CITY OF CASPER

• #1 FIELD MEDICAL ASSESSMENT PROTOCOL
• #2 IMMEDIATE CARE PROTOCOL
• #3 BASELINE ASSESSMENT PROTOCOL
• #4 INITIAL FOLLOW-UP CARE PROTOCOL
• #5 LONG-TERM FOLLOW-UP CARE PROTOCOL

#1 FIELD MEDICAL ASSESSMENT PROTOCOL

The field medical assessment is performed to determine whether children discovered at the scene of a methamphetamine laboratory seizure or distribution site are in need of emergency medical care. The assessment must be performed by a medically trained person (e.g. EMT, MD, PA, RN). If no medical personnel are available on-site, the child must be seen at the Wyoming Medical Center or Child Advocacy (CAP) center clinic. In either case, a medical assessment should be performed on each child within 2 hours of discovering children at a methamphetamine lab and/or distribution site. If a suspected lab site or reason to believe contamination may have occurred, then notify Casper Fire Department via chain of command and request an on-scene decontamination prior to medical assessment (base decision on immediacy of medical attention). An on-call Department of Family Services (DFS) caseworker must be notified immediately upon discovery of children at a drug lab and/or distribution site.

STEPS:

1. For children with obvious injury or illness call 911.

2. For all children who are not obviously critical, perform a field medical assessment consisting of:

A. Vital signs (temperature, blood pressure, pulse, respiration)

B. Pediatric Triangle of Assessment (Airway, Breathing, Circulation)

3. For life-threatening findings, seek immediate medical attention (See Protocol #2) Transport to the Wyoming Medical Center prior to decontamination.

4. A child’s personal possessions should always be left at a lab or distribution site to avoid possible chemical/drug contamination in other settings. ONLY in cases of gross chemical/drug contamination is it necessary to remove a child’s clothing and provide clean attire prior to removing the child from a site. (Contaminated clothing remains at the site and is collected/bagged as evidence.)

5. If there are no pressing clinical findings DFS caseworker to arrange clinical assessment at CAP within 24 hours.

Problems requiring immediate care are those that cannot wait 24 hours to be treated at the baseline exam (See Protocol #3). Immediate care must be provided as soon as possible after significant health problems are identified. Preferably, care should be provided within 2 hours, but no later than 4 hours after the child is identified at a lab or distribution site. Immediate care may be provided at the Wyoming Medical Center depending on the severity or urgency of the problem. If a field medical assessment was not provided, as outlined in protocol #1, children should be taken to the Wyoming Medical Center within 2 hours for the medical assessment.

STEPS:

1. Perform the field medical assessment (Follow protocol #1 if not already done in the field). Decontaminate if practicable.

2. Administer tests and procedures as indicated by clinical findings. A urine specimen should be collected from each child within 12 hours of identification because some chemicals/drugs are eliminated in a short time. Use appropriate chain of evidence procedures and request a urine screen and confirmatory test results to be reported at any detectable level. (Initial medical screen and submission to DCI Crime Lab for analysis recommended).

3. Call poison control if clinically indicated - 1-800-876-4766.

4. Follow baseline assessment (See Protocol #3) if appropriate and schedule baseline assessment exam to be completed within 24 hours of lab or distribution site seizure.

5. OBTAIN MEDICAL RECORDS RELEASE and provide to all appropriate parties to insure continuity of care.

6. DFS personnel should evaluate placement options and implement short-term shelter care for child. NOTE: Law enforcement is ONLY authorized agent to require specific tests be conducted on a child after placement in protective custody and before shelter care hearing (generally within 48 hours after the child is placed in custody).

#3 BASELINE ASSESSMENT PROTOCOL