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