.211 Management of a Client Emergency During/Following a Sputum Induction
CA.56.01.114 and CA.53.02.114 Safety Pendants
CA.30.01.606 Accident/Near Miss Report

CONTACT FOR INQUIRIES

Manager, Control of Infectious Diseases

APPROVED BY

Director, Health Protection