MEDICAL UPDATE 2015 -2016 Col Dr Carey Capell

MEDICAL UPDATE 2015 -2016 Col (Dr) Carey Capell Citadel Surgeon

Overview • Infirmary Staff • Medical Services • Hours of Operation • Blue Book Issues • When to Call EMS

Infirmary Staff • Dr. Carey Capell, ’ 71 • Flight Surgeon / Pediatrician • Dr. Kenny Caldwell, ’ 79 • Orthopedic Surgeon / Citadel Team Doc • Ms. Celeste Conlon, MSN, CFNP • Family Nurse Practitioner / Chief Nurse 7 RNs & 2 CNAs 1 Admin. Assistant • Mr. Andy Clawson, MS ATC • Sports Medicine Director 7 Athletic Trainers

Infirmary Services • Clinics: • Acute/Urgent Care Clinic • Sports Med/Ortho Clinic • Women’s Health Clinic • Allergy Shots/Immunizations • Inpatient (36 Beds): • Daytime & Overnight Admissions • Emergencies: • Minor - Infirmary • Major – ER (Roper, MUSC, etc)

Services (Cont. ) • Pharmacy • Laboratory • X-Ray • EKG • Specialist Referrals • Dental Referrals

Hours of Operation • Outpatient (Clinics) • “Sick Call”(Doc, NP): 0630 -1100 & 1230 -1430 M-F • Walk-In Clinic (Nurse): 1430 -2100 M-F & W/E • Sports Med Clinic (Trainer): 0700 Mon-Fri • Orthopedic Clinic (Doc): 0700 Mon & Fri (only) • Inpatient (Admissions) 24 hrs/day • Emergencies: 24 hrs/day Clinics are closed for lunch: 1200 -1230 M-F

Blue Book • Medical Leave: • Appointment confirmation (Dr. office) • Accountability (date, time, address, phone #) • Med Leave usually approved…but… • May adjust appointment dates/times (SMI, etc) • Save an unnecessary trip (time, gas, and $$) • PT Uniforms: • Authorized only for in-patients, X-Uniform • X-Uniform is an uncommon restriction • Not authorized for TDS, XMD, XPT, SS, etc.

Blue Book (Cont. ) • Excused Duty Status: • XMD • “XMD includes: XPT, X-Brace, X-Run, X-Push-Ups, X-Pull-Ups, X-Sit-Ups, X-Rifle, and X-Instrument. “ • “XMD prohibits participation in inspections, parade, drill, rifle manual, rapid gallery walking, driving the stairs, sweep detail and all other official military duties. ” • XPT • “XPT: Not required to perform official physical training but must be present, in PT uniform, to observe instruction during PT sessions. ” • “XPT status does not prohibit light, conditioning exercise, such as walking and swimming, unless specifically prohibited by the Infirmary or Sports Medicine staffs. ”

Blue Book (Cont. ) • Excused Duty Status: • SS (Soft Shoe): • “Must wear athletic shoes when in uniform. “ • “May not leave campus in uniform while wearing athletic shoes. ” • “R” (Restricted to Campus): • “R” (restricted) designation added to any of the above restricts the cadet to campus. “ • “Typically, restriction to campus for the weekend will accompany excused disposition (XMD, XPT, etc. ) initiated on a Friday afternoon. “ • “Except as noted above, cadets in restricted status are subject to all cadet rules and regulations. ”

Blue Book (Cont. ) • Temporary Disability Status (TDS) • “A cadet is placed on TDS when a medical condition requires that he/she be excused from military duties or physical training for an extended period of time (normally several weeks), but not permanently. “ • “TDS will always be accompanied by excused duty (e. g. , TDS and XMD, or TDS and SS). TDS does NOT make a cadet “X-Uniform. ” • “A cadet placed on TDS will not be referred to the Campus Assessment Team (CAT) for medical review except under unusual circumstances; e. g. , recovery taking longer than expected or extending into a new semester. “ • “TDS typically ends with the current semester. If more time is required for rehabilitation, then TDS must be renewed based on orders from the treating physician(s). ”

Blue Book (Cont. ) • Infirmary Slip (Duty Excuse): • “Cadets are given two (2) Infirmary Slips after leaving the Infirmary. ” • “Grace period: 20 minutes to report for next duty. ” • “Upon arrival for duty or class, cadets will present a copy of their Infirmary Slip to a member of the Chain‑of‑Command or to their Instructor, who will annotate time of arrival and sign the slip. “ • “This copy of the Infirmary Slip will then be presented to the Company Clerk upon return to the Company area. ” • “Cadets must carry the second copy of the Infirmary Slip with them as proof of excused status (XPT, X-Cover, etc. ), as appropriate. ”

Blue Book (Cont. ) • Intoxicated: • “Cadets who return to the barracks when intoxicated must be identified to the barracks guard, TAC Officer, COC, or OC and escorted to the Infirmary for further evaluation. ” • “Those who are unable to walk may be transported to the Infirmary by Public Safety, (843) 953 -5114. ” • Disposition: Infirmary will (1) send the cadet back to the barracks or (2) arrange transport to ER; cadets can’t sleep it off in Infirmary • Too Ill for Duty: • “Cadets considering themselves “Too Ill for Duty” MUST report to the Infirmary for evaluation and treatment. ” • “Transportation and necessary assistance can be arranged for cadets unable to walk to the Infirmary. “ • “Those cadets who have not reported to the Infirmary and signed in will not be excused from duty. ” • “Sleeping in due to ‘illness’ is not an excuse for missed duty. “

Blue Book (Cont. ) • In-Patients: • Duty uniform while in-patient in Infirmary: • Complete PT uniform; duty uniform optional • In-Patients cannot leave campus unless: • Medical Pass (doctor’s appt, hospital visit, etc. ) • Medical Leave (proper leave uniform) • In-Patients are excused from all duties • “Class Status. ” When placed on CS, cadet… • Must attend class if medically able to do so • Must sign out to class, library, barracks, etc.

The Blue Book • Campus Assessment Team (CAT): • Assoc. Provost, Asst. Cmdt, Surgeon, Police, CCC, Acad. Supt. Center; Gen’l Counsel (advisor) • Ad Hoc: Admissions, TAC, Prof. , Coach, CARE • CAT Triggers: • Applicant not meeting phys/behavioral standards • Knob misses >30% of the cadre training period • >21+ visits/sem: Infirmary, medical/dental appt. • >21+ days/sem: excused duty (XMD, SS, etc) • Major illness or injury limiting military, athletic, or academic participation for a “protracted period”

When to Call EMS? • Infirmary…. or… 911? • A knob “passes out” driving the stairs to 4 th Div; he is sweating, pale, breathing rapidly, not responding to cadets…just moaning a bit • Cadet responder: “I think he’s unconscious!” • Cadet calls 911 • Costs: • Ambulance = $400 • ER visit = $600+ • Lab, etc. = $400+ • Hospital admission = $1000/night • If in doubt, call us… or get him to the Infirmary

When to Call EMS? (Cont. ) • For patient transport on campus: • Call: JOD, Public Safety, Sports Med (golf cart) • Note: Infirmary is not manned for house calls • Gen. Order No. 1 – “Call 911 if”: • Severe Trauma (fall > 10’, bone sticking out, etc) • Profuse Bleeding from an open wound • Not Breathing (chest is still, no breath sounds) • Totally Unconscious • Unable to Walk (even with assistance) to a vehicle for transport to the Infirmary

Questions? • Call: 3 -4827/6847 • E-mail: carey. capell@citadel. edu