Learning

This SOP does not create a clinic, replace 911, or authorize practice beyond license and current training. CLINICIAN ONLY procedures (needle decompression, surgical airway, LMA in a crashing patient) are restricted to a licensed physician, PA, NP, or paramedic under the church medical director. When in doubt: scene safety, 911, ABCs, bleed control, stay, document, hand off.

But a Samaritan, as he journeyed, came to where he was, and when he saw him, he had compassion.

Luke 10:33

Purpose: a single playbook for medical problems during gathered worship, classes, nursery, and playground — early recognition, correct actions, kit use, rapid EMS.

Scope: church property during services, classes, playground, and the hour before and after. Lay first aid / BLS and the medical team. Not planned clinics, camps, or off-campus events (write a rider).

Authority: obtain consent; same-sex chaperone for private exams; two-adult rule. Good-Samaritan and related protections are a matter of local law — they are not a license to freelance.

Activation: recognize, name tasks, give dispatch details, send a runner, use a short radio code. Point at people. Named tasks get done.

• Call 911 for: unresponsive, seizure meeting red flags, no breathing, suspected heart attack or stroke, life-threatening bleeding, severe breathing difficulty, head injury with flags, open or neurovascular-compromised fracture, severe hypoglycemia, significant trauma, vomiting/diarrhea with red flags, or a parent request.

Primary survey, every patient, every time, under 60 seconds: Safety, Response, Airway, Breathing, Circulation (massive bleed now), Disability, Expose selectively.

Secondary: last known well, SAMPLE, vitals, meds from family or bottles. Recovery position for the unconscious patient who is breathing adequately with no spinal injury.

If the kit has no AED, no epinephrine, no naloxone, and no glucagon, those are the next purchases — in that conversation with the medical director. Post AED and bag locations in the usher area, nursery, and playground gate.

Source standard: current AHA Adult and Pediatric BLS. Adult arrest: 911/AED, hard floor, 100–120 compressions, 2–2.4 inches, 30:2 or hands-only, AED as soon as it arrives. Child/infant: breaths matter; 15:2 with two rescuers; pediatric pads if you have them.

Choking: severe obstruction is silent. Adult/child — back blows and abdominal thrusts; infant — back blows and chest thrusts; unresponsive — CPR, look before breaths, no blind sweeps.

Adjuncts: NPA (semiconscious, no facial/basal-skull trauma), OPA (unconscious, no gag), BVM two-person when you can. LMA and surgical airway: clinician only.

Source: ACS Stop the Bleed. Life-threatening: 911, gloves, pressure, tourniquet 2–3 inches above, time it, second tourniquet if the first fails, pack junctional wounds. Ordinary: irrigate, pressure, dress. Do not put hemostatic agents on a scrape.

• Chest trauma: seal open wounds; tension physiology is clinician-only needle decompression.
• Stroke: minutes matter. BE-FAST. Last known well as a clock time. Glucose. No aspirin.
• Chest pain / ACS: 911, rest, chew 162–325 mg aspirin if eligible, no NSAIDs, oxygen only if needed.
• Hypoglycemia: meter, oral glucose if they can swallow, nothing oral if not. Do not drive them home after a significant hypo.
• Seizure: protect, time, nothing in the mouth. 911 on first, long, repeat, infant, pregnant, diabetic, trauma, or not returning to baseline.
• Falls / head / spine: do not twist. Jaw-thrust. Red flags ride in an ambulance. Elderly hip is EMS.
• Fractures: NV check, SAM splint, ice. Nursemaid's elbow is a clinician reduction — do not yank children by the hands.
• GI: red flags first (pain, neuro, blood, infant, toxic). Hygiene. Isolate toys.
• Playground: abrasions, FOOSH, ankles, heads, nursemaid, choking, heat, stings.
• Anaphylaxis: 911, epinephrine in the thigh, repeat if still crashing. Antihistamines are adjuncts.
• Syncope: typical vagal vs red flags (exertional, no prodrome, chest pain, pregnancy, neuro). Stay down until they can stand.
• Heat: shade and fluids for cramps/exhaustion; 911 and aggressive cooling for heat stroke.

Every dose is documented. Parents decide for children when present. If the story is not simple pain, fever, dyspepsia, or documented hypoglycemia, skip the bottle and use the phone.

Write it while it is true: name, age, times, problem, vitals, glucose, what you gave, tourniquet time, witnesses, parent notification, EMS unit. Twenty-second handoff, then answer questions.

After EMS: biohazard cleanup, restock the same day, pastoral care for the family, incident report to the medical director within 24 hours. Child events also follow the child-protection reporting path. Debrief once. Do not turn it into a courtroom.

• All service-team members and Sunday School leads: current Stop the Bleed + hands-only CPR at minimum.
• Designated medical team: current AHA BLS. Pediatric emphasis for anyone covering the playground.
• Clinicians on the roster: annual skills for BVM, LMA, needle decompression, and surgical airway on a model, plus a walk-through of this bag.
• One announced drill per year that includes a playground fall and a sanctuary collapse. A protocol no one has walked is a PDF.

If you see it, do this first, then open the matching branch in the medical decision tree. Unresponsive → 911 + AED + CPR. Arterial bleed → pressure, tourniquet, time. FAST change → 911, last known well, glucose, no aspirin. Crushing chest pain → 911, ASA if eligible. Seizing → protect, time, nothing in the mouth.