Why are Emergency Policies in Sleep Centers Required and Important?
Developing emergency policies in sleep centers is crucial to safety and meeting accreditation standards
If you have ever been through an AASM accreditation you have had the experience of creating emergency policies for your facility and making sure they address key components to assure that you and your staff have the proper tools to deal with any emergencies that might arise in the sleep center.
How do you know where to start? Having been through many an accreditation, I find the easiest place to start is with the AASM standards. The standards are like a road map and will lay out what policies you are required to have and also what should be clearly defined in those policies. Answering the question, “What do I need to know in the event of specific emergency?” will go a long way towards guiding what you need to include in your policies as well. A very common sense approach is a great way to write an emergency policy that is easy to follow. When an emergency occurs, that last thing you want to have is a policy that is confusing, vague, or doesn’t have detailed instructions on what you should do.
At a minimum the following emergency policies are required for your center:
- Cardiac emergencies
- Neurologic emergencies, particularly seizures
- Psychiatric emergencies, particularly suicidal ideation
- Environmental emergencies including fire, weather, belligerent patients, and bomb threats
So let’s think about some of the key components. What would you want to know if faced with one of the above emergencies in the sleep center?
For starters, who are you going to call for help? If your facility is located inside of a hospital, you most likely have the availability of a code team for all medical emergencies. But even when you have a code team you’ll still need to know how to call them. Do you call the house supervisor, push a code button, or call the operator for example. Knowing exactly how to get help to you is half the battle.
If your facility is located in a medical building outside of the hospital or off site, you will likely need to call 911 for all emergencies. In either case, the other important factor is being able to communicate where you are so you can get help to you. In the event you need to call 911, do you know your center’s address? If you’re in a hospital, do you know the room numbers or appropriate wing to give direction if needed?
All emergency policies should include the phone number to call for an emergency and the center location/address designated in the actual policy. Along with the phone number, list any specific code to relay to denote the type of emergency; i.e. code RED for fire or BLUE for cardiac emergencies. Listing the emergency numbers and the center location at the bottom of each emergency policy is an easy and consistent place to have this information for easy reference if needed. I’d also recommend having this information posted in large print in a place that is visible when using the center land line.
Let’s use an example of being in a medical building on the second floor in a 2 bed sleep center and you’re the only technologist present during nighttime testing. If one of your patients has a medical emergency or codes, how will EMS get to you? Do you have to go to the first floor and open the door so they can get in? These are very pertinent questions as many centers are choosing to relocate off campus for more space and less of a hospital feel for their patients. If you are located in a facility where you must rely on 911 for help it is absolutely critical you know how EMS personnel will get to your suite once you call 911.
If you work in a center with more than one technologist on duty at a time this becomes a little easier, as one technologist can open the door for EMS while the other remains with the patient. But what if you work alone? Have you ever heard of a KNOX-BOX? This is an ingenious little box that is installed on the outside of your building that has a universal key for emergency personnel to open the box and get the key to your building so they can enter without you having to leave your patient. For the cost, around $300, it’s definitely worth it. Availability will depend on your local emergency services use of the boxes.
KNOX-BOX or not, you want your local emergency services to know that you are there at night with patients. Give your police department and EMS department a call to let them know that night time testing is taking place at your location. EMS having familiarity with your facility can save valuable minutes in the event of an emergency when 911 must be called.
Here are a few tips on important things to include in your emergency policies:
- Phone numbers of who to call and any specific instructions needed when calling
- An Emergency code list (if in a hospital this might be on the back of your badge)
- Medical director’s phone number
- List all numbers on the actual policy and post a handy phone list
- Sleep center address or location within the hospital
- List address or location on the actual policy
- Define safe places for environmental emergency policies
- For example, where to go in the event of a fire, tornado, or bomb threat
- If you have multiple technologists in the sleep center, specific duties should be listed for each technologist so it is clear what each technologist’s role is during the emergency (technologist 1 starts CPR, technologist 2 calls 911)
- When to call the medical director versus EMS, clearly define when to call 911 first
A short note on home sleep apnea testing (HSAT) emergency policies. Yes, you are required to have one. This is very simple, CALL 911! If an HSAT patient calls your HSAT support line for help with a medical emergency, they should be immediately referred to 911 and this should be clearly stated in your HSAT emergency policy.
As the patients in our sleep centers are presenting now with more and more comorbidities, emergency policies are more important than ever. The chance of encountering a medical emergency sometime in your career is almost a certainty. Knowing what to do when faced with that emergency is everything, and having your center’s policies written clearly so you know what to do is critical. We always have to hope for the best but be prepared for the worst to assure safety for all.