1. Response & Identification of Medical Issues

2. Training Objectives 1.Comprehend the term communicable disease. 2.Identify the seven (7) communicable diseases which are of greatest concern to detention officers and how each is transmitted.

3. Training Objectives 3.Analyze the procedures and precautions that must be taken to protect staff and inmates from infection by communicable diseases in reference to: a.Gloves b.Eye mask c.Gown d.Equipment e.Handling of contaminated clothing/items f.Hand washing

4. Training Objectives 4.Determine North Carolina statute requirement reference disclosure of sensitive medical information. 5.Explain the procedures to follow or implement to address mental health needs of inmates in a detention facility. 6.Identify the procedures that must be followed when distributing prescribed medication to an inmate.

5. Training Objectives 7.Discover the reasons for inmates to be granted an opportunity to communicate health complaints. 8.Determine the important elements of supervision that must be followed when supervising sick call. 9.Compare and contrast the proper procedures to be followed when distributing over-the-counter medication versus prescribed medication to inmates in a detention facility. 10.Recognize the dangers of a gynecological emergency that might occur within a detention setting.

6. G.S. 153A-225(a)(3) In regards to communicable diseases, a medical plan must provide for the detection, examination and treatment of prisoners who are infected with tuberculosis or venereal diseases.

7. Communicable Disease indirectly to a person from an infected person or animal through the agency of an intermediate animal, host or vector, or through the inanimate environment. An illness due to an infectious agent or its toxic products which is transmitted directly or

8. Tuberculosis Hepatitis Pediculosis AIDS Gonorrhea Syphilis MRSA Communicable Diseases Common in Detention Facilities

9. Tuberculosis Tuberculosis is a communicable disease caused by the tubercle bracilli. The probability that TB will be transmitted depends on three factors: 2.The environment in which exposure occurred 3.The duration of exposure 1.The infectiousness of the person with TB

10. Hepatitis Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E

11. Pediculosis (lice) Head Lice Pubic (crab) lice Body lice

12. (Acquired Immune Deficiency Syndrome) AIDS Maurina.files.wordpress.com/2007/05/red_ribbon.jpg

13. HIV – Positive Groups a) Homosexual or bisexual men b) Heterosexual IV drug users c) Persons with hemophilia or others who received transfusions prior to 1985 d) Female heterosexual contacts of men with HIV-Positive e) Children from HIV-Positive mothers during birth Approximately 95% of AIDS cases in the U.S. have occurred among the following groups of people:

14. a. Extreme tiredness, with headache or dizziness b. Continued fever or night sweats c. Weight loss of more than 10 pounds d. Swollen glands in the neck e. Purple or discolored growths on the skin HIV – Positive Symptoms

15. f. Heavy, continued dry cough g. Continuing bouts of diarrhea h. Thrush, a thick whitish coating on the tongue i. Unexplained bleeding from any body opening j. Progressive shortness of breath HIV – Positive Symptoms

16. Gonorrhea is the most commonly reported communicable disease after the common cold. In 2000, there were 15,072 reported cases of gonorrhea in North Carolina. With 15,072 reported cases of gonorrhea, North Carolina ranks 9 th in the nation. Gonorrhea

17. Syphilis Syphilis is caused by the treponema pallidum, a microscopic organism usually transmitted by sexual contact, but the organisms can also spread by skin contact (where skin is broken or cut).

18. MRSA MRSA is a type of Staphylococcus aureus. Staphylococcus aureus, often referred to simply as staph are bacteria commonly carried on the skin or in the nose of healthy people. Some staphylococcus aureus are resistant to the class of antibiotics that are frequently used to treat staph such as methicillin and thus are called Methicillin-Resistant Staphylococcus Aureus.

19. www.envisioninc.net/catalog/images/TB_Mask.jpg Tuberculosis – Precautions and Protections 1. Use universal precautions 2. Isolate from other inmates so the infections will not spread 3. Place inmate in a cell with good ventilation 4. Have inmate wear a mask when speaking or having contact with detention personnel

20. www.envisioninc.net/catalog/images/TB_Mask.jpg Hepatitis A – Precautions and Protections 1. Universal precautions 2. Vaccine available 3. A single dose of immune globulin given within one week of exposure

21. www.envisioninc.net/catalog/images/TB_Mask.jpg Hepatitis B – Precautions and Protections 1. Universal precautions 2. Vaccine available 3. Hepatitis B immune globulin

22. www.envisioninc.net/catalog/images/TB_Mask.jpg Hepatitis C – Precautions and Protections 1. Universal precautions indicated 2. No vaccine available

23. www.envisioninc.net/catalog/images/TB_Mask.jpg Hepatitis D – Precautions and Protections 1. Universal precautions indicated 2. Vaccine and hepatitis B immune globulin therapy

24. www.envisioninc.net/catalog/images/TB_Mask.jpg Hepatitis E – Precautions and Protections 1. Universal precautions indicated 2. Vaccine and hepatitis B immune globulin therapy 3. No post exposure prophylaxis available

25. Pediculosis (lice) Precautions and Protections Head Lice Inmates should not be allowed to share combs, caps or other similar personal items. Staff and inmates need to use a pediculicidal shampoo or lotion for the removal of the lice and/or their eggs.

26. Pediculosis (lice) Precautions and Protections Crab Lice Persons discovered to be infected should be isolated and any skin to skin contact should be avoided. Strict personal hygiene practices should be mandatory.

27. Scabies Precautions and Protections Usually, the treatment is a cream, lotion or shampoo. Skin to skin contact should be avoided. Disinfecting of personal articles should occur together with treatment.

28. Universal Precautions Universal precautions shall be observed to prevent contact with blood or other potentially infectious materials. Officers need to consider all bodily fluids as potentially infectious.

29. Personal Protective Equipment a.Agencies should provide appropriate personal protective equipment such as gloves, gowns, face shields or masks, eye protection, and pocket masks. b.The agency should ensure that personal protective equipment in the appropriate sizes is accessible to all employees. c.If garment is penetrated by blood or other potentially infectious material, the garment shall be removed immediately.

30. Personal Protective Equipment d.All personal protective equipment shall be removed prior to leaving the work area. e.When personal protective equipment is removed, it shall be placed in an appropriately designated area. f.Gloves shall be worn when officers think they may come into contact with blood or other potentially infectious materials.

31. Personal Protective Equipment g.Masks, in combination with eye protection, shall be worn whenever splashes or spray spatter to the officers eyes, nose, or mouth is anticipated. h.Appropriate protective clothing such as gowns, aprons, lab coats, clinic jackets shall be worn in occupational exposure situations.

32. Personal Protective Equipment i.All equipment and environmental and working surfaces shall be cleaned and decontaminated after contact with blood or other potentially infectious materials. j.Regulated waste 1.Contaminated sharps 2.Laundry

33. IMPORTANT PROTECTIVE GUIDELINES 1.Staff should wear protective gloves 2.Staff should change protective gloves and wash hands 3.Hand washing is very important 4.Appropriate protective clothing should be worn at all times 5.Hidden needles – use extreme caution 6.When searching, carry puncture-proof containers 7.Practice proper waste disposal

34. Privacy of Information The U. S. Constitution included a right to privacy that requires deputies and detention officers to avoid the unnecessary disclosure of highly sensitive information about a person.

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37. 1.Actual threats to commit suicide 2.Previous attempts to commit suicide 3.Depression, which might be revealed by crying, withdrawal, insomnia 4.Giving away personal property 5.Signs of serious mental health problems

38. 7.History of mental illness8.Severe aggressiveness and difficulty relating to others 9.Speaking unrealistically about the future 6.Drug or alcohol intoxication or withdrawal

39. HIGH RISK PERIODS 1.First 24 hours of confinement 2.After receiving bad news 3.Before and after court 4.Weekends and holidays 5.Before anticipated release 6.During intoxication or withdrawal 7.During poor physical health 8.After being assaulted by another inmate

40. Prescribed Medication Prescribed medication that is provided for a specific inmate by a pharmacist or other qualified person from the outside the facility must be accompanied with specific information.

41. Prescribed Medication Information 1.Name, address and telephone number or the pharmacy that provided the medication 2.Name of the prescriber 3.Date the medication was provided 4.Name of the inmate 5.Instructions for administering 6.Name, strength, and dosage form of the medication

42. Detention officers will not administer medication to one inmate from another inmates prescription. The remainder of any prescribed medication that is provided for a specific inmate by a pharmacist or other qualified person from outside the detention facility may be sent with the inmate at his time of release. Important Information

43. Every medication label must give instructions as to the dosage. The timing of the dosage could also be more specific than four times a day. The label might specify that the medication be taken at certain intervals as needed. It is very important to follow the label directions regarding the timing of the dosage very carefully. Be aware of and follow any special orders on the medication label.

44. Opportunity to Communicate Health Complaints Inmates are to be provided an opportunity to communicate their health complaints by submitting sick call slips. This applies to all health complaints, including dental needs and mental health problems.

45. Emergency Medical Problems Unconsciousness or semi-consciousness Serious alcohol or drug-induced intoxication Severe bleeding Serious breathing difficulties Serious head injury Severe burns Severe pain Other symptoms or complaints which indicate that an inmate might need immediate medical attention

46. Dental Medical Emergencies Severe pain Severe facial swelling Broken teeth Other symptoms or complaints which indicate that an inmate might need immediate dental treatment

47. Non-Prescription Medication It is very important to accurately record the administration of non-prescription medications, such as aspirin, laxatives, cold tablets, etc.

48. Female Gynecological and Obstetrical Emergencies Gynecological emergencies Genital trauma Obstetrical emergencies

49. Diabetes Diabetes mellitus Diabetic coma and insulin shock Care for diabetic emergencies

51. Training Objectives 1.Comprehend the term communicable disease. 2.Identify the seven (7) communicable diseases which are of greatest concern to detention officers and how each is transmitted.

52. Training Objectives 3.Analyze the procedures and precautions that must be taken to protect staff and inmates from infection by communicable diseases in reference to: a.Gloves b.Eye mask c.Gown d.Equipment e.Handling of contaminated clothing/items f.Hand washing

53. Training Objectives 4.Determine North Carolina statute requirement reference disclosure of sensitive medical information. 5.Explain the procedures to follow or implement to address mental health needs of inmates in a detention facility. 6.Identify the procedures that must be followed when distributing prescribed medication to an inmate.

54. Training Objectives 7.Discover the reasons for inmates to be granted an opportunity to communicate health complaints. 8.Determine the important elements of supervision that must be followed when supervising sick call. 9.Compare and contrast the proper procedures to be followed when distributing over-the-counter medication versus prescribed medication to inmates in a detention facility. 10.Recognize the dangers of a gynecological emergency that might occur within a detention setting.