Trainer Resource Guide - dds.ca.gov · Changes observed by the DSP or reported by the ... problems for individuals at risk. • Describe health problems associated ... What Kind of

Year 1, Session 8: SIGN

S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

8. Signs & Symptoms of Illness or Injury

Trainer Resource Guide


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

SignsandSymptomsofIllnessorInjuryO U T C O M E S

Whenyoufinishthissession,youwillbeableto:

K E Y W O R D S

S-1

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


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

ACTIVITY: What Do You Want to Know?• Readdirectionsaloud.• Askforstudentvolunteerstoshareanswers.• Makenoteofstudentanswersandlinkbacktostudentknowledge

andinterestsasappropriateasyoureviewsessioncontent.• Attheendofthissession,youwillreturntothisactivitytogive

studentsanopportunitytoanswerthethirdquestion.


T-2


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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?

S-2


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

Recognizing Changes

InthissessionwewilltalkabouthowtousetheDSP’stoolsofobservationandcommunicationwhenlookingfor

signs and symptoms,orchangesthatmaytellyouofanillnessorinjury.Earlyidentificationofanillnessorinjurycansaveanindividual’slife.

AsaDSPyougettoknowanindividualbyspendingtimewithhimorherandlearningwhatisusualforthatindividual,suchashisorherdailyroutines,behavior,wayofcommunicating,

appearance,usualmood,andphysicalhealth.Ifyouknowwhatisnormalforanindividual,youwillknowwhensomethinghaschangedorisdifferent.

Youalsoneedtoknowanindividual’shealthhistory.Thiswillhelpyoutonoticeachangeinhisorherhealthandtodecidewhattodo.Youwillknowifthechangeissomethingthathashappenedbeforeandwhatwasdone,andyouwillhavesomecluesastowhatyouneedtodonext.


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.

S-3


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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


(cont.onnextpage)


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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?”

S-4

A C T I V I T Y


Directions: As a class, discuss the scenario below.

Scenario: Rachelusuallycomeshomefromschoolinagoodmood,humming,andhappilygoestoherroomtoplaywithhertoys.Today,shecamehomefromschoolcryingand,whenofferedafavoritetoy,ignoresit.• Doyourecognizeachange?Ifso,what?• HowelsecouldyoufindoutwhatisbotheringRachel?


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-5

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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.

S-5



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-6


• 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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.

S-6



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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)

S-7

Assessing What to Do When You Learn About a Change (cont.)


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-8


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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

• 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

S-8



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-9


Routine Treatment• SignsandsymptomsthatcanbeaddressedbysimpleFirstAidorwrittendoctor’s

ordersareconsideredroutineandcanbetreatedinthehome.Forexample,a minor scratch on the finger may be treated in the home.

• DSPsmustbefamiliarwiththeindividual,hisorherhealthhistory,medications,andanywrittendoctor’sordersbeforedecidingwhattodo.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

Routine Treatment Signsorsymptomsthatmaybe

addressedwithsimpleFirstAidorforwhichtherearewrittendoctor’sordersareconsideredtoberoutine treatmentandcanbetreatedinthehome.Forexample,aDSPmayprovideminorFirstAidinthehomeforasmallscratchonthefinger.Somesymptomsreportedby

theindividual,suchasaheadacheorswellingoftheankles,maybetreatedinthehomeiftherearewrittendoctor’sordersthatspecifywhattodo.TheDSPmustbefamiliarwiththeindividual,hisorherhealthhistory,medications,andanywrittendoctors’ordersbeforedecidingwhattodo.

S-9



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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

S-10


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-11

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).



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.

S-11


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-12

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



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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/


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.”

S-13


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

A C T I V I T Y

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?

S-14


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-15

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



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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

S-15


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-16

Diabetes (cont.)

Show Slide #30: When to Get Urgent Care for an Individual Who Is Diabetic

• ReviewusingthebulletsonpageS-16.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

• 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.

S-16

Diabetes (cont.)


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.


T-17


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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

seizurelasted.S-17


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-18

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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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?

S-18

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.


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-19

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).


(cont. on next page)


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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

S-19


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-20

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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.

S-20

Constipation (cont.)


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-21

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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-22


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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

• 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.

S-22



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-23

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.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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.

S-23

Choking (cont.)


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-24

Summary• Askstudentstoturnbacktothe“What Do You Want To Know?”

activityatthebeginningofthesession.Givestudents5minutestothinkaboutwhattheylearnedandanswerthethirdquestion.

• Askforvolunteerstosharetheiranswers.• ReviewsummaryinboxonpageS-24.

Show Slide #45: Practice and Share• DirectStudentstoPracticeandSharedirections.• Readthedirectionsandmakesurestudentsunderstandthe

assignment.



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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?

S-24


S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

T-25

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



S AN

D SYM

PTOM

S OF ILLN

ESS OR

INJU

RYTR

AIN

ER R

ESOU

RC

E GU

IDE

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

S-25

Session 8 Quiz

Documents

Trainer Resource Guide - dds.ca.gov · Changes observed by the DSP or reported by the ... problems for individuals at risk. • Describe health problems associated ... What Kind of