Aspiration
how does staff help prevent this
making sure all foods are within IDDSI level 6 food modification, removing distractions while eating, encourage eating slowly if you notice he is eating quickly.
how do we/he help support with constipation?
EM has Prunes every morning along with poly powder. EM drinks lots of water and stays hydrated. staff observe when EM enters the restroom and stays in the area to monitor if BM is produced.
What does EM and staff do to help prevent falls?
EM will reach for staffs arm if he feels unsteady, will use railings on stairs and when available, staff will be within arms reach when on uneven surface or stairs.
Staff ensures floors are kept free of clutter and pathways are clear, ensures floors in home are in good repair.
Staff ensures good lighting.
floors are kept free of liquid spills.
Shower has non slip mat
How can Erich communicate he is in pain?
EM may make groaning sounds to indicate pain.
Sign Doctor by putting his hand on opposite shoulder/arm.
May squint or touch head if he has a headache or pain in his head.
can EM carry any amount of money himself?
yes! $2 while making purchase with staff assistance. EM will give change back and receipt to staff when finished.
what signs of aspiration do we watch for ?
gagging/ choking while eating, persistent coughing, wheezing or breathing is rapid and difficult, temp above 100 degrees after choking, gagging, or vomiting, o2 saturation of 90% or below after choking, gagging, vomiting. EM ingests/chokes on non edible object.
Symptoms observed?
Hard, small, dry stool.
spending 20 min on toilet with no results.
Bloated stomach.
Unusual straining while on the toilet.
increased irritability: banging on walls windows and furniture, stomping feet on floor.
no BM or only small BM for 2 days.
where are areas to be cautious of falls?
Stairs, uneven ground, slopes, and icy conditions.
How can staff communicate with EM on if he is in pain?
Yes no questions (holding two hands out asking him to pick yes or no)
short closed ended question like yes or no using same method of holding two hands out and asking. I'm to pick.
what do I like to buy?
Stickers, art supplies, puzzles, water bottles/cups, and souvenirs from trips for his room.
Actions taken if aspiration occurs?
stop food and drink immediately, keep em upright in a sitting position, start first aid as trained, take and record vitals every 2 hours for 8 hours then once every 8hrs for 72 hrs if o2 saturation is 90% or below or temp is 100 degrees or above after choking, gagging or vomiting contact PCP.
when to call 911?
EM appears gravely ill, you are concerned about his immediate health and safety.
EM vomit smells like BM or looks like coffee grounds or dark jelly.
EM has a very hard protruding abdomen.
EM has severe abdominal pain.
what do you do if fall occurs?
offer hand or arm to allow EM to steady himself getting up.
Move to safe area for EM to sit and begin skin/first aid checks.(start first aid if needed)
follow unreported pain protocol.
Monitor via skin checks 1x per shift for 48hrs.
what are some Signs and symptoms he may be in pain?
He may limp or favor a specific limb.
restlessness or pacing, rubbing specific body part.
increased agitation (banging on furniture, walls, or windows.Paired with above symptoms)
refusal to eat (potential dental pain or stomach pain)
refusal to get out of bed or up from chair for long period of time.
how much can I spend before needing approval from ISP team?
$100
When do we need to call 911?
EM appears gravely ill, you are concerned about his immediate health and safety, EM is blue, not breathing, or is having difficult breathing.
expected documentation and where is it documented if protocol is entered?
intake and elimination, MED T-Log titled "constipation Protocol" including signs and symptoms observed and actions taken each shift until BM is produced.
what Documentation/Notification is needed if fall occurs?
Notification: Supervisor & admin on call.
Documentation: High Level T-Log (staff following up with EM condition each shift for 24hrs.
High Level GER.
skin trauma tracking 1x per shift for 48 hrs.
what actions do staff take if symptoms are observed?
Follow basic first aid training.
take B/P and temp 1x per shift for 48hrs document on Therap and log.
Preform full body check for unseen injuries.
offer appropriate PRN.
Continue to monitor EM for signs and symptoms of unreported pain/illness and if symptoms continue contact supervisor and medical professional.
what items should be tracked on my personal property record?
Any item purchased that is over $40.
report purchase to supervisor so it can be added to his record.
what documentation/notification is needed?
notifications: Supervisor, Robin.
Documentation: High T-log, MED level GER, Vitals tracking.
how many days can EM go without BM before we initiate constipation protocol and what steps are taken?
2 days
(starts 8pm on second day and staff will administer PRN from MAR step one(day 2): dolcasate stool softener, step two(day3): additional peg powder along with normal dose in AM, Step 3(day4): additional peg powder along with normal peg powder dosage, Step 4 (day5): Glycerin Sup 2gm)
when to call 911?
if after fall there is loss/altered consciousness or signs of broken bones/hits head.
Expected notification: Supervisor, program director/admin on call,Robin, PCP, service coordinator
Expected documentation: High GER, High Level Health T-log.
Required documentation/Notifications?
Contact: Supervisor, PCP/medical profesional.
Documentation: Therap- MED Health T-Log, Vital tracking, skin trauma tracking(as needed), GER(as needed) refer to GER Matrix for appropriate notification Level.
what do you do if money is lost or missing?
attempt to locate lost/missing funds.
Report immediately to supervisor if unable to locate funds.
High level GER and Tlog and follow GER Matrix for appropriate contacts.