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Chapter One
Before Giving Care and Checking an Ill or Injured Person
The EMS System
Network of community resources and medical personnel that provides emergency care to victims of injury or sudden illness
The Citizen Responder
Someone who recognizes an emergency and decides to help
First aid – is immediate care given to a victim of injury or sudden illness until more advanced care can come
In other words – this is you doing what you have learned
The EMS Dispatcher
The dispatcher is the person who receives the call from the citizen responder
This person determines what help is needed
Some are trained to give the caller instructions until EMS comes
In other words, the person who answers when you call 9-1-1
First Responder
This is the first person to arrive on the scene who is trained to provide a higher level of care
They are often close to the scene and have the appropriate equipment and supplies to give care
The Emergency Medical Technician
The EMT is capable of providing more advanced care and life support techniques
EMT Basic Level – all ambulance personnel have this basic training
EMT Paramedics – at this level they can give medication, IV fluids, and provide advanced airway care. They are the highest level of care outside of the hospital
Hospital & Rehabilitation
Hospital – once the victim arrives at the hospital, the personnel there takes over
Rehabilitation – the goal of rehab is to return the victim to his/her previous state of health
Your Role in the EMS System
Recognize that an emergency exists Decide to act Activate the EMS system Give care until help arrives
Recognizing an Emergency
Unusual Noises Unusual Sights Unusual Odors Unusual
Appearance and
Behavior
Barriers to ActionThings that would stop you from helping a victim.
Panic of fear of doing something wrong Being unsure of the person’s condition
and what to do Assuming someone else will take
action The type of injury or illness Fear of catching a disease Fear of being sued Being unsure when to call 9-1-1
The Good Samaritan Law
All 50 states have enacted Good Samaritan Laws
This gives legal protection to people who willingly provide care to ill or injured person
The laws protect citizens who act the same way that a “reasonable and prudent person” would if that person were in the same situation
Disease Transmission
In order to get a disease the following conditions must be present – The victim must be infected with a disease The rescuer must be exposed to the
infected victim’s body substance The rescuer must come in contact with the
substance through an entry site There must be a sufficient amount of the
infected body substance to cause infection
In other words…
Pathogen
Quantity
Susceptibility
Entry Site
Preventing Disease TransmissionStandard Precautions
Avoid contact Disposable gloves Before putting on personal
protective equipment (PPE) cover any of your own open wounds
Breathing barriers Cover infected area Wash your hands Tell EMS or doctor if you have
come in direct contact with a person’s body fluids
Cleaning Up Blood Spills
Clean up the spill immediately or as soon as possible after it occurs.
Use disposable gloves and other PPE when cleaning.
Wipe up the spill with paper towels. After the area has been wiped up, flood
the area with a disinfectant – 1 ½ cups bleach to 1 gallon of water.
Dispose and label “biohazard”
In case of an emergency the basic steps are -
Check the scene and the person
Call 9-1-1
Care for the person
Check
Is the scene safe? Chemicals, traffic,
fire, smoke, extreme weather
Avoid confined areas with no ventilation
If you can’t get near the victim, call 9-1-1
CheckWhat happened?
Look for clues to what caused the emergency.
Nearby objects, broken glass, spilled bottle
Check How many people were involved?
Look carefully for more than one person. If one person is bleeding or screaming you
may not notice an unconscious person. In an emergency with more than one victim
you may have to prioritize care.
Is anyone else available to help?
Check Is there immediate
danger involved? Do not move seriously
injured victims unless there is immediate danger or you have to move the person to give proper care such as CPR.
Make sure bystanders do not move the victims.
Check What is wrong?
Try to find out what is wrong. Look for signals of life threatening
emergencies. Unconscious, no breathing, no pulse,
severe bleeding Use all senses to try to notice if
anything is abnormal
Call
Often times the most important thing you can do is call 9-1-1.
When you are the only person at the scene - First shout for help. If no one arrives, you will have to decide
whether to call first or care first.
When to call -
Unconscious or altered level of consciousness
Breathing problems Persistent chest pain Persistent abdominal
pain or pressure Severe external
bleeding Severe burns Suspected poisoning
Vomiting blood or passing blood
Seizures Stroke Injuries to the
head, neck, or back
Suspected broken bone or an open fracture
Also call for these situations -
Fire or explosion Downed electrical wires Swiftly moving or rapidly rising water Presence of poisonous gas Serious car accident Injured or ill person who cannot be
moved easily
Which of the following are reasons to call 9-1-1?
Bruise on arm Cat scratch on cheek No signs of life Deep burn on face No breathing Cramp in thigh Splinter in foot Vomiting blood Persistent chest pain
Cut lip Seizures Abrasion on elbow Injured arm with bone showing through
the skin Bloody nose Unconscious Mild sunburn Injury to the head
Call First or Care First?
You should always CALL FIRST for – An unconscious adult or adolescent A witnessed sudden collapse of a child
or infant An unconscious infant or child known to
be at high risk for heart problems These are all possible cardiac
emergencies therefore time is crucial
Call First or Care First?
You should CARE FIRST for – An unwitnessed collapse of an
unconscious person younger than 12 years old
Any victim of a drowning These situations are more likely to
be breathing emergencies
Call Provide information requested by
the dispatcher Location Description of person’s condition
Do not hang up first Whenever possible have a
bystander make the call for you
Care Do no further harm Monitor the person’s breathing and
consciousness Help the person rest in the most
comfortable position Keep the person from getting chilled
or overheated Reassure the person Give any specific care needed
Give Care Until Help Arrives
If you are trained in first aid, you can give help that can save a life in the first few minutes
Get bystanders to help by – Calling 9-1-1 Clearing the scene Directing EMS personnel when they arrive Helping provide care Providing information about the victim Comforting and reassuring victims
Should you just take them to the hospital yourself?
Never transport a person – When the trip might cause greater damage
to the person When the person may develop a life
threatening condition If you are unsure of the injury or illness
If you take the person to the hospital – Take someone with you and the victim Pay attention to any changes in the victim
while en route
Why would you move a victim?
Only move the ill or injured person if –
You are faced with immediate danger
You have to get to another person who may have a more serious problem
You have to move the person to give them proper care
Emergency Moves
Walking Assist
Your body acts as a crutch supporting the person’s weight while you both walk
Emergency Moves
Two Person Seat Carry Can be used for any person who is conscious or
not seriously injured Lift the person in the seat formed by the
responders’ arms
Emergency Moves
Pack Strap Carry Can be used with a
conscious or unconscious person
Put your back to the person, back straight, knees bent
Your shoulders should be in their armpits
Cross the persons arms in front of you and grab their wrists
Lean forward and pull the person up onto your back
Emergency Moves
Blanket Drag Roll the person as
a unit Gather the blanket
at the head and move the person
Emergency Moves
Clothes Drag Can be used on a
person suspected of having a head, neck, or back injury
It helps keeps these areas stabilized
During this move the person’s head is cradled by clothing and the responder’s arms
Emergency Moves
Foot Drag Use this move on
a person who is too big to carry or move in any other way
Pull the person in a straight line and be careful not to bump them in to anything
Reaching a Person in the Water
Reaching Assist
Throwing Assist
Getting Permission to Give Care
Also known as consent You must –
Tell the person who you are How much training you have What you think is wrong What you plan to do
Then the person may decide whether they want care
If the victim is an infant or a child, get permission from the parent
Implied Consent
If the victim is an infant or child and you can not find the parent
Unable to respond because of the illness or injury
If the adult is unconscious
Conscious Ill or Injured Person - no immediate life threatening conditions
Two Basic Steps –
Step One
Interview the person and bystanders1. What happened?2. Do you feel pain or discomfort
anywhere?3. Do you have any allergies?4. Do you have any medical conditions or
are you taking any medication?Write down the information and give it
to EMS personnel when they arrive.
Conscious Ill or Injured Person - no immediate life threatening conditions
Two Basic Steps –
Step Two
Check from Head to Toe1. Do not move areas of the body that hurt.2. Look for cuts, bruises, bumps, and
depressions.3. Watch for changes in consciousness and
breathing.4. Notice how the skin looks and feels.5. Look over the body.6. Look for a medical ID tag.
Checking an Ill or Injured Infant or Child – What You May Do Differently
Start your check at the victim’s feet instead of their head.
Check the victim while he or she is seated in his or her parent’s or guardian’s lap.
Shock
Three conditions must be present for adequate blood flow – The heart must be working well. An adequate amount of oxygen-rich
blood must be circulating in the body. Blood vessels must be intact and able
to adjust blood flow.
Shock
A condition in which the circulatory system fails to circulate oxygen rich blood to all parts of the body.
When vital organs do not get oxygen rich blood they do not work properly.
Signs & Symptoms of Shock
Restlessness or irritability Rapid and weak pulse Rapid breathing Pale, ashen, or bluish, cool, moist
skin Excessive thirst Nausea and vomiting Drowsiness or loss of consciousness
Care for Shock
CALL 9-1-1 Have the person lie down Control any external
bleeding Maintain normal body
temperature Do not give the person
anything to eat or drink Reassure the person Continue to monitor the
person’s breathing
Checking an Unconscious Person
If you think someone is unconscious – Tap their should and ask if they are ok Infant – tap shoulder or flick the bottom of
their foot If they do not respond CALL 9-1-1 Check to see if the person –
Has an open airway and is breathing Is bleeding severely
Signs of Life
Consciousness, normal breathing and circulation and skin characteristics are referred to as signs of life.
Checking an Unconscious Person
As easy to remember as ABC!
Airway – open the airway Breathing – check for
movement or breathing Circulation – check for
severe bleeding
Checking the Airway & Breathing
Head Tilt/Chin Lift Moves the tongue away
from the back of the throat, allowing air to enter
Checking the Airway & Breathing
Look, listen, and feel for breathing for no more than 10 seconds.
Agonal breath is irregular, gasping or shallow. Someone with agonal breathing should be treated like a non-breathing victim.
If the victim is not breathing -
Adult – begin CPR immediately
Child or Infant – give 2 rescue breaths Child – pinch nose, complete seal over mouth Infant – complete seal over mouth and nose
What to do next -
Vomit, fluids blocking the airway, or if you must leave the victim, place the person in the H.A.IN.E.S. recovery position.
Special Situations
Air in the Stomach Avoid forcing air into the person’s
stomach by keeping the person’s head tilted back.
Air in the stomach can cause the victim to vomit.
Choking Harder to breathe
Special Situations
Vomiting H.A.IN.E.S. Clear it out Continue care
Special Situations
Mouth to Nose Breathing Close the mouth by pushing on the chin If possible, open the victim’s mouth
between rescue breaths to let the air out
Special Situations
Mouth to Stoma Breathing Expose the person’s neck down to the
breastbone Keep the airway in neutral position If the tube is blocked, remove the inner
tube If partial breather, rescuer must seal
the mouth and nose
Special Situations
Head, Neck, and Spinal Injuries If a child is in a car seat, do not remove
the child from the seat Minimize movement when opening the
airway Tilt the head and left the chin just
enough to open the airway
Incident Stress
After responding to an emergency, it is not uncommon for the rescuer to be unable to cope with the stress of the situation.
If not appropriately managed, this stress can lead to PTSD.
Signals of Incident Stress
Anxiousness and unable to sleep Nightmares Restlessness Confusion Low attention span, poor concentration Denial, guilt, anger, depression Nausea Increased or decreased eating
Guidelines for Coping with Incident Stress
Seek help Use relaxation techniques Eat a balanced diet Avoid alcohol and drugs Get enough sleep Participate in some type of physical
activity