Service providers work with consumers on a daily basis and are therefore better able to monitor health status. They can identify changes in consumer condition whether the change is gradual or sudden. It is crucial that service providers be familiar with the signs and symptoms of both urgent and emergency medical conditions in order to be able to seek appropriate interventions. When considering signs and symptoms exhibited by a consumer, it is good to ask yourself, “Would I call my doctor if someone in my family had these symptoms or would I call the emergency number?”. That answer will provide a common sense guide. If you would call your doctor first, then this is probably an urgent situation. If there is no doubt that you would call 911, then this is an emergency situation.

Signs and Symptoms of Emergency Conditions

In the event of an emergency, direct support staff must act quickly and seek immediate medical attention. If there is any doubt about what is an emergency situation, call 911. Don’t call someone to ask if you should call 911. If it is a question in your mind, make the 911 call.

The following situations are always considered emergencies and you should Call 911 immediately:

• Bleeding that you can’t control
• Severe injuries as a result of accidents such as broken bones
• Choking (not breathing and not coughing)
• No pulse
• Loss of consciousness not related to a seizure
• Seizure lasting over five minutes or continuous seizures
• Electrical shock
• Drowning or near drowning
• Chest pain, difficulty breathing, or any other sign of a heart attack
• Behavior that is dangerous to self or others and cannot be managed
• Stroke or suspected stroke (paralysis, numbness, confusion)
• Severe asthmatic attack when prescribed medications do not work
• Poisoning including overdoses of medication. Call 911 and then call Poison Control.
• Severe reactions to a medication with difficulty breathing or itching. Call at the first sign of a reaction because this can happen very quickly.
• Severe reactions to insect bites or other previously unknown allergic reactions
• Unable to detect breathing

When you call 911, tell them who you are, where you are, what has happened, when it happened and stay on the phone until the dispatcher tells you to hang up. Stay with the sick or injured person and follow first aid and/or CPR procedures. If possible, send another person to watch for the ambulance and quickly guide the emergency personnel to the scene.

Timeliness in recognizing the signs and symptoms of an urgent or emergency medical situation can be the difference between life and death.
 

Signs and Symptoms of Urgent Medical Conditions

Urgent medical conditions are conditions that you must report to a health care professional as soon as possible. While they may not pose an immediate threat to the life or safety of a consumer, a call must be made for advice and a prompt appointment made for professional evaluation of the consumer’s condition. There are many physical and behavioral changes that require urgent medical attention.

As stated above, direct support staff who see an individual consumer on a daily basis are in the best position to notice subtle changes in behavior that may be indicative of a change in health status. These staff should be supported and empowered to seek prompt or immediate medical care for that individual depending on the circumstances. Training in recognition of signs and symptoms of illness is essential to staff directly responsible for consumers.

Following are examples of changes that may indicate a need for urgent medical care:

Behavioral Changes

• Rapid change in behavior or increase in challenging behavior such as aggression or self injurious behavior
• Sleeping most of the day; unusual difficulty in arousing
• Scratching/holding one or both ears
• Holding abdomen
• Dramatic change in facial expression or demeanor
• Any evidence of pain or discomfort
• New or sudden onset of incontinence

Physical Changes

• Onset of fever of 101 degrees or higher
• Diarrhea or vomiting lasting more than four hours
• Rash lasting several days or getting worse
• Increase in seizure activity
• Onset of limping, inability to walk, or difficulty in movement
• Severe sore throat/difficulty swallowing
• Infection at injury site
• Swelling

Post a phone number for all household members to see that states where to call for medical advice. Include the primary care physician and any consultants.