Emergency Procedures Fact Sheet
Purpose of the Emergency Plan
Emergency procedures are necessary to ensure safety of all patients and staff during all types of medical and non-medical emergencies. Every medical and technical staff member shares in providing safety to all. The detailed procedures provide thorough written protocols so all staff members are prepared to respond until other medical emergency assistance arrive.
The Emergency Written Plan Requirements:
- Mechanisms and specific phone contact information for emergency personnel, facility director and other sleep facility staff. It should describe the location of any special phones, alarms, call buttons, and/door access information.
- Provide and outline specific responsibilities of each technical staff member: Indicate the step by step protocol that is to occur during the emergency. When more than one technician is scheduled, indicate the role of each technician. If only one technician is present, define how ER personnel are to gain access to the facility to prevent staff from leaving the patient.
- Medical and Non-medical emergency plan
- Policy addressing conducting and documenting emergency drills annually
- Policy addressing AED, use, maintenance and training
- If using Hospital wide Emergency plan, specific customized procedures defining responsibilities of sleep staff are required for medical and non-medical emergencies
Types of Emergencies
Cardiopulmonary emergencies may include:
- Cardiac arrest
- Ventricular Tachycardia > than 10 seconds
- Ventricular Fibrillation
- Apnea greater than 2 minutes
- Changes in cardiac rhythm
- Persistent bigeminy or trigemini
- Atrial Flutter or fibrillation
- Tachycardia or bradycardia
Neurological emergencies–specifically seizures. Other examples of neurological emergencies include loss of consciousness, changes in speech, weakness in limbs or face, severe or unrelenting headache.
Psychiatric emergencies—specifically suicide ideation. Other examples may include homicidal ideation, hallucinations, acute psychosis, acute mania, any life-threatening behavior directed to harm self or others.
Environmental emergencies such as fire, local weather threats, (earthquakes, floods, hurricanes, tornadoes) , utility loss, bomb threats, workplace or any threat of violence (potential for assault or inappropriate behavior during testing—for discussion) and belligerent patient.
All necessary emergency equipment as required by the facility’s emergency plan is to be accessible and properly functioning. A policy is required addressing the maintenance, use and training of emergency equipment.
- Automated External Defibrillator
- Crash Cart
- Fire Extinguisher
Applicable Accreditation Standards
Facilities must have a written plan accessible in written or electronic format delineating the following:
- Mechanism and specific details for contacting emergency personnel.
- Facility sleep personnel to be contacted in the emergency; and
- Specific respsonsibilities of the medical and each technical staff member.
At a minimum, the policies and procedures must address (a) cardiopulmonary emergencies to include emergency equipment required; (b) neurologic emergencies, particularly seizures; psychiatric emergencies, particularly suicidal ideation and environmental emergencies such as fire, weather, belligerent patients and bomb threats.
Facilities must conduct and document drills of their emergency procedures on an annual basis, at minimum annual drills of response to cardio-pulmonary and fire emergencies are to be documented.
The sleep facility must have appropriate equipment to address all possible emergencies as outlined in the plan. At minimum facilities must have either an automated external defibrillator (AED) or access to an on-site medical emergency response team. Documentation of training of personnel on emergency equipment is to be maintained.
Facilities must have explicit policies and procedures to minimize the risk for assault or allegations of inappropriate behavior during the testing timeframe. Facility should use continuous video monitoring throughout the patient encounter and/or specific training for the use of chaperones during interactions between patients and staff.
Key Things to Keep In Mind
- Describe specific step by step detail for all facility staff members to implement until arrival of ER personnel or ERT.
- If the facility is located within a hospital, and you are to follow the hospital wide plan, there should be a customized written plan for the sleep facility defining responsibilities for each staff member for all medical emergencies and non-medical emergencies that occur within the sleep facility.
- Specific contact information for medical and other facility staff is to be documented in the emergency policy.
- Describe how emergency personnel (911) are to access the sleep facility during an emergency ( e.g. lock box, access through hospital entrance etc) to ensure non interrupted emergency care is provided to the patient. Scenarios would include when there is only 1 staff on site during testing hours.
- Indicate where the emergency equipment (AED ) is located.
- Reference the Accreditation Reference Manual for specifics on what the emergency policies should include.