Medical Emergencies: Guidelines for Staff

Imagine this scenario.

You’re the director of nursing for a mid-sized intermediate care facility. You learn from a nursing staff member, Laureen, that a resident was complaining of stomach pain. You know that this particular resident is scheduled for regular blood pressure checks and you notice the last chart reading was high. You ask Laureen to explain what happened. According to Laureen, the RN on duty directed Laureen to bring James to the emergency department. Instead of immediately taking James there, Laureen waited for her co-worker to return from an outing. She gave James a shower and a shave and changed him into clean clothing while they waited. When the other staff returned, Laureen took James outside to hail a taxi. While doing so, James collapsed on the sidewalk. Laureen called her supervisor to tell him that James had collapsed. Some bystanders administered CPR to James while Laureen was on the phone.

Staff Actions

There are several issues presented in the above case study: poor communication between the RN and support staff; delayed outreach to emergency personnel; and lack of internal policies for transporting people receiving services to the emergency room.

Unfortunately, situations like these are far too common in programs where staff have not been adequately prepped for emergencies. Here are a few common guidelines for staff to follow as soon as they identify a medical emergency:

Interested in our Medical Emergency Guidelines chart to add to your library of staff resources? Click here to download. 

• Don’t delay, call right away! Call 911 for any concerns about the immediate health and safety of people receiving services.
• If applicable, call an emergency code such as a code blue for an internal emergency response.
• For settings such as day habilitation programs where there are nurses on the premises, call 911 immediately in an emergency, then contact the nurse.
• After calling 911, immediately start CPR for anyone not breathing.
• If rescue breaths are not possible due to an airway obstruction or the presence of bodily fluids, start chest compressions.
• Stay calm and follow the directions from the 911 dispatcher.
• Do not delay medical attention because of concerns about staffing. Contact 911 immediately for all medical emergencies, then address staffing concerns.
• Do chest compressions on a hard, flat service. Place a backboard under the person or move them to the floor if they are not already there.
• Provide emotional support to people who witnessed the medical emergency and may be scared or worried for their peer.

The Justice Center has developed a toolkit dedicated to providing agencies with resources that help staff respond to medical crises. The kit includes agency best practices, training tips, and case studies to support internal training protocols. Click below to download the full toolkit.

DOWNLOAD HERE