Protocols For Intake Workers

Here is a cheat-sheet for training people to do basic health screening. Anyone who is good with people can learn this very quickly from a health worker. This is the list of medical things an intake worker at Common Ground Health Clinic in New Orleans is trained to consider with each patient.

Vital Signs: safety first

Try to obtain vital signs within the first few minutes after your home visit begins.

Red flags

  1. Chest pain/ tightness/ feeling of doom = heart attack
  2. One sided weakness or numbness/ difficulty talking or swallowing = stroke
  3. Elevated blood pressure + confusion, dizziness, blurred vision = hypertensive emergency
  4. Swollen legs, shortness of breath = heart failure
  5. Blurred vision, "feels funny," increased urination = hyperglycemia

Notify provider if

  • Blood pressure >220/120 (either systolic or diastolic)
  • Blood sugar >300 regardless of last meal
  • Heart rate >120
  • Temperature >102.5
  • Patient is complaining of difficulty breathing or chest pain

Reminders

  • To avoid inaccurate blood pressure readings, use appropriate sized cuff — cuff bladder should encircle 80% of arm
  • Using a cuff that is too small can result in abnormally high reading
  • Fever exists if temperature is >100.4, not >98.6
  • Fasting blood sugar includes previous 10 hours with only water/ black coffee

Blood pressure staging

  • 120/80 — 139/89 … Pre-hypertension
  • 140/90 — 159/99 … Stage I Hypertension
  • >160/100 … Stage II Hypertension
  • If diabetic, BP Goal = 130/85
  • Diagnosis of Hypertension = two abnormal readings on two different days (diagnosis can only be made by a medical provider)

Glucose staging

Fasting

  • <110 … Normal
  • 106 - 125 … Pre-diabetic (IGT)
  • >126 … Diabetes

Not fasting

  • <200 … Normal
  • >200 + symptoms … Diabetes
  • Diagnosis of Diabetes type II = two abnormal readings on two different days (diagnosis can only be made by a medical provider)
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