Bechtel Environmental, Safety, and Health (BESH)
Emergency Response:Assessing the Scene and the Victim(s)
Bechtel First Response TrainingSession 2
Slide 2Bechtel Environmental, Safety, and Health (BESH)
Safety is Our ValueSafety is Our Value
“We measure safety performance by the number
of incidents. But let’s be clear…
it’s really not about incident rates…it’s about people.
People who have faces, names, families, hopes, and dreams.”
-Riley BechtelAugust 15, 2001
Slide 3Bechtel Environmental, Safety, and Health (BESH)
Assessing the Scene and Victim(s)Assessing the Scene and Victim(s)Enabling Learning ObjectivesEnabling Learning Objectives
Defining proper emergency response
Prioritizing safety Securing the scene Calling for help Prioritizing care Indications for moving
victims Methods of safely
repositioning, moving and rescuing victims
Slide 4Bechtel Environmental, Safety, and Health (BESH)
Proper Emergency ResponseProper Emergency Response
prevents the present situation from getting worse protects workers from further danger and injury provides first aid to the injured worker(s) protects material and equipment from further damage isolates and secures the area to ensure that nothing is
disturbed
Slide 5Bechtel Environmental, Safety, and Health (BESH)
Prioritize Your Own SafetyPrioritize Your Own Safety
Priority for safety is in the order of:
self, site, patient A responder who becomes one of
the injured is not aiding the problem but contributing to it
Personal protective equipment (PPE) must be available and worn
– protective gloves, eye and ear protection; maintain your badge on your person at all times
All responders must be familiar with where the first response equipment is located and how to use it
Additional equipment should be added only for a specific reason and by authorization of the Safety & Health Department
Slide 6Bechtel Environmental, Safety, and Health (BESH)
Secure the Scene Before Administering Secure the Scene Before Administering AidAid
Evaluate the scene for number of injured and nature of the event
Assess the safety of the scene, including the potential for toxic vapors or gases in the air, and other risks such as electrical or fire hazards
Prioritize care when there are several injured
Check victims for medical alert tags Perform a logical head-to-toe check
for injuries Move the victim only if absolutely
necessary to prevent further injury from a hazard at the scene
If possible, leave material where it is found
Secure area until the investigation is completed
Slide 7Bechtel Environmental, Safety, and Health (BESH)
Taking ChargeTaking Charge
Immediately assess seriousness of situation and size up the scene for:– scene safety, – body substance isolation determination, – mechanism of injury/nature of illness determination, – number of patients, and – resources needed
Priority should be personal injury followed by property damage. Questions to answer immediately:– Can the present situation get worse? – Is anybody injured? – How can damage be minimized?
Eliminate and contain hazards
Slide 8Bechtel Environmental, Safety, and Health (BESH)
Making a Mayday CallMaking a Mayday Call
State your name, location, and nature of the emergency
Registered Nurse will counsel and transport to scene, activate EMS
Provide initial first aid as soon as possible
Continuously monitor the victim(s) Safety will meet and escort EMS
directly to the incident scene Ensure clear access for EMS Identify witnesses and immediately
make a list of those directly involved in incident, including injured persons. Tell witnesses that their help will be needed later.
Incidents attract onlookers. Direct them away from scene.
Slide 9Bechtel Environmental, Safety, and Health (BESH)
Victim AssessmentVictim Assessment
Perform a logical head-to-toe check for injuries
Assess each victim for
– responsiveness,
– Airway patency (blockage),
– Breathing,
– Circulation, and
– medical alert necklace or bracelet
Take a victim’s history at the scene, including determining the mechanism of injury
Slide 10Bechtel Environmental, Safety, and Health (BESH)
American Heart Association CPR Guidelines American Heart Association CPR Guidelines 20102010
1. Assess the victim
2. Call for help
3. Being Chest Compressions Push hard and push fast Perform compressions at the
rate of 100 CPM If trained in CPR, after 30
compressions, open the airway and give 2 breaths
If not trained or if you do not feel comfortable, continue compressions without interruption until other help arrives
Slide 11Bechtel Environmental, Safety, and Health (BESH)
Triage PrinciplesTriage Principles
Nurse will assume command of the scene and will triage the injured when she/he arrives on the scene – EMS will assume command of the
scene when they arrive Triage is a system for sorting
casualties into priority for treatment by subsequent teams, enables limited resources to be deployed efficiently
Treating a less critically ill patient could deny life-saving interventions to others who may die as a result
Non-medical person has no authority to tag an injured person as deceased – Dead bodies should be left where
they are (uncovered)
Slide 12Bechtel Environmental, Safety, and Health (BESH)
Emergency RescueEmergency Rescue
Moving a victim from a dangerous location to a place of safety
Procedure:– Avoid unnecessary
disturbances– Ensure open airway– Control bleeding– Check for injury– Immobilize injured parts
before moving– Transport
Slide 13Bechtel Environmental, Safety, and Health (BESH)
Indications for moving VictimsIndications for moving Victims
Victims who are in immediate danger should be moved away from the danger at once by whatever means possible. Indications: Fire, danger of explosion Danger of asphyxia due to
lack of O2 or gas Serious traffic hazard Risk of drowning Exposure to cold/heat Possibility of injury from
collapsing walls or building Electrical injury or potential
injury Pinning by machinery
Slide 14Bechtel Environmental, Safety, and Health (BESH)
Moving VictimsMoving Victims
Victims who are NOT in immediate danger should be moved only after they have been stabilized
Position to prevent aggravating injuries or to prevent additional injuries
Be prepared to assist other rescuers with lifting and moving victims
Slide 15Bechtel Environmental, Safety, and Health (BESH)
Positioning VictimsPositioning Victims
Reposition the head to open the airway
Stabilize patient in position found until all assessments are complete, bleeding is controlled, and injuries are splinted
Roll unresponsive people onto their left side into the recovery position
Patient who is nauseated or vomiting should be allowed to remain in a position of comfort
Non-trauma patients can be positioned as found
Slide 16Bechtel Environmental, Safety, and Health (BESH)
Methods of TransferMethods of Transfer
Pulling the Victim Lifting the Victim Supporting the Victim Two Man Carry Blanket Lift Three Man Hammock
Carry
Slide 17Bechtel Environmental, Safety, and Health (BESH)
Moving the InjuredMoving the Injured
Keep patient’s head in line with the body
Pull patient in the direction of the long axis of the body to provide as much protection to the spine as possible
Greatest danger when moving a patient quickly is the possibility of aggravating a spinal injury or compromising the patient’s airway
1st protect yourself 2nd protect the airway 3rd protect the breathing 4th protect the circulation 5th protect the spine 6th protect the rest of the body
Slide 18Bechtel Environmental, Safety, and Health (BESH)
Three Man Hammock CarryThree Man Hammock Carry
Slide 19Bechtel Environmental, Safety, and Health (BESH)
Backboard
Backboard is used as a method of preventing an injured neck/back from getting worse and as a way to move an injured person that is suspected of having a neck/back injury without making the injury worse.
Nurse will use symptoms, mechanism of injury (e.g. how far did they fall) and medical knowledge to decide if a backboard is necessary
Slide 20Bechtel Environmental, Safety, and Health (BESH)
Stokes Basket
Normal position: horizontal or feet down Start with splinting/wound management Padding beneath patient in a Stokes basket
Under knees, between legs, along sides, around head Not under neck
Never leave patient unattended, always have plan if need to tip patient Strap patient in tight, don’t depend on seat belts On-going care: pedal pulse/vitals
Ask patient if they feel numbness/tingling/hot spots (indicates straps too tight or loose)
Rescuer at the head is in charge Feet first, rescuer at patient’s head looks forward
Slide 21Bechtel Environmental, Safety, and Health (BESH)
Assessing the Scene Review QuestionsAssessing the Scene Review Questions
1. If you encounter another person in immediate danger, what is the first priority? SELF
2. Name three situations that require emergency move of a victim.– Fire, danger of explosion– Danger of asphyxia due to lack of O2 or gas– Serious traffic hazard– Risk of drowning– Exposure to cold/heat– Possibility of injury from collapsing walls or
building– Electrical injury or potential injury– Pinning by machinery
3. What is the sequence followed when performing an initial assessment?
1. Perform a logical head-to-toe check for injuries
2. Assess responsiveness3. Airway patency (blockage)4. Breathing5. Circulation6. medical alert necklace or bracelet
Slide 22Bechtel Environmental, Safety, and Health (BESH)
We value yourWe value your Safety Safety and and HealthHealth
Questions?Questions?Speak with your Project Nurse or
Safety Professional
Slide 23Bechtel Environmental, Safety, and Health (BESH)
Learn More about Learn More about Assessing Scene Assessing Scene SafetySafety
American Heart Association (AHA.org)
Centers for Disease Control (CDC.gov)
National Institute for Occupational Safety & Health (NIOSH.org)
National Safety Council (NSC.org)
Occupational Safety & Health Administration (OSHA.gov)
U.S. Department of Health and Human Services (HHS.gov)
U.S Department of Homeland Security (DHS.gov)