First Aid Lecture Chapter 2: Action at an Emergency

First Aid Lecture: Recognition and Action at an Emergency

Quick-write: “A hero is no braver than an ordinary man, but he is brave five minutes longer”

What did Ralph Waldo Emerson mean by this quote? How does this apply to you and your role as an ordinary bystander to an emergency or as a trained medical professional?

The Bystander: Often the link between an injured victim and EMS help.

I. Compared to medical professionals, bystanders are less likely to help in public places due to:

1. Ignorance

·  Uncertain of what steps to take: not confident in their abilities

2. Confusion about what is an emergency/Recognition that something is wrong

·  Severity: catastrophic emergencies attract more attention

·  Physical Distance: too far from the scene of the emergency

·  Relationship: knowing the victim increases the likelihood that they notice it.

·  Time Exposed: the longer the bystander is aware of the situation, the more likely they notice it as an emergency.

3. Characteristics of emergency

·  Unpleasant: blood, vomit, alcohol

·  Fear of HIV

·  Obligations: children, schedule

·  Does not witness the emergency or does not know the victim

II. What should be done?

1.  Make a quick decision to help upon recognizing the emergency:

·  many people refuse to acknowledge the emergency

·  develop an attitude: decide to help BEFORE you encounter an emergency

“I shall pass through this life but once.

Any good, therefore, that I can do

Or any kindness I can show to any fellow creature

Let me do it now.

Let me not defer or neglect it,

For I shall not pass this way again.”

-Etienne de Grellet

·  developing the attitude to help involves:

a. Appreciating the importance of you help

b. Feeling confident in your abilities

c. Being willing to take the time

d. Putting potential risks of helping into perspective

2.  Contact EMS without delay, when needed: electing to bypass EMS, transporting victims by private vehicle can pose a danger to victims.

3.  Assess the Victim: decide if life-threatening conditions exist and what kind of help victim needs.

4.  Provide first Aid

III. When do you call for help?

1. When you are not sure what to do
2. Someone is seriously ill or injured. For example the person:

·  Does not respond to voice, touch, or pain

·  Is unresponsive without a pulse after 5 – 10 seconds.

·  Has chest discomfort

·  Has signs of stroke (slurred speech, unequal pupils, loss of control on one side of face or body)

·  Has problems breathing

·  Has a severe burn

·  Has a severe wound: gunshot, major cuts, punctures, etc.

·  Severe bites (snakes, spiders, dogs)

·  Has a severe life-threatening bleed (does not stop after 10 minutes of direct pressure)

·  Has a seizure

·  Suddenly can’t move a part of the body

·  Has received an electric shock

·  Has been exposed to poison

·  Has been assaulted

·  Has attempted suicide

·  Persistent vomiting, or severe vomiting (like blood)

IV. How do you call for help?

1. If alone:

·  Yell for help while you check the victim.

·  If no one answers your yell and immediate care isn’t needed, leave for a moment while you phone 911, get first aid supplies, and AED if available.

·  Return to victim.

1. With others:

·  Stay with the ill or injured person and be prepared to give 1st aid and CPR

·  Assign a specific person to phone 911, get first aid supplies, and AED if available.

· 

V. Rescuer Reactions:

1.  Rescuers must desensitize themselves at an injury scene.

·  Rescuers collapsing detracts attn from original victim who has a more severe injury

·  Relaxation techniques to help a rescuer desensitize and reduce anxiety at an emergency:

a. Close eyes, take several deep breaths, blank your mind, and say the number “one” as you breathe out. Do not count, just say one.

b. Change thought patterns to the pleasant – imagine a favorite place, sing a favorite tune to yourself in your mind.

2. Post-care reaction: a feeling of “let-down” after giving first aid.

·  Discuss your feelings, fears and reactions with someone within 24-72 hours of a trauma

·  Prevents emotional problems that might develop later

VI. How to complete a 10-second scene survey during an emergency situation

Look for 3 things:

1. Danger: Look for hazards that could be dangerous to you, victim, others.

·  Withdraw and get help before proceeding, when hazards exist.

·  Move the victim only if she’s in danger or if you need to mover her to provide 1st aid or CPR.

2. Help: Look for people that can help you and look for phones. Have someone phone or phone yourself.

3. Who and How Many: Number of victims, approximate age (adult, child, female, male)

4. Determine cause of injuries.

Ex. victim thrown against steering wheel.

VII. Information to provide EMS

·  Victim’s location: address, intersecting roads, specific locale

·  Your phone number and name

·  What happened

·  Number of people needing help and any special conditions

·  Victim’s condition and any first aid you have tried

VIII. Disease Precautions

1.  Greatest threat: blood-borne diseases

·  Transmitted fluid to fluid – require contact of mucous membrane or open wound to contaminated fluid.

·  Examples:

a. Hepatitis B – viral infection of the liver.

Vaccine is available.

Can lead to cirrhosis (liver damage).

b. Hepatitis C – no vaccine or effective treatment

c. HIV

2. Personal Protective Equipment (PPE):

·  Latex/Vinyl Gloves – always use if possible (latex allergies are common, so stock 1st Aid kit with vinyl.

·  Eye-wear protects from blood spatters.

·  Mask from airborne particles: TB, Cold virus.

·  Mouth to barrier device recommended for CPR

3. Universal Precautions/Body Substance Isolation: Assume all body fluids are a possible risk of disease transmission.

·  Wear gloves, eye protection, masks when available.

·  Use absorbent material to soak up blood or other infectious materials – do not directly contact fluid!

·  Clean spill area with a disinfecting solution – diluted bleach (10%)

·  Discard contaminated materials in appropriate waste container – in Biohazard waste bag, Ziploc bag, or trash bag and seal

·  Use soap and water to wash parts of your body that have been contaminated by body fluids: 10-15 seconds of scrubbing with soap.

·  Use paper towel to turn off faucet to prevent recontamination.

IX: Skill - Removal of Gloves: (video)

1. Grip one glove on the outside of the glove near the cuff and peel it down until it comes off inside out..

2.  As glove comes off, cup it in the palm of other hand.

3.  Slide two fingers under the cuff of the other glove. Do not touch the outside of the glove.

4.  Peel the glove off so that it comes out inside out, with the first glove inside.

5.  Dispose of properly.

X: Skill – Proper Hand Washing (video)