EMERGENCY RESPONSE TRAINING
Download
Report
Transcript EMERGENCY RESPONSE TRAINING
American Red Cross
Emergency Response
EMERGENCY
RESPONSE
TRAINING
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Emergency Response Training
Instructors
Books
Facilities
Certificates
upon completion
Schedule
Tests
Participation
Hands-on
training
Physical requirements
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM2
American Red Cross
Emergency Response
Chapter 1
The First Responder
Components
of the EMS system
Roles and responsibilities of the First
Responder
Medical Oversight
Statutes and regulations
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Links in the Chain of Survival
1. Citizen Response
2. Early activation of EMS
3. First Responder Care
4. Advanced Out-of-Hospital Care
5. Hospital Care
6. Rehabilitation
Pg 5-11
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM1
American Red Cross
Emergency Response
First Responders
Fire
fighters
Law enforcement personnel
Lifeguards
Ski patrollers
Industrial response team
Athletic trainers
Disaster team members
First aid station attendants
Pg 12-14
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM2
American Red Cross
Emergency Response
Video
The First Responder
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
First Responder Characteristics
Maintains
caring and professional attitude
Controls fears
Presents professional appearance
Maintains skills and knowledge
Stays healthy
Recognizes and keeps victim’s needs as
priority
Pg 12-13
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM3
American Red Cross
Emergency Response
Primary Responsibilities of
First Responders
Ensure
safety of self and others
Gain access to victim
Identify life-threatening conditions
Summon more advanced medical personnel
when necessary
Provide care
Assist more advanced medical personnel
Pg 13-14
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 4
American Red Cross
Emergency Response
Secondary Responsibilities of
First Responders
Summon
additional help.
Control and direct bystanders.
Keep records.
Reassure others at scene.
Pg 13-14
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 5
American Red Cross
Emergency Response
Medical Oversight
Includes
medical director
Direct medical control
Indirect medical control
protocols
standing
orders
Pg 14
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 6
American Red Cross
Emergency Response
Chapter 2
First Responder Well-Being
Recognizing
Stress
Emotional Reactions
Scene Safety
Protective Equipment
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Emotional Aspects of
Emergency Care
Stressful
Situations
Death and Dying
The Grieving Process
Helping the Victim and the Family
Pg 18-20
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Stress Management
Warning Signs of Stress
Irritability
Inability to concentrate
Difficulty sleeping/nightmares
Anxiety
Guilt
Loss of interest in work
Managing Stress
Healthy physical and mental habits
Diet
Balance of work, recreation, family and health
Seek professional help if necessary
Pg 20
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 7
American Red Cross
Emergency Response
Critical Incident Stress
Strong
emotional reaction that interferes
with ability to function
Can build-up over days, weeks, months or
years
May require counseling
See Pages 442-443
Pg 20-22
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 8
American Red Cross
Emergency Response
CIS Management
Pre-incident
stress education
On-scene peer support
Critical Incident Stress Debriefing (CISD)
Critical Incident Stress Defusing
Family support
Know when to Access CISD
Pg 21
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
The Emergency Scene
Scene
Safety
Personal Safety
Safety of Others
Be aware of special emergency situations
Hazardous
Materials
Motor Vehicle Crashes
Pg 22-25
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
At the Scene, Evaluate Location
Problems
Dangers
Number
of victims
Behavior of victims/bystanders
Need for additional assistance
Pg 22-25
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 9
American Red Cross
Emergency Response
Evaluate the scene
Pg 23
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 3
American Red Cross
Emergency Response
Ensure Your Safety By Evaluating
potential dangers.
Wearing proper gear.
Doing what you are trained to do.
Summoning additional resources.
Pg 23
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 10
American Red Cross
Emergency Response
Possible Dangers at an
Emergency Scene
Crime
Traffic
Fire
Electricity
Water/ice
Hazardous materials
Unstable structures or
vehicles
Natural disasters
Multiple victims
Hostile situations
Suicide
Hostage situations
Pg 29-33
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 11
American Red Cross
Emergency Response
Enrichment
Specific Emotional Crisis
Suicide
Assault
Sexual Assault
Physical Assault
Crisis
Intervention
Dealing with Emergency Situations at the
Scene
Pg 26-29
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 3
Disease Transmission
How
the immune system works
How diseases are transmitted
Conditions required for disease
transmission
Body Substance Isolation
Exposure control and documentation
OSHA requirements
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Preventing Disease Transmission
Part I
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
OSHA Regulations
Occupational
Safety and Health
Administration regulations regarding “blood
borne pathogens”
Apply
to employers whose employees, as a
result of job requirements, have potential
exposure to blood borne pathogens.
Provide safeguards to reduce disease
transmission
Pg 45-46
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Potentially Infectious Body Fluids
Semen
Vaginal
Secretions
Cerebrospinal fluid Synovial fluid
Pleural fluid
Pericardial fluid
Amniotic fluid
Peritoneal fluid
Pg 36-37
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
How Infections Occur
Disease-causing Agents
Viruses
(Hepatitis, measles, mumps, meningitis,
colds, HIV, herpes)
Bacteria (Tetanus, meningitis, tuberculosis,
diphtheria, food poisoning)
Fungi (Athlete’s foot, ringworm)
Protozoa (Malaria, dysentery)
Rickettsia (Typhus, Rocky Mountain spotted
fever)
Pg 37-38
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
The Body’s Defenses
Immune
system (antibodies)
Acquired
immunity
Specific immunity by Immunization
Understanding
how diseases spread
Taking precautions (BSI)
Pg 38-39
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Conditions Necessary for Disease
Transmission
Pathogen
present
Pg 39
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 12
American Red Cross
Emergency Response
Conditions Necessary for Disease
Transmission
Pathogen
present
Sufficient
Quantity
Pg 39
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 12
American Red Cross
Emergency Response
Conditions Necessary for Disease
Transmission
Susceptibility to
the disease
Pathogen
present
Sufficient
Quantity
Pg 39
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 12
American Red Cross
Emergency Response
Conditions Necessary for Disease
Transmission
Susceptibility to
the disease
Pathogen
present
Sufficient
Quantity
Transmission
Site
Pg 39
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 12
American Red Cross
Emergency Response
How Pathogens Enter the Body
Direct
Pg 40
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 13
American Red Cross
Emergency Response
How Pathogens Enter the Body
Direct
Indirect
Pg 40
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 13
American Red Cross
Emergency Response
How Pathogens Enter the Body
Direct
Indirect
Airborne
Pg 40
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 13
American Red Cross
Emergency Response
How Pathogens Enter the Body
Direct
Indirect
Airborne
Vector
Pg 40
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 13
American Red Cross
Emergency Response
Video
Preventing Disease Transmission
Part II
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Diseases that Cause Concern
Herpes
Simplex
Meningitis
Tuberculosis (TB)
Hepatitis
HIV
Pg 41-44
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Meningitis
• The bacteria are spread
through the exchange
of respiratory and throat
secretions (i.e.,
coughing, kissing)
Copyright © 2000 by the American National Red Cross
All rights reserved
Emergency Response
Tuberculosis (TB)
• TB is spread from
person to person
through the air.
When Help Can’t Wait
American Red Cross
Emergency Response
Viral Meningitis
through direct contact with respiratory
secretions (saliva, sputum, or nasal
mucus) of an infected person. By
shaking hands with an infected person
or touching something they have
handled, and then rubbing your own
nose, mouth or eyes. The virus can
also be found in the stool of persons
who are infected.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Preventing Disease Transmission
Part III
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Exposure Control Plan
Exposure
determination
Schedules and methods for implementing
OSHA standard
Procedures for evaluation exposures
Immunizations
Pg 44-51
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 14
American Red Cross
Emergency Response
Standard Precautions (BSI) to
Prevent Disease Transmission
Protective
equipment
Personal hygiene practice
Engineering controls
Work practice controls
Pg 49-51
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 15
American Red Cross
Emergency Response
If an exposure occurs …
Wash
any area of contact
Document the situation. Most employers
have protocols for reporting infectious
disease exposure
Notify your superior and any necessary
medical personnel immediately.
Pg 51-52
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Removing Gloves
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Practice Session
Workbook Page 21
Removing
Gloves
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 4
Legal and Ethical Issues
First
Responder responsibilities
Victim’s rights
Special populations (Enrichment)
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Legal Considerations
Scope
of Practice
Standard of Care
Duty to Act
Competence
Consent
Expressed (Informed)
Implied
Advance
Directives
/DNR Orders ….
Pg 56-62
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 16
American Red Cross
• Refusal of Care
•Battery
•Abandonment
•Negligence
•Good Samaritan Laws
•Confidentiality
•Evidence Preservation
•Documentation
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Obtain Consent Before
Providing Care
Identify
yourself
State level of training
Explain what you observe
Explain what you plan to do
Pg 57
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 17
American Red Cross
Emergency Response
Four Components of Negligence
Duty
Breach
of Duty
Cause
Damage
Pg 60
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 18
American Red Cross
Emergency Response
Enrichment
Special Populations
The
Elderly Victim
Victims with Physical or Mental Disabilities
Visually
Impaired
Hearing Impaired
Physically Disabled
Developmentally Disabled
Pg 63-67
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 5
Human Body Systems
Describe
the various body systems and how
they interact.
Anatomical terms (Enrichment)
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Major Body Systems
Respiratory
Circulatory
Nervous
Musculoskeletal
Integumentary
Copyright © 2000 by the American National Red Cross
All rights reserved
(skin)
When Help Can’t Wait
TM 19
American Red Cross
Emergency Response
Video
Human Body Systems
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
The Body Systems
Cells performing a common
function form tissues.
Different tissues work together
to form organs.
Pg 70
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 5
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
The Circulatory System
Pg 72-74
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 9
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
The Nervous System
Images courtesy of the
EMTB Anatomy Review
Pg 74-76
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
The Muscular System
Pg 76-79
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 11
American Red Cross
Emergency Response
Muscle Groups
Pg 78
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 12
American Red Cross
Emergency Response
The Skeletal System
Pg 79
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 13
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
The Integumentary System
Pg 79-80
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Enrichment
Anatomical Terms (positions)
Anatomical
Position is face forward with
palms front
Medial/Lateral
Proximal/Distal
Anterior/Posterior
Superior/Inferior
Right/Left refer to victims right/left
Pg 81-83
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Enrichment
Anatomical Terms (cavities)
Cranial
Spinal
Thoracic
Abdominal
Pelvic
Pg 83-85
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 16
American Red Cross
Emergency Response
Enrichment
The Digestive System
Images courtesy of the
EMTB Anatomy Review
Pg 84-87
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Enrichment
The Endocrine System
Images courtesy of the
EMTB Anatomy Review
Pg 87
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Enrichment
The Genitourinary System
Images courtesy of the
EMTB Anatomy Review
Pg 87-88
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Interrelationships of Body
Systems
Body systems work together to maintain a healthy
state
Systems do not work independently. Injury or
disease is rarely restricted to one system
Significant injury or illness may result in shock
The more systems involved the more serious the
emergency
Basic care may be all that is needed until more
advanced care is available.
Pg 89
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 6
Lifting and Moving
Body
mechanics
Safety Precautions
Emergency and non-emergency moves
Special equipment
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Lifting and Moving
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Safety Precautions when
Moving a Victim
Consider the following:
The distance the victim must be moved
Dangerous conditions at the scene
The size of the victim
Your physical ability
Whether others can help you
The victim’s condition
Any aids to transport at the scene
Pg 92
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 20
American Red Cross
Emergency Response
Basic Guidelines for
Moving a Victim
Only move a victim you can safely handle
Bend at knees and hips
Lift with your legs, not your back
Take short steps
Move forward when possible
Look where you are walking
Protect victim’s head, neck and back
Communicate clearly and frequently with your partner, the
victim, and other EMS providers
Tell the victim what is expected of them
Pg 92
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 20
American Red Cross
Emergency Response
Emergency Moves
General Considerations
Only perform an Emergency Move when the victim is in immediate danger
access must be gained to another victim
with life-threatening conditions
the victim must be moved to provide proper
care
Pg 92-93
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Moves
Emergency Moves
Walking Assist
Fire
Non-urgent Moves
Direct
fighter’s carry
Pack-strap carry
Two-Person Seat
Carry
Clothes Drag
Blanket Drag
Shoulder Drag
Foot Drag
lift
Extremity lift
Direct carry
Draw sheet method
Pg 93-98
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 21
American Red Cross
Emergency Response
Practice Session
Workbook Pages 45-50
Walking Assist
(One or Two Rescuers)
Fire Fighter’s Carry
Pack-Strap Carry
Two-person Seat Carry
Clothes Drag
Direct Carry
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
As you approach a scene ...
… have a plan in mind.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 17
American Red Cross
Emergency Response
Scenario 1
Emotional Aspects of Emergency Medical Care:
Death of a Child
You are summoned to respond to a call for injuries from a
fall. You arrive to find a child lying motionless on the
ground. He has fallen from a third story window. Two
women are standing by the fallen child. One woman
rushes to you and starts to tell you it happened 10 minutes
ago. The child’s mother is kneeling next to her child,
crying and screaming. It appears the child is dead. As you
try to get close to the child to perform an initial
assessment, the mother refuses to let you near, screaming
at you to stay away. How do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 22
American Red Cross
Emergency Response
Scenario 2
Unconscious Victim, Bleeding:
Possible Crime Scene
A vehicle has struck a pedestrian. The victim is lying
motionless in the street, bleeding from a wound on the
thigh. Bystanders are surrounding the car, claiming the
driver had started to drive away. The driver is still in the
car. He is shouting out the window and looks extremely
upset. How do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 23
American Red Cross
Emergency Response
Scenario 3
Conscious Victim:
Dangerous Scene
You and another rescuer are searching for a missing hiker.
At the bottom of a dry gully, you find the victim who has
an injured leg resulting from a fall. He is in severe pain
and unable to walk. The sides of the gully are very steep.
You can see a rapidly approaching storm and realize that it
is going to rain very shortly and the gully will flood. How
do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 24
American Red Cross
Emergency Response
Scenario 4
Legal and Ethical Issues
You arrive at a scene where a man is lying on the sidewalk.
He has one leg that appears to be bleeding, but not
profusely. He is very pale, in pain and is breathing
heavily. He is conscious and able to speak. When you
approach him, he waves you off and yells at you to go
away. When you explain who you are and that you are
trained and want to help him, he says he doesn’t want any
help. His friends will take care of him. How do you
respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 25
American Red Cross
Emergency Response
Chapter 7
Assessment
Components
of a scene size-up
Initial Assessment
CABC
Physical
Exam
SAMPLE history
On-going assessment
Common mechanisms of injury
Taking vital signs
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Assessment - Scene Size-Up
Scene
safety
Mechanism of injury/nature of illness
Number of victims
Resources needed
Pg 106
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 26
American Red Cross
Emergency Response
Video
Performing an Initial Assessment
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Assessment - Initial Assessment
Form
a general impression
Assess level of consciousness
Assess airway
Assess breathing
Assess circulation (pulse, severe bleeding,
and skin characteristics)
Pg 109-116
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 27
American Red Cross
Emergency Response
Levels of Consciousness - AVPU
Level
Characteristic Victim Behavior
Alert
Is able to respond to you
Verbal
Only responds to verbal
commands
Painful
Only responds to a painful
stimulus
Unresponsive Does not respond
Pg 110
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 28
American Red Cross
Emergency Response
Airway Assessment
May
need to position the head and neck to
open the airway
Tongue can sometimes block the airway
To open airway For
illness use head-tilt/chin-lift
For injury use jaw-thrust without head-tilt
(protects neck and back)
Inspect
for obvious obstructions
Pg 111
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Breathing Assessment
Look,
listen and feel
Determine rate and quality of breathing,
note any abnormal sounds of distress
If not breathing provide rescue breathing
Pg 112
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Circulation Assessment
Check
pulse rate and quality
Check skin color, temperature and moisture
Check for severe bleeding
Record victim’s age, gender, chief
complaint, LOC and status of airway,
breathing and circulation. Note the time.
Pg 113
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs of Circulation
Breathing
Coughing
Any
type of body movement
Pulse
Pg 113
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Circulation Assessment
Pg 114
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 18
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Other Indications of Circulation
Color – pale, ashen or flushed
Skin Temperature – hot or cold
Skin Moisture – moist or dry
(Pale or bluish skin that feels cool and moist
indicates poor blood flow. Persons with
darker skin will appear ashen.)
Capillary refill – normal or slow. Use for
infants and children. Less than 2 seconds
unless cold temperature.
Skin
Pg 114-116
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Performing a Physical Exam and
SAMPLE History
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Assessment - Physical Exam
Gather
information about problem
Identify signs and symptoms
Check victim from head to toe
Look and palpate (feel) for signs of
injury - (DOTS)
Pg 116-119
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 29
American Red Cross
Deformity
Open
injuries
Tenderness
Swelling
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Assessment - SAMPLE History
Signs and symptoms
Allergies
Medications
Pertinent past history
Last oral intake
Events leading up to injury or illness
Pg 120
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 30
American Red Cross
Emergency Response
Ongoing Assessment
Repeat
and record vital signs
-every
5 minutes for serious problem (unstable)
-every 15 minutes for non-serious problem
Pg 120
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Practice Session
Workbook Pages 59-65
Performing
an Initial Assessment
Performing a Physical Exam and SAMPLE
History
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
When to Summon More
Advanced Medical Personnel
Unconscious or altered LOC
Breathing problems
Persistent chest or abdominal pain or pressure
No pulse
Severe bleeding
Vomiting or passing blood
Suspected poisoning
Seizures, severe headache or slurred speech
Suspected or obvious injuries to head or spine
Painful, swollen or deformed areas
(when in doubt, summon the help)
Pg 121-122
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Measuring Blood Pressure
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Measuring Blood Pressure
Systolic Pressure
Reflects
pressure in arteries when heart is
working/contracting
Diastolic Pressure Reflects pressure in arteries when heart is
resting/refilling
Palpation
Measures
Auscultation
only the Systolic pressure by feeling for
the radial pulse. Record as palpated (eg. BP120p).
Announce as “BP <pressure> by palpation”
Measures both Systolic and Diastolic pressures
by listening for the pulse with a stethoscope.
Record as <systolic>/<diastolic> (eg. BP 120/80).
Announce as “BP <systolic> over <diastolic>”.
Pg 123-126
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 31
American Red Cross
Emergency Response
Video
Blood Pressure Practice
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Practice Session
Workbook Pages 66-70
Blood
Pressure Measurement (Palpation)
Blood Pressure Measurement (Auscultation)
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 8
Breathing Emergencies
The
Breathing Process
Respiratory Distress
Illness
causing respiratory distress
Respiratory Arrest
Airway
Obstruction
Anatomical
Mechanical
Care
for choking victims
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Respiratory System Review
The body requires a
constant supply of
oxygen. Various
illnesses and accidents
can cause breathing
emergencies.
Images courtesy of the
EMTB Anatomy Review
Pg 136
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Asthma
Facts
Narrows air passages
Triggered byAllergic reaction to pollen/food/a drug/insect
stings
Emotional stress/physical activity
Signs and symptoms
Struggling to breathe
Wheezing when exhaling
Pg 137
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 32
American Red Cross
Emergency Response
Emphysema
Facts
Lungs lose ability to exchange carbon dioxide and
oxygen effectively
Caused by
Smoking: usually develops over many years
Signs and symptoms
Shortness of breath
Possible coughing, cyanosis, or high fever
Advanced cases: Restlessness, confusion,
weakness
Pg 138
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 33
American Red Cross
Emergency Response
Hyperventilation
Facts
Rapid breathing upsets body’s balance of oxygen and
carbon dioxide
Triggered by
Fear/anxiety
Injury to head/ severe bleeding/ illness
Asthma
Exercise
Signs and symptoms
Shallow, rapid breathing
Dizziness
Numbness in fingers/toes
Pg 138
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 34
American Red Cross
Emergency Response
Anaphylaxis
(Severe Allergic Reaction)
Facts
Swelling of air passages restricts breathing
Triggered by
Food/ insect stings/ a drug
Signs and symptoms
Skin rash
Tightness in chest/throat
Swelling of face/ neck/ tongue
Pg 138
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 35
American Red Cross
Emergency Response
Care for Respiratory Distress
Have
victim rest in comfortable position
Keep victim from getting chilled or
overheated
Reduce heat; add moisture
If authorized, help victim take any
medications
Summon more advanced medical personnel
Monitor vital signs
Pg 139
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 36
American Red Cross
Emergency Response
Key Points of Respiratory Arrest
Life
threatening
Commonly caused by illness, injury or
choking
Often preceded by respiratory distress
Body systems will progressively fail
Pg 139-140
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 37
American Red Cross
Emergency Response
Rescue Breathing
Follow
BSI precautions - use a barrier
Pg 140-141
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Rescue Breathing
Check
LOC
If unconscious, open the airway and check
for breathing
If not breathing, give two breaths
Check for signs of circulation
If circulation is present, continue with
rescue breathing
Check for circulation every minute
Pg 141
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Face Shields/Barriers
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Rescue Breathing
Special considerations
Vomiting
Mouth-to-nose
breathing
Mouth-to-stoma breathing
Victims with dentures
Suspected injury to the spine
Pg 141-144
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Airway Obstruction
Partial
Victim can still move air to and from lungs; can
cough, speak, breathe
Complete
Victim is unable to speak, breathe, cough; no air
movement
Pg 146-147
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 40
American Red Cross
Emergency Response
Chapter 9
Breathing Devices
Suctioning
Airways
Oral
Nasal
Barrier
Shields
Resuscitation Masks
Oxygen (Enrichment section)
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Video
Suctioning
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Steps for Suctioning
Turn
head to side or roll body if head, neck,
or back injury suspected
Open victim’s mouth
Remove large pieces of matter
Measure distance of insertion
Insert suction device into back of mouth
Suction for no more than 15 seconds at a
time
Pg 164
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 41
American Red Cross
Emergency Response
Practice Session
Workbook Pages 101
Suctioning
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Airway Insertion
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Airway Adjuncts
Two
types of airways: Oral(oropharyngeal)
and nasal (nasopharyngeal)
Available in various sizes
Oral airways are only used on unresponsive
victims
Nasal airways may be used on victims who
are responsive but need assistance keeping
the tongue from obstructing the airway
Pg 165-166
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Inserting an Oral Airway
Select
airway of proper size
Open victim’s mouth
Insert airway with curved end along roof of
mouth
Advance airway gently until resistance is
felt
Rotate airway 1/2 turn
Flange should rest on lips
Pg 166
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 42
American Red Cross
Emergency Response
Inserting an Oral Airway
Insert and advance
Rotate
Pg 167
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 20
American Red Cross
Emergency Response
Inserting a Nasal Airway
Select
airway of proper size
Lubricate nasal airway
Insert nasal airway into right nostril with
bevel toward middle of nose
Advance airway gently, until flange rests on
nose
Pg 166
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 43
American Red Cross
Emergency Response
Inserting a Nasal Airway
Pg 168
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Practice Session
Workbook Pages 102-105
Inserting
an Oral Airway
Inserting a Nasal Airway
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Using a Resuscitation Mask
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Criteria for a Resuscitation Mask
Transparent,
pliable
One-way valve
15mm or 22mm coupling assembly
Able to deliver supplemental oxygen
Able to withstand extreme temperatures
Easily assembled and used
Pg 168
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 44
American Red Cross
Emergency Response
Using a Resuscitation Mask
Tilt
head back
Lift jaw
Open mouth
Pg 169
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 45
American Red Cross
Emergency Response
Practice Session
Workbook Pages 106-107
Using
a Resuscitation Mask
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Oxygen Delivery
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Supplemental Oxygen Delivery
System Components
Oxygen
cylinder
Pressure regulator with flowmeter
Delivery device
Pg 173-179
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 46
American Red Cross
Emergency Response
Oxygen Delivery Devices
Device
Common Oxygen
Flow Rate Concentration
Function
Nasal
cannula
1-4 lpm
24-36%
Breathing victims only
Resuscitation
6+ lpm
35-55%
Breathing and
nonbreathing victims
Bag-valvemask
10+ lpm
90+%
Breathing and
nonbreathing victims
90+%
Breathing victims only
Nonrebreather- 15 lpm
mask
Pg 177
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 47
American Red Cross
Emergency Response
Precautions During
Oxygen Delivery
Do
not operate around flames/ sparks
Do not stand cylinder upright
Do not use grease/ oil/ petroleum products
to lubricate
Check oxygen flow before placing delivery
device on victim
Pg 179
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 48
American Red Cross
Emergency Response
Practice Session
Workbook Pages 110-113
Oxygen
Delivery
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 10
Cardiac Emergencies
Heart Attack
Cardiac Arrest
CPR
for Adults
Cardiac Emergencies in Infants and
Children
CPR in Infants and Children
Two-Rescuer CPR
Preventing Cardiovascular Disease
AED s
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
The Heart
Right atrium - receives
blood from body
Left atrium - receives
blood from lungs
Right ventricle - pumps
blood to lungs
Left ventricle - pumps
blood to body
Pg 190
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 49
American Red Cross
Emergency Response
Video
Recognizing a Heart Attack
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
The Heart Attack
Heart
muscle does not get enough oxygen
through coronary arteries and dies
Depending upon which heart muscle and
how much is affected, a heart attack may
range from undetected to sudden cardiac
death
Usually caused by Cardiovascular disease
Pg 192
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs and Symptoms of
Heart Attack
Persistent
chest pain or discomfort
Breathing difficulty
Changes in pulse rate
Pale, bluish, or moist skin
Nausea, vomiting
Sweating
General ill appearance
Pg 192-193
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 50
American Red Cross
Emergency Response
Care for Heart Attack
Stop
victim’s activity
Have victim rest in a comfortable position
Summon more advanced medical personnel
Be calm and reassuring
Monitor breathing and pulse, look for
changes in victim’s appearance or behavior.
Administer supplemental oxygen if it is
available and you are trained
Pg 194
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 51
American Red Cross
Emergency Response
Controllable Risk Factors for
Cardiovascular Disease
Smoking
Diet
high in fat
High blood pressure
Obesity
Lack of regular exercise
Pg 209-211
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 52
American Red Cross
Emergency Response
Cardiac Arrest
Cardiovascular
disease is most common
cause but also caused by drowning,
suffocation, drugs, injuries, loss of blood,
electrocution or stroke
CPR will delay death
Defibrillation might restart heart rhythm
Pg 209-211
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Time Without Breathing Until
Brain Damage Occurs
Pg 198
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
When to Stop CPR
Another
trained rescuer takes over
You are too exhausted to continue
Victim’s heart starts beating
Scene becomes unsafe
A defibrillator is available with trained user
present
You are presented with a valid DNR order
Advanced medical personnel order you to
discontinue
Pg 202
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 53
American Red Cross
Emergency Response
Ways to Prevent Cardiac
Emergencies in Children
Prevent
injuries leading to cardiac emergencies
Proper medical care
Recognize early signs of respiratory
emergency
Agitation
Drowsiness
Change
in skin color
Increased difficulty breathing
Increased heart and breathing rates
Pg 202
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 54
American Red Cross
Emergency Response
Special Resuscitation Situations
Near
drowning
Must
seek follow-up care
Electrocution
Insure
personal safety
Serious burns can occur along the entire path
from the entry to the exit sites. Identify both if
possible.
Lightening
strike
Can
cause severe burns and fractures, including
the spine.
From CPR-PR
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Special Resuscitation Situations
Traumatic
injury
Survival
rate is poor, transport ASAP. Always
suspect head/neck injury
Hypothermia
Pulse
is hard to find, check for 45 seconds
Transport ASAP
Warm slowly, handle gently
From CPR-PR
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Special Resuscitation Situations
Difficult
locations
Only
move if unsafe or impractical to do CPR
When transporting up or down stairs, perform
CPR for one minute on the landings, try not to
interrupt CPR for more than 30 seconds
From CPR-PR
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
As you approach a scene ...
… have a plan in mind.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 17
American Red Cross
Emergency Response
Scenario 5
Conscious Person,
Difficulty Breathing
At work, you are summoned to assist a fellow worker who
is ill. As you arrive, you notice the person lying on the
ground, having obvious difficulty breathing. How do you
respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 55
American Red Cross
Emergency Response
Scenario 6
Conscious Person,
Breathing, with Severe Bleeding
While hiking, a man strays from the path in search of more
challenging terrain. The man loses his footing on loose
rocks and slides approximately 15 feet down the rocky
slope. When you arrive, you notice that he is bleeding
badly from a deep wound on the lower leg. You notice that
he appears pale, cool, and is sweating. He tells you he is
feeling dizzy, nauseated, and thirsty. How do you
respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 56
American Red Cross
Emergency Response
Scenario 7
Unconscious Person,
Breathing
A frantic neighbor is knocking at your door. She says that
she cannot wake her sleeping roommate. She remembers
that her roommate took some pills about two hours ago,
but she is not sure what they were or where her roommate
keeps them. You enter and see a woman lying face up on
the couch, not moving. She has vomited. How do you
respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 57
American Red Cross
Emergency Response
Scenario 8
Unconscious Person,
Not Breathing, Has Pulse
It’s early morning, and you are the lifeguard at a local
pool. The pool is almost deserted. Only two people were
swimming, but now they are finished and have gone to the
locker rooms. It is time to lock up the pool, and you
proceed to the locker rooms. You are startled to see a body
lying motionless on the damp floor next to a row of
lockers. You recognize the older woman who had been
swimming laps earlier. How do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 58
American Red Cross
Emergency Response
Scenario 9
Unconscious Person,
Not Breathing, No Pulse
In the early morning, you respond to a call dispatched as a
“heart attack.” You find an elderly man lying motionless
on the floor. His wife tells you that he had been feeling ill
for several hours and had vomited. She says that he
emerged from the bathroom clutching his chest and in
apparent pain, and suddenly collapsed on the floor. How
do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 59
American Red Cross
Emergency Response
Scenario 10
Unconscious Person,
Breathing, With Severe Bleeding
You witness a bicyclist struck by a car. The bicyclist is
thrown from the bike, striking her head. The driver of the
vehicle gets out to help. As you approach, you see the
bicyclist lying on her side, twitching. Blood is spurting
from her thigh onto the pavement. You want to help. How
do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 60
American Red Cross
Emergency Response
Chapter 11
Bleeding and Shock
Blood
and Blood Vessels
When Bleeding Occurs
External
Internal
Shock
(Hypoperfusion)
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Blood Components
Plasma
Liquid.
White
Carries nutrients and waste products
Blood Cells
Disease
fighting component. Aids in producing
antibodies needed to fight infection
Red
Blood Cells
Transport
Oxygen and Carbon Dioxide
Platelets
Essential
to the clotting process
Pg 222
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Major Functions of Blood
Protects
against disease
Maintains constant body temperature
Transports oxygen, nutrients and wastes
Pg 222
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 61
American Red Cross
Emergency Response
Blood Vessels
Arteries -
Systemic Arteries carry oxygen-rich blood from the
heart to the rest of the body
Pulmonary arteries carry oxygen-poor blood from the
heart to the lungs
Capillaries - Deliver oxygen and nutrients and remove
waste products from the cells
Veins Systemic Veins carry waste products from the cells to
the heart
Pulmonary Veins carry oxygen-rich blood from the
lungs to the heart for delivery to the body
Pg 222-223
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
When Bleeding Occurs
Brain, Heart and Lungs attempt to compensate for
blood loss to maintain flow to vital organs
Platelets collect to clot the blood, white blood cells
try to attack infections, body produces more red
blood cells
Fluid is reabsorbed from the kidneys, lungs and
intestines to maintain needed volume
Pg 223
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Bleeding
Bleeding may be internal or external. Whichever
the case, uncontrolled bleeding is a lifethreatening emergency
Pg 223-229
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Recognizing External Bleeding
Visible blood
Bleeding is serious when
Blood is spurting from a wound
Blood fails to clot after all measures have been taken
Arterial bleeding is bright red and oxygen rich.
May spurt and be harder to control
Venous bleeding is dark and flows at a steady rate
Capillary blood is dark red and “oozes”. Usually
clots spontaneously
Pg 223-226
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for External Bleeding
Direct
pressure
Elevation
Pressure bandage
If necessary Use pressure points
Summon more advanced medical personnel
Pg 226-227
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 62
American Red Cross
Emergency Response
Practice Session
Bleeding
control
Direct
pressure
Elevation
Pressure bandage
Pressure points
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Recognizing Internal Bleeding
Discoloration of the skin
Soft tissues are tender, swollen or firm
Anxiety or restlessness
Rapid, weak pulse
Rapid breathing
Skin feels cool or moist or looks pale, ashen or bluish
Nausea and vomiting
Excessive thirst
Declining level of consciousness (LOC)
Drop in blood pressure
Pg 228
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for Internal Bleeding
If minor injury Apply ice or cold pack
If serious injury
Summon more advanced medical personnel
Do no further harm
Monitor ABCs and vital signs
Have victim rest in a comfortable position
Keep victim from getting chilled or over heated
Reassure victim
Provide care for other conditions
Administer Oxygen if it is available and you are
trained to do so
Pg 229
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 63
American Red Cross
Emergency Response
When the Body is Healthy …
Three conditions are necessary to maintain
adequate blood flow –
The heart must be working well
An adequate amount of blood must be
circulating in the body
The blood vessels must be intact and able to
adjust blood flow
Pg 229
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Shock
The
circulatory system fails to provide
oxygen-rich blood to all body parts
Several types of shock - Anaphylactic,
Cardiogenic, Hemorrhagic, Metabolic,
Neurogenic, Psychogenic, Respiratory, Septic
Three
phases of shock -
Compensated
Decompensated
Terminal
Care
is the same in all cases
Pg 230-231
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Shock
Pg 231
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs and Symptoms of Shock
Restlessness/irritability
Rapid/weak
pulse
Rapid breathing
Pale, ashen or bluish/cool/moist skin
Excessive thirst
Nausea and vomiting
Drowsiness/loss of consciousness
Pg 232
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 64
American Red Cross
Emergency Response
Stages of Shock
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Compensated Shock:
Pulse
fast - Bounding
Breathing rate increases
Superficial blood vessels constrict
Blood pressure maintained
Increased diastolic
Body sweats
capillary refilling prolonged (2-4 seconds)
Anxious
Pg 232
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 65
American Red Cross
Emergency Response
Decompensated Shock:
•
•
•
•
•
•
•
LOC deteriorates
Tachycardia
Tachypnea and shallow
Decreased systolic pressure
Decreased diastolic pressure
weak and thready pulse
Blue/pale skin
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Terminal Shock:
•
•
•
•
Very low blood pressure
dilation of peripheral blood vessels
Unconscious
death
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Care for Shock
Do
no harm
Monitor ABCs
Help victim rest in a position of comfort
Keep victim from getting chilled or
overheated
Reassure the victim
Provide care for specific conditions
Pg 232-233
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Further Care for Shock
Control
any external bleeding as soon as
possible
Elevate the legs about 12 inches if you do
not suspect head, neck or back injuries or
injuries to the hips or legs
Administer Oxygen if available
Give nothing to eat or drink
Call advanced medical assistance
Pg 233
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 12
Specific Injuries
Soft
Tissue Injuries
Closed
Open
Burns
Chest
Injuries
Injuries to the Abdomen
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Video
Injuries
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
The Structure of the Skin
The epidermis provides a barrier
to bacteria and other organisms
that can cause infections and
helps regulate the body’s
temperature
The dermis contains structures of
the nerves, the sweat and oil
glands and the blood vessels
Pg 238
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 29
American Red Cross
Emergency Response
Wounds
Closed
Open
Types
Abrasion
Laceration
Avulsion
Puncture
Impaled Object
Infection
Pg 239-243
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 66
American Red Cross
Emergency Response
Wounds
Closed
Pg 239
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 29
American Red Cross
Emergency Response
Wounds
Abrasion
Pg 240
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 30
American Red Cross
Emergency Response
Wounds
Laceration
Pg 241
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 30
American Red Cross
Emergency Response
Wounds
Avulsion
Pg 241
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 31
American Red Cross
Emergency Response
Wounds
Puncture
Pg 242
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 31
American Red Cross
Emergency Response
Wounds
Impaled
Object
Pg 243
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 31
American Red Cross
Emergency Response
Wounds
Infection
Pg 249
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 32
American Red Cross
Emergency Response
Dressings
Dressings
absorb blood and must be sterile.
Commonly 2” or 4” square
Universal dressings cover very large
wounds
Occlusive dressings do not allow air to pass
Pg 243
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Bandages
Wrap or cover any part of the body to hold
dressings in place
Adhesive bandages are small pads of nonstick
gauze and a strip of adhesive tape
Bandage compresses can be tied in place
Roller bandages are self adhering and are used to
cover dressings
Elastic bandage keeps pressure on a body part but
must be used with caution
Triangular bandages are used as slings
Pg 244-246
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Applying a Roller Bandage
Elevate
injured part
Secure end of bandage
Completely cover dressings
Don’t cover fingers or toes
Apply additional dressings if necessary
Pg 244
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 70
American Red Cross
Emergency Response
Care for closed injuries
Direct
pressure
Elevation
Cold
Do
not apply ice directly to the skin
Pg 247
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for severe open injuries
Don’t
waste time washing the wound
Control the bleeding
Control with direct pressure
Summon more advanced medical care
Use pressure points as necessary
Wash hands after completing care
Pg 247-248
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Pressure Point Location
Pg 227
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Controlling External Bleeding
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Types of Burns
Depth
Superficial
Partial-thickness
Full-thickness
Source
Thermal
Chemical
Electrical
Radiation
Pg 249-250
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 67
American Red Cross
Emergency Response
Types of Burns
Depth
Superficial
Red
and dry and usually painful
Often cause swelling in the burn area
Generally heal in a few days without scarring
Pg 250
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 33
American Red Cross
Emergency Response
Types of Burns
Depth
Partial-thickness
Red and wet and may have blisters that may open and weep
clear fluid
Are usually painful
Often cause swelling in the burn area
Generally heal in 3-4 weeks
May result in scarring
Pg 250-251
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 34
American Red Cross
Emergency Response
Types of Burns
Depth
Full-thickness
Appear brown or charred (black) with tissues underneath
sometimes appearing white
May either be extremely painful or relatively painless if the
burn destroyed the nerve ending
Take longer to heal
Usually result in scarring
Pg 251-252
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 35
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Critical Burns
Burns
causing breathing difficulty
Burns covering more than one body part
Burns on the head, neck, hands, feet or
genitals
Any partial- or full-thickness burns to
children or the elderly
Burns from chemicals, explosions or
electricity
Pg 252
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 68
American Red Cross
Emergency Response
The “Rule of Nines”
Used
to estimate the percentage of the body
affected by a burn
Head = 9%
Front of trunk = 18%
Back of trunk = 18%
Arm = 9%
Leg = 18%
Groin = 1%
Pg 253
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for Burns
Cool
burned area with cool water
Cover burned area with dry dressings
Minimize shock by keeping victim from
getting chilled or overheated
If caused by a chemical have the victim
remove any contaminated clothes
If an eye is burned by a chemical flush the
eye for at least 20 minutes
Pg 252-255
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 69
American Red Cross
Emergency Response
Care for Electrical Burns
Make
sure the scene is safe
Turn off electrical current before
approaching the victim
During the physical exam, look for all entry
and exit wounds. All tissue between these
areas may be affected
Pg 256
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Video
Bandaging
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Practice Session
Workbook Pages 158-163
Care
for a Major Open Wound (Forearm)
Care for a Major Open Wound (Leg)
Care for a Wound with an Embedded Object
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs and Symptoms
of Chest Injury
Difficulty
breathing
Severe pain
Obvious deformity
Discoloration of skin
Coughing up blood
Pg 258-259
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 71
American Red Cross
Emergency Response
Types of Chest Injuries
Rib
Fractures
Flail
Chest
Pg 259
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 36
American Red Cross
Emergency Response
Types of Chest Injuries
Puncture
Injuries
Pg 260
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 37
American Red Cross
Emergency Response
Types of Chest Injuries
Sucking
Chest Wound
Pg 261
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 38
American Red Cross
Emergency Response
Care for Serious Chest Injury
Summon
more advanced medical personnel
Position victim to aid breathing
If ribs are broken, bind arm to injured side
Cover sucking chest wound
Administer oxygen
Monitor breathing and pulse
Pg 259-260
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 72
American Red Cross
Emergency Response
Practice Session
(Not in the workbook)
Chest
Injury
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs and Symptoms
of Abdominal Injury
Nausea
and vomiting
Pale or ashen, moist skin
Thirst
Pain, tenderness or rigid abdomen
Weakness
Organs protruding from the abdomen
Pg 261-262
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Abdominal Organs
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 39
American Red Cross
Emergency Response
Care for Serious Abdominal Injury
Open Wound
Do not put pressure on protruding organs or try
to put them back inside
Position victim on back
Remove clothing around wound
Cover loosely with moist, clean dressing
Cover dressing with plastic wrap
Cover with folder towel to maintain warmth
Administer oxygen
Pg 262
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 73
American Red Cross
Emergency Response
Closed Wound
Position victim on back
Bend knees slightly
Administer oxygen if available
Minimize shock
Summon more advanced medical personnel
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs and Symptoms
of Pelvic Injury
Same
as for abdominal injury with the
addition of loss of sensation or movement in
the legs, which sometimes occurs
Pg 261-264
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for Serious Pelvic Injury
Summon
more advanced medical personnel
Minimize movement
Control bleeding
Administer oxygen if available
Minimize shock
Pg 261-264
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 74
American Red Cross
Emergency Response
Care for Open Wound to Genitalia
Cover
with sterile dressing
Control bleeding
Do not put anything into the vagina
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Embedded Objects
Do
not remove objects in the eye, ear or
nose
Remove objects from the cheek
Remove objects from the chest if it will
interfere with chest compressions
Pg 263
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Amputations
Wrap
the part in a sterile dressing
Wrap the dressing in plastic
Pack in ice to cool, not freeze. Transport
with the victim.
Pg 263
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 13
Muscle and Bone Injuries
Musculoskeletal
System Review
Injuries to Bones and Joints
Immobilization
The Skeletal system
Types of Musculoskeletal injuries
Caring for specific injuries
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Musculoskeletal System Review
Muscles
attach to bones
with tendons
Joints are held together
by ligaments
Images courtesy of the
EMTB Anatomy Review
Pg 277
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Musculoskeletal System Review
Bones are different shapes and sizes
Pg 287
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Musculoskeletal System Review
Bones can fracture or separate in various ways
Crack
Broken
Through
Separation
Chip
Pg 289
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Common Signs and Symptoms
of Musculoskeletal Injury
Pain
Swelling
Deformity
Discoloration
Bone protruding from wound
Inability to use affected part
Grating bones
Snapping or popping sound
Cause of injury, such as fall from a height
Pg 278-279
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 75
American Red Cross
Emergency Response
Video
Immobilizing Muscle and Bone
Injuries
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for Muscle and Bone Injury
Rest
Ice
Elevation
Immobilization
Or
Rest
Ice
Compression
Elevation
Pg 280
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 76
American Red Cross
Emergency Response
Immobilization - Types of Splints
Soft
Rigid
Anatomic
Traction
Air
splints- precautions
Vacuum
Pg 281
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Video
Splinting
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Emergency Care for Muscle and
Bone Injuries Take
BSI precautions
Control life-threatening injuries
Allow victim to rest in comfortable position
Apply cold to reduce pain and swelling
Support area above and below injury
Cover open wounds with sterile dressing
Do not reposition protruding bones
Pg 279-283
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 77
American Red Cross
Emergency Response
Types of
Muscle and Bone Injuries
Fracture
Dislocation
Sprain
Strain
Pg 288-289
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Caring for Specific Injuries to
Bones and Muscles
Upper
Extremity injuries
Shoulder
-
The
clavicle is the most frequently injured, typically
from a fall
Great force is required to break the scapula. Suspect
other injuries is this occurs
Splint in position. Use a pillow or rolled blanket to
fill any gaps between the arm and chest
Pg 290-292
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Caring for Specific Injuries to
Bones and Muscles
Upper
Extremity injuries
Upper Arm
the
humerus is the longest bone in the arm and can
be broken at any point
Injury may be very painful and may have
considerable deformity
Control external bleeding and immobilize the upper
arm from the shoulder to elbow
Sling and bind to the chest
Pg 295-296
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Caring for Specific Injuries to
Bones and Muscles
Upper
Extremity injuries
Elbow
Injuries
are made worse by movement
Immobilize from the shoulder to the wrist in the
position found
Splint and secure to the body
If the elbow is bent, splint diagonally across the
inside of the arm
Pg 296
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Caring for Specific Injuries to
Bones and Muscles
Upper
Extremity injuries
Forearm,
Wrist and Hand
Apply
a pressure bandage in a figure-eight
Place a roll of gauze in the hand
Put the arm in a sling and secure to the chest
If fingers are broken, splint to an adjacent finger
Pg 297-299
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Caring for Specific Injuries to
Bones and Muscles
Lower
Extremity injuries
Thigh
Many
femur fractures involve the upper end of the
bone and are called hip fractures
A leg with a broken femur may appear shorter than
the other leg and be turned outward
Femur fractures can cause serious internal bleeding
which may result in life-threatening shock. A
traction splint may be used for mid-shaft fractures
Pg 299-302
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Caring for Specific Injuries to
Bones and Muscles
Lower
Extremity injuries
Lower
Leg
Open
fractures are common. With some fractures of
the fibula the victim may still be able to walk
Immobilize using a rigid splint or anatomical splint
Pg 299-302
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Caring for Specific Injuries to
Bones and Muscles
Lower
Extremity injuries
Knee
Very
vulnerable to injury. Sprains, fractures and
dislocations are especially common with athletic
injuries
Violent force may fracture the kneecap
If the knee can be straightened, splint as with any
other leg injury. If bent, splint in the position found
Pg 303-304
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Caring for Specific Injuries to
Bones and Muscles
Lower
Extremity injuries
Ankle
and Foot injuries
It
can be difficult to distinguish between minor and
severe foot and ankle injuries. Treat as if they were
serious
Victims of a fall may injure the foot or ankle as well
as other parts of the body, such as the back. Do a
full physical survey
Pg 304
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Practice Session
Workbook Pages 176-183
Applying
a Rigid Splint
Applying a Sling and Binder
Applying an Anatomic Splint
Applying a Soft Splint
Applying a Traction Splint
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 14
Head, Neck and Back Injuries
Recognizing
Serious Head, Neck and Back
Injuries
Injury Situations
Care for these injuries
Immobilizing the victim
Preventing Head, Neck and back injuries
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Head, Neck and Back Injury
Although
a small percentage of injuries they
account for over half of the fatalities
Nearly 80,000 victims are permanently
disabled each year in the U.S.
Prompt care can prevent some injuries from
becoming more serious
Bleeding in the skull can occur rapidly or
slowly over a period of days
Pg 313
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Head, Neck and Back Injury
Injuries to the skull can
cause bleeding inside the
skull or brain which can
result in severe pain,
headaches or changes in
level of consciousness
Pg 313-314
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Head, Neck and Back Injury
The spine consists of
individual vertebrae which
protect the spinal cord while
allowing flexibility. The
disks are separated by
compressible disks and
individual nerves or nerve
bundles exit between the
vertebrae.
Pg 314-315
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
When to Suspect a Head, Neck
or Back Injury
Any fall greater than victim’s height
Any motor vehicle collision
A person found unconscious for unknown reasons
Any injury that penetrates the head or trunk
A motor vehicle crash involving a driver or
passengers not wearing safety belts
Any person thrown from a motor vehicle
Any injury in which a victim’s helmet is broken
Pg 314
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 78
American Red Cross
Emergency Response
Signs and Symptoms of Serious
Head, Neck or Back Injuries
Change
in level of consciousness
Severe pain/pressure in head/neck/back
Tingling/loss of sensation/movement in
extremities
Unusual lumps/depression on head/spine
Blood/fluids in the ears/nose
…….
Pg 314-317
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 79
American Red Cross
Profuse
Emergency Response
external bleeding of head/neck/back
Seizures
Impaired breathing/vision
Nausea/vomiting
Persistent headache
Loss of balance
Bruising of head: around eyes/back of head
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Assessing a victim with a
Head, Neck or Back Injury
Responsive victim
Ask about the mechanism of injury
Ask the victimDoes your head, neck or back hurt?
What happened?
Where does it hurt?
Can you move your hands and feet?
Can you feel me touching your fingers
Can you feel me touching your toes?
Pg 317
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Unresponsive victim
Look for the mechanism of injury
Maintain airway and breathing
Stabilize the head, neck and back manually
in the position the victim is found
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Video
Immobilizing Head, Neck
and Back Injuries
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for
Head, Neck and Back Injuries
Minimize
In-line
Movement
stabilization unless contra-indicated
Maintain
an open airway
Complete physical assessment and on-going
assessment
Control external bleeding
Keep victim from getting chilled or
overheated
Pg 317-319
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Additional Care for
Head, Neck and Back Injuries
Head injury may include a concussion, which is a
temporary impairment of the brain function
Never place pressure on the eyeball. For an
embedded object, stabilize with a paper cup
For a nosebleed, pinch the nostril and have the
person lean forward
For teeth knocked out, control the bleeding and
save the teeth. They can be replanted
Pg 319-325
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Practice Session
Workbook Pages 194-196
Bandaging
an Eye with an Embedded
Object
Pg 322
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
When Not to Use
In-line Stabilization
When
victim’s head is severely angled
When victim complains of pain, pressure or
muscle spasms on initial head movement
When rescuer feels resistance when
attempting to move head
Pg 317
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 80
American Red Cross
Emergency Response
Specific Injuries
Concussion
Scalp
Cheek
Injury
Nose Injury
Eye Injury
Ear Injury
Mouth, Jaw and Neck Injury
Pg 319-324
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Immobilizing the Victim
Hold
in-line stabilization
Apply a cervical collar
Secure the body to a backboard
Secure the head (last!)
Note:
Only remove helmets if they interfere
with breathing or breathing assistance. ER
will want helmet with the victim
Pg 326-328
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Ways to Prevent Head,
Neck and Back Injuries Wear safety belts
Wear helmets and protective eyewear
Safeguard against falls
Take safety precautions in sports and recreation
Avoid improper drug use
Inspect equipment
Think and talk safety
Pg 334-336
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 81
American Red Cross
Emergency Response
Practice Session
Workbook Pages 194-196
Immobilizing
Copyright © 2000 by the American National Red Cross
All rights reserved
a Head, Neck or Back Injury
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 15
Medical and Behavioral Emergencies
Medical Emergencies
Altered
Mental Status
Seizures
Stroke
Diabetic Emergency
Heat and Cold Exposure
Behavioral Emergencies
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
General Signs and Symptoms
of Medical Emergencies
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
General Signs and Symptoms
of Medical Emergencies
Change
in level of consciousness
Headache/lightheaded/dizzy/weak
Nausea/vomiting
Change in breathing, pulse, or
skin temperature, color or moisture
Pg 341-342
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 82
American Red Cross
Emergency Response
Video
Medical Emergencies
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Altered Mental Status
Can Result From Fever
Infection
Poisoning, including substance abuse or misuse
High or low blood sugar or insulin reactions
Head injury
Any condition that results in decreased blood flow
to the brain
Conditions resulting from mental, emotional, or
behavioral disorders
Pg 341
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 83
American Red Cross
Emergency Response
Altered Mental Status
A person who faints has experienced an altered
level of consciousness. The brain was deprived of
its normal flow of blood
Fainting usually resolves itself when the blood
flow is restored
Fainting by itself does not usually harm the victim
but injury may occur from falling
Fainting does have an underlying cause that
should be explored
Pg 341
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for a Victim of an
Altered Level of Consciousness
Do
initial assessment, physical exam,
and SAMPLE history as needed
Elevate legs
Do ongoing assessment
Check airway;
…….
Pg 342
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 84
American Red Cross
put
Emergency Response
unconscious victims in recovery
position
Loosen any restrictive clothing
Do not give victim anything to eat
Have suction equipment available
Summon more advanced medical
personnel
Reassure victim
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Causes of Seizures
Fever
Infection
Chronic medical conditions
Poisoning
Low blood sugar
Head injury
Any condition causing decreased Level Of
Consciousness (LOC)
Pregnancy complications
Pg 342
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 85
American Red Cross
Emergency Response
Seizure Indications
The chronic form of seizure is known as epilepsy
Before a seizure, the victim may experience a
warning called an aura. This is an unusual
sensation or feeling such as a visual hallucination;
strange sound, taste or smell; or an urgent need to
get to safety
Seizures may range from mild blackouts that
appear to be daydreaming to sudden uncontrolled
muscular contractions lasting several minutes
Pg 342-343
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
To Care for a Seizure Victim Summon more advanced medical personnel
Do not try to stop seizure or restrain victim
Protect victim from injury
Protect victim’s modesty
Manage airway by rolling victim onto his or her
side
Remove nearby objects and protect victim’s head
Do not place anything between teeth
When seizure is over, do physical exam and care
for any injuries found
Pg 343
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 86
American Red Cross
Emergency Response
For a Seizure Victim, Call if The seizure lasts more than a few minutes
The victim has repeated seizures
The victim appears to be injured
You are uncertain about the cause of the seizure
The victim is pregnant
The victim is a known diabetic
The victim is an infant or child
The seizure takes place in water
The victim fails to regain consciousness after the
seizure
Pg 343
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Those at Greatest Risk
for Heat-related Illness
Young
children and the elderly
Those involved in strenuous activity in a hot
environment
Those with pre-existing health problems
Those using illicit drugs or medications
Those who have had a heat-related illness in
the past
Pg 343-346
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 89
American Red Cross
Emergency Response
Signs and Symptoms
of Heat-related Illness
Headache
Cool, moist, pale or ashen skin (early stages)
Dry, red, hot skin (later stages)
Nausea
Exhaustion
Progressive loss of consciousness
Rapid, weak pulse (later stages)
Rapid, shallow breathing (later stages)
High body temperature (later stages)
Pg 347-348
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 90
American Red Cross
Emergency Response
Care for Heat Exposure
Remove
victim from hot environment
Give small amounts of cool water to
conscious victim
Have victim lie down in a cool or shady
area and elevate legs if possible
Loosen or remove clothing
Apply cool, wet towels or cold packs to
wrists, armpits, groin and legs
Fan victim
Pg 348
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 91
American Red Cross
Emergency Response
Scenario 11
Heat Emergency
You are involved with a fire-fighting training
exercise involving a burning structure. It has been
a really hot day, with temperatures in the 90s. You
and others have been wearing you heavy turnout
gear for hours. Suddenly, someone collapses.
You notice that her skin is hot, flushed and wet.
Her pulse is very fast. How do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 92
American Red Cross
Emergency Response
Factors Affecting
Normal Body Temperature
Air
temperature
Humidity
Wind
Clothing
Intensity of activity
Body’s ability to adapt (physical fitness
level)
Pg 348
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 93
American Red Cross
Emergency Response
Those at Greatest Risk
for Cold Exposure
Young
children and elderly
Those without adequate equipment, clothing
or training for cold environment
Those with health problems
Those using illicit drugs, medications or
alcohol
Pg 345-346
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 94
American Red Cross
Emergency Response
Signs and Symptoms
of Hypothermia
Cool
skin
Shivering
Numbness
Decreasing level of consciousness (LOC)
Poor coordination
Difficulty speaking
Rigid posture
Pg 348-350
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 95
American Red Cross
Emergency Response
Care for Hypothermia
Summon more advanced medical personnel
Reassure victim
Handle victim gently
Remove victim from cold environment
Have victim stop all activity and rest
Remove wet clothing
Place victim in dry blankets or clothing and wrap
in plastic if available
Protect from any further heat loss
Pg 348-349
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 96
American Red Cross
Emergency Response
Frostbite
Superficial frostbite
Most common form of frostbite
Skin is frozen, underlying tissues are not
Involves loss of feeling and sensation
Person feels tingling sensation when rewarmed
Deep frostbite
Skin is white and waxy
Skin is firm when palpated
Swelling and blisters may be present
When rewarmed, skin appears red with areas of
purple and blue
Pg 349
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 97
American Red Cross
Emergency Response
Care for Localized Cold Injury
Handle the affected area gently
Remove wet clothing and any jewelry from the
affected area
Cover the affected area with dry dressings and
bandage loosely
Do not rub the area or break any blisters
Do not re-expose the injury to cold
Do not apply heat
Pg 349
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
To Prevent
Overexposure Emergencies
Do
not work in the hottest or coldest part of
the day
Take frequent breaks
Replenish body with food and fluids
Reduce work intensity
Wear clothing appropriate for task and
environment
Pg 350
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 98
American Red Cross
Emergency Response
Behavioral Emergencies
A behavioral emergency is a situation in which a
person exhibits abnormal behavior that is
unacceptable or intolerable.
Common causes for the behavior alteration include -
Pg 350-351
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Situational
Emergency Response
stress
Illness or injury resulting in lack of oxygen
or low blood sugar
Substance abuse
Mental illness, including crises involving
panic, agitation, self destructive behavior,
and/or violence.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Actions Indicating a
Behavioral Emergency
Threatening
posture
Possessing a weapon(s)
Threatening harm to others or self
Being verbally abusive
Speaking in a nonsensical manner
Withdrawing deeply
Hallucinating
Pg 351
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 99
American Red Cross
Emergency Response
To Calm a Victim of a
Behavioral Emergency Assume non-threatening posture
Acknowledge that victim appears upset
Get in front of victim and at eye level
Avoid unnecessary contact
Do not threaten, challenge or argue with victim
Involve others that victim trusts
Encourage victim to discuss whatever is troubling
him/her
Pg 351-352
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 100
American Red Cross
Emergency Response
Diabetic Emergencies
Too much Sugar
Too much Insulin
Pg 354-359
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Hyperglycemia
Too
much sugar and too little insulin in the
blood stream
Without insulin the body cells can not
convert the available sugar into energy
Without sugar the body breaks down other
food sources
The result can be a diabetic coma
Pg 354-359
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Causes of Hyperglycemia
• Eating too much food relative to the amount
of insulin injected
• Missing an insulin injection
• Blockage in insulin pump tubing
• Disconnected insulin pump infusion set
• Illness or stress
hyperglycemia caused by insufficient insulin can
lead to diabetic ketoacidosis.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Symptoms of Hyperglycemia
• Frequent urination
• Frequent thirst
• Blurry vision
• Dry mouth
• Fatigue
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Hypoglycemia
Adequate
insulin
Too little sugar
Sugar is used rapidly
Also called insulin reaction
Pg 355
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 87
American Red Cross
Emergency Response
Signs and Symptoms of
Diabetic Emergencies
Change
in level of consciousness (LOC)
Rapid breathing and pulse
Feeling and looking ill
Pg 359
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 88
American Red Cross
Emergency Response
Signs and Symptoms of
Hyperglycemia
•
•
•
•
•
Frequent urination
Frequent thirst
Blurry vision
Dry mouth
Fatigue
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs and Symptoms of
Hypoglycemia
•
•
•
•
•
•
•
Grouchiness
Shakiness
Sweating
Fast heart rate
Pale skin
Dizziness
Yawning….
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
• Confusion
• Poor coordination
• Inability to cooperate
• Slurred speech
Severe
• Unconsciousness
• Convulsions …
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Care for
Diabetic Emergencies
If
conscious, ask victim about medical
conditions
Do a SAMPLE history. (Important to know
when medication and food were last taken)
If conscious and able to swallow, give sugar
in some liquid form
If no improvement in 5 minutes, summon
advanced medical personnel
Pg 359
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
For Hyperglycemia
• Drink lots of water
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Enrichment
Stroke
Called
a Cerebrovascular Accident (CVA)
Caused by a disruption of blood flow to a
part of the brain
Can be caused by a blood clot lodging in an
artery or a ruptured artery
A Transient Ischemic Attack (TIA) is a
short-term stroke
Pg 359-360
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Enrichment
Stroke
Pg 360
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Enrichment
Signs and Symptoms of a Stroke
Ill
appearance
Changes in LOC
Sudden weakness and numbness in face,
arm or leg, usually on one side
Difficulty speaking or understanding speech
Pupils of unequal size, blurred vision
Headache, confusion, change in mood
Pg 360
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Enrichment
Care for a Stroke Victim
Care
for life-threatening conditions
Summon advanced medical help
Comfort and reassure victim
Administer Oxygen if available
Nothing to eat or drink
Prompt medical attention is critical
Do NOT give aspirin
Pg 360-362
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 16
Poisoning
How
Poisons Enter the Body
Care for Poisoning
Inhaled
Poisons
Ingested Poisons
Absorbed Poisons
Injected Poisons
Anaphylaxis
Substance Abuse
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
How Poisons Enter the Body
Ingestion
Inhalation
Injection
Absorption
Pg 367
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 101
American Red Cross
Emergency Response
Clues of Poisoning
Odors
Flames
or smoke
Containers that are open or out of place
Plants partially eaten or disturbed
Pg 367
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 102
American Red Cross
Emergency Response
Signs and Symptoms
of Poisoning
Nausea
or vomiting
Chest or abdominal pain
Breathing difficulty
Altered consciousness
Seizures
Burns sometimes found on or around the
mouth
Pg 368
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Poisoning Severity
The
type and amount of poison
How and when it entered the body
Victim’s size, weight and age
Pg 369
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 103
American Red Cross
Emergency Response
General Principle for
Poisoning Emergencies
Conduct
scene size-up
Remove victim from source of poison
Conduct initial assessment
Conduct physical exam and SAMPLE history
Summon more advanced medical personnel
Contact PCC (as per local protocols)
1-800-222-1222
Do not give anything to eat or drink
Pg 369
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 104
American Red Cross
Emergency Response
When NOT to Induce Vomiting
for Ingested Poisons
Victim
is unconscious
Victim is having a seizure
Victim is pregnant
Victim has ingested corrosive substance or
petroleum product
Victim is known to have heart disease
Pg 371-372
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 105
American Red Cross
Emergency Response
Care for
Inhaled Poisons
Conduct
scene size-up, toxic fumes may be
colorless, odorless and tasteless.
Remove victim from source of poison if
possible
Administer Oxygen
Care for life-threatening conditions
Call for advanced medical personnel
Pg 370-371
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for
Absorbed Poisons
Brush
off dry chemicals using gloved hand
or cloth. Keep out of eyes and eyes of
victim and bystanders
Flush area with large amounts of cool
running water, remove jewelry if necessary
Summon advanced medical personnel
Pg 372-374
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for
Injected Poisons
Remove
stinger, scrape it away with a card
or knife
Wash the site, cover it and apply cold to
reduce the pain and swelling
Monitor for anaphylaxis
Specific care depends on source. Know the
local risks
Pg 374
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for
Tick bites
Rocky
Mountain spotted fever is a serious
tick-borne disease. Another is Lyme disease
Deer ticks are difficult to see. They can
attach themselves without your knowledge
If you find an embedded tick, pull it off
with a fine-tipped tweezers and seek
treatment
Pg 374-378
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Deer Tick
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Female deer tick with dime for
size comparison.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for
Spider and Scorpion bites
In the United States the two spiders to be careful
of are the Black Widow and the Brown Recluse
Spiders prefer dark places where they are seldom
disturbed. Bites occur usually on the hands or
arms
Antivenin is available for the black widow. Those
bit by the Brown Recluse should seek medical
treatment
Pg 378-380
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Black Widow
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Brown Recluse
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Guidelines for
Initial Snakebite Care
Take victim to medical care immediately
Wash wound if possible
Immobilize affected part
Minimize victim’s movement
Keep affected part lower than heart
Summon more advanced medical personnel
Consider using a commercial suction kit if
advanced medical care is more than 30 minutes
away.
Pg 380-381
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 106
American Red Cross
Emergency Response
Guidelines for
Initial Snakebite Care
DO
NOT apply ice
DO NOT cut the wound
DO NOT apply a tourniquet
DO NOT use electric shock
Pg 380-381
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Guidelines for
Marine Life Injuries
Some marine life such as jellyfish can inflict painful
injuries
Care for injuries from jellyfish, sea anemone and
Portuguese man-of-war by soaking the injured part in
vinegar.
If the sting was from a sting ray, sea urchin or spiny fish
soak the affected area for 30 minutes in non-scalding hot
water
Summon advanced medical personnel if the victim has a
history of allergic reactions to marine life stings, is stung
on the face or neck or develops any severe problems such
as difficulty breathing.
Pg 381
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Guidelines for
Animal Bites
The most serious result is from a wild animal with rabies
Rabies is fatal if not treated. Anyone bitten must get
medical attention
Get the victim away from the animal safely
Get a description of the animal and the area in which it was
last seen. Do not try to restrain or capture the animal
For minor wounds, wash with soap and water. For serious
bleeding control the bleeding and summon more advanced
medical personnel
Local laws may require a report to be filed
Pg 382
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Human Bites
May
be highly contaminated with bacteria
Require professional medical care
immediately
Need to be washed with soap and water
Can bleed if severe; control severe bleeding
Pg 383
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 107
American Red Cross
Emergency Response
Substance Abuse
Can
be intentional or unintentional
Drug use can lead to dependency and
addiction
Unavailability can lead to withdrawal
Drugs can be stimulants, Hallucinogens,
Depressants, Narcotics, Inhalants, Cannabis
products, steroids or OTC (Over The
Counter) medications
Pg 384-388
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 108
American Red Cross
Emergency Response
Stimulants
Stimulants
affect the central nervous system
by increasing physical and mental activity
They produce temporary feelings of
alertness and prevent fatigue
Stimulants can be ingested as pills, but
some can be absorbed or inhaled
Cocaine and Crack are the most publicized
and powerful stimulants
Pg 388
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Hallucinogens
Hallucinogens
have physical effects similar
to stimulants. They are classified
differently because of the other mindaltering effects including Panic,
paranoid delusions, vivid hallucinations,
profound depression, tension and anxiety
The
most widely used are LSD,
mushrooms, PCP and mescaline, ecstasy
ketamine
Pg 389
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Depressants
Depressants decrease physical and mental activity
and are commonly used for medical purposes
Common depressants are alcohol, barbiturates,
benzodiazepines, narcotics and inhalants
Depressants will
Relieve anxiety
Alter consciousness
Promote sleep
Depress respiration
Relieve pain
Relax muscles
Impair coordination and judgement
Pg 390
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Narcotics
Narcotics
work on the central nervous
system to reduce pain. All are illegal
without a prescription. Some are not
prescribed at all.
The some are morphine, opium, heroin and
codeine. Others, like demerol and percodan
are synthetic
Pg 390
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Inhalants
Produce
mood-altering effects and depress
the central nervous system.
Inhalants will damage the heart, lungs, brain
and liver
Solvents such as acetone, toluene and
butane may be inhaled for their effects
The user will appear drunk
Pg 391
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Cannabis Products
Products
include marijuana, THC and
hashish
Marijuana is the most widely used illicit
drug in the United States
Cannabis products produce feelings of
elation, distorted perceptions of time and
space and impaired judgement and motor
coordination
Pg 391
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Designer Drugs
Variations
of other substances, designer
drugs do not fit neatly into any of the other
categories
A user will experience a variety of
unpredictable and dangerous effects. Signs
and symptoms range from stimulant-like
effects to hallucinogenic effects and erratic
mood swings
Pg 391
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs and Symptoms
of Substance Abuse
Stimulants - Sweating, chills, nausea, vomiting, fever,
headache, dizziness, rapid pulse, rapid breathing, high
blood pressure, chest pain, respiratory distress, disruption
of normal heart rhythms
Hallucinogens - Sudden mood changes, claiming to see or
hear things not present, acting anxious or frightened
Depressants - Drowsiness, confusion, slurred speech, slow
heart and breathing rates, poor coordination
Alcohol - Unconscious, hard to arouse, vomiting violently,
confused, restless, trembling and experiencing
hallucinations.
Pg 394
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Care for Substance
Misuse and Abuse
Your
initial care does not require you to
know the substance
Care as you would for poisoning.
Pg 396
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 109
American Red Cross
Emergency Response
Preventing Substance Abuse
Contributing factors include –
A lack of parental supervision
The breakdown of the traditional family structure
A wish to escape unpleasant surroundings and stressful
situations
The widespread availability of substances
Peer pressure and the basic need to belong
Low self-esteem, including feelings of guilt or shame
Media glamorization, especially of alcohol and tobacco,
promoting the idea that using substances enhances fun and
popularity
A history of substance abuse in the home or community
environments
Pg 396
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Preventing Substance Misuse
Read the product information and use only as
directed
Ask doctor or pharmacist about the intended use
and side effects of prescription and over-thecounter medications. If taking more than one
medication ask about possible interactions.
Never use another person’s prescribed medications
Always keep medications in their appropriate,
marked containers
Discard all out-of-date medications.
Keep medications out of reach of children
Pg 397
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Scenario 12
Substance Abuse
A 25-year-old woman has several drinks at a party. She
later says that she feels dizzy and nauseated. She goes into
another room. Soon after, someone enters shouting that
the woman has collapsed to the floor and is unconscious.
Among the object scattered on the floor from her open
purse are several containers of pills. One is marked
“Valium.” How would you help the woman? In terms of
providing initial care, does it matter that she may have
become unconscious because of substance abuse or
misuse?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 110
American Red Cross
Emergency Response
Signs and Symptoms
of Anaphylaxis
Hives
Itching
Rash
Weakness
Nausea/vomiting
Dizziness
Trouble
breathing
Pg 383-384
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 111
American Red Cross
Emergency Response
Care for Anaphylaxis
Summon
more advanced medical personnel
immediately
Position victim in the most comfortable
position that aids breathing
Administer supplemental oxygen
Have victim use anaphylaxis kit if one is
available
Pg 384
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 112
American Red Cross
Emergency Response
As you approach a scene ...
… have a plan in mind.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 17
American Red Cross
Emergency Response
Scenario 13
Conscious Person
Serious Head and Back Injury
At work, you are summoned to assist another employee
who has been injured in a nine-foot fall from a ladder. As
you arrive, you see the person lying on the ground. She is
trembling and moaning in pain. A bystander says that she
landed on her back. The victim has not moved from this
position. She says that she has tingling and numbness in
her lower legs and feet and pain in her back. She also has
a two-inch laceration on the side of her head. How do you
respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 113
American Red Cross
Emergency Response
Scenario 14
Serious Extremity Injury
You are summoned to the scene of a collision between a
bicyclist and skateboarder. Both were thrown to the
pavement. Both were wearing helmets and other
protective padding and both are conscious and in pain.
The skateboarder was struck on the outside of his leg by
the bike. The leg is bent, and his knee has an obvious
deformity. The bicyclist was thrown over the handle bars,
landing on her arms. She is bleeding from abrasions on
both forearms and her wrist has an obvious deformity.
How do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 114
American Red Cross
Emergency Response
Scenario 15
Conscious Victim
Limb Injury
You are a spectator at your child’s Little League baseball
game. The pitcher is struck with a line drive to the
forearm and falls to the ground. The victim is crying and
in pain, unable to move the limb. Swelling and deformity
are present. The nearest hospital is only a few blocks
away. The player’s parents are not at the game. How do
you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 115
American Red Cross
Emergency Response
Scenario 16
Medical Emergency
An elderly woman loses her balance and collapses to the
floor in a supermarket. When you arrive, she is not fully
conscious. Her eyes are open and the left side of her face
appears to be drooping. She is making mumbling sounds
but you can not tell what she is saying. She has also
vomited. How do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 116
American Red Cross
Emergency Response
Scenario 17
Substance Abuse
A dangerous ritual is about to begin - 21 drinks for the 21st
birthday. A group of close friends has gathered for a special party
for the “birthday boy.” Everyone knows it is a dangerous game,
but because each of these friends when through it, they believe it
is a rite of passage into adulthood. The activities begin and the
guest of honor is soon “chugging beers” and downing shots of
liquor at a rapid pace. Four hours after the drinking began you
are summoned to assist the guest of honor who is vomiting
violently in the bathroom. He slumps to the floor and begins
violent convulsions, followed by unconsciousness. He seems to
stop breathing and then takes a deep breath. How do you
respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 117
American Red Cross
Emergency Response
Scenario 18
Hypothermia
You have been involved in a search for a lost sixyear-old child. The search is now into its third
day. The child became lost when he wandered
away from his mountain campsite. He has already
spent two nights in the wilderness in cold, rainy
weather. When the child is discovered, he is
disoriented. His clothing is wet. His face and
hands are cold to the touch. He is shivering. How
do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 118
American Red Cross
Emergency Response
Chapter 17
Childbirth
The
Birth Process
Preparing for Delivery
Assisting with Delivery
Caring for the Newborn and Mother
Possible Complications
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
The Labor Process
Stage One Preparation
Stage Two Delivery of
the Baby
Stage Three Delivery of
the Placenta
Stage Four Stabilization
Woman’s body prepares for childbirth
Time period: From first contraction until
uterus is fully dilated
Crowning occurs
Delivery of the baby
Occurs within 30 minutes after birth
Placenta separates from the uterine wall
and exits through the vagina
Recovery and stabilization of mother
Lasts approximately 1 hour
Uterus contracts to control bleeding
Pg 403-404
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 119
American Red Cross
Emergency Response
Assessing Labor
First
pregnancy?
Amniotic sac ruptured?
Contraction?
Are
they close together?
Are they strong?
Blood
discharge?
Urge to bear down?
Pg 404
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 120
American Red Cross
Emergency Response
Preparing for Delivery
Use
complete BSI protection
Provide as sanitary an environment as
possible
Reassure the mother
STAY CALM
Pg 404
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Assisting with Delivery
Time
the contractions. If less than 3
minutes apart, be prepared to help with
delivery of the baby
Have bulb syringe, gauze pads and plastic
bag available
Support the head, allow to emerge slowly
Use a towel to catch the baby. If possible
note the time
Pg 405
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Assisting with Delivery
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Assisting with Delivery
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Caring for the Newborn
Open the airway
Stimulate the baby if crying does not occur
Keep infant warm
Record first set of vital signs
Evaluate the following a 1 and 5 minutes after
birth
Appearance
Pulse
Grimace (response to stimuli)
Activity and muscle tone (not floppy or limp)
Respirations
Pg 407-409
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Assess APGAR Score at 1 and 5
minutes after birth
A ppearance
P ulse
G rimace
A ctivity
R espiration
0
Blue/Pale
Absent
None
Flaccid
Absent
Copyright © 2000 by the American National Red Cross
All rights reserved
1
Body pink, hands blue
Below 100
Grimace
Some
Weak, slow
When Help Can’t Wait
2
Pink
Above 100
Cough, sneeze, cry
Active motion
Good, crying
American Red Cross
Emergency Response
Caring for the Mother
Allow
mother to nurse newborn
Prepare for delivery of the placenta within
30 minutes. Place in a bag or wrap in a
towel for transport to the hospital
Gently clean the mother
Gently massage the lower abdomen
Monitor vital signs and maintain body
temperature
Pg 407-409
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Scenario 19
Childbirth
A car pulls into the firehouse. The driver jumps
out screaming for help for his wife who is in the
back seat. The woman is 35 years old and full
term in her pregnancy. Her contractions are less
than 2 minutes apart. She says that “the baby is
coming” and she feels the need to push. Her
husband tells you this will be their fourth child.
How do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 121
American Red Cross
Emergency Response
Practice Session
Childbirth
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Possible complications
Prolapsed
Do
cord
not allow cord to wrap around infants neck
Pg 410
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Possible complications
Breech
Be
birth
prepared to provide airway
Pg 411
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
If baby is delivering:
– Do not hurry or slow delivery
– Suction infant with bulb syringe (mouth,
then nose) as soon as head is delivered
– If cord wrapped around neck, attempt to
unwrap the cord. If unsuccessful, double
clamp and cut the cord at least 4” from baby
between clamps
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Chapter 18
Infants and Children
Communicating
with children
Anatomical and Physiological concerns
Common problems
Child abuse awareness
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Steps to Gain a Child’s Trust
Approach
child slowly
Get to eye level
Smile
Ask the child’s name
Talk slowly and distinctly using words the
child understands
Ask simple, clear questions
Reassure child
Pg 414
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 122
American Red Cross
Emergency Response
Steps to Gain a Child’s Trust
Infants less than 6 months old are fairly easy to approach
Infants over 6 months show “stranger anxiety”. Conduct
the assessment in the caregivers arms or lap
Toddlers between 1-2 need reassurance that they will not
be separated from a parent or caregiver
Preschool between 3-5 need assurance that the first
responder will not leave them. Let them inspect equipment
and demonstrate on a doll or stuffed animal
School-aged children are self-conscious about their bodies.
Respect their modesty
Adolescents between 13-18 behave much like adults and
are more comfortable with same gender rescuers. Earn
their trust by speaking to them and not the parents or
caregivers
Pg 414
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Anatomical and Physiological
Concerns
Infant and children have smaller airways than
adults. Airways are easily blocked by secretions
and swelling.
Infant’s and children’s tongues are large in relation
to the jaw and can block the airway
Infants normally breathe through the nose so
suctioning nasal secretions can improve problems
Injured or ill infants or children are at risk for
generalized cold exposure
Pg 415-417
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Maintaining an
Airway with Children
Do not hyper-extend the head and neck to open the
airway
Placing a folded towel under the shoulders will
help to maintain good airway position
During suctioning, take care not to stimulate the
back of the throat and activate the gag reflex
Oral airway adjuncts are not used for initial
ventilation efforts. Nasal airways are not
commonly used by first responders
Pg 416
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Maintaining an
Airway with Children
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Child and Infant Assessment
When
you have an injured child or infant,
you have an injured family
Calm the family and obtain consent
Observe the child before touching. Look
for signs of life-threatening problems
Whenever possible, do not separate the
child from the parent or caregiver
Begin at the toes and work up
Pg 417-418
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs of Partial Airway Obstruction
in Infants or Children
Stridor
Retraction
on breathing in
Good circulation causing skin to become
very pink
Pg 418
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 123
American Red Cross
Emergency Response
Signs of Complete Airway
Obstruction in Infants or Children
Inability
to cough, cry or speak
Cyanosis
Loss of consciousness
Altered mental status
Pg 419
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs of Respiratory Distress in
Infants or Children
Infants: respiratory rate > 60 per minute
Children: respiratory rate > 30/40 per minute
Nasal flaring
Use of neck muscles and muscles between and
below margin of the ribs to aid breathing
Stridor
Cyanosis
Altered mental status
Grunting
Pg 419
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 124
American Red Cross
Emergency Response
Signs of Respiratory Arrest in
Infants or Children
Infants: respiratory rate <10 per minute
Children: respiratory rate <20 per minute
Limp muscle tone
Unresponsiveness
Slow or absent heart beat
Weak or absent distal pulses
Cyanosis
Pg 419
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Other Common Problems with
Infants and Children
Circulatory Failure
Illness
Fever - may develop into febrile seizure
Poisoning
Altered Mental Status
Indicated by increased heart rate, unequal central and distal pulses,
poor skin circulation (slow capillary refill) and mental status
change
May be caused by low blood sugar, poisoning, post seizure,
infection, head trauma or decreased oxygen levels
Sudden Infant Death Syndrome (SIDS)
Pg 419
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs and Symptoms
of Febrile Seizure
Sudden rise in body temperature
Change in level of consciousness
Rhythmic jerking of head and limbs
Confusion
Drowsiness
Crying out
Becoming rigid
Holding breath
Upward rolling of eyes
Pg 419
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 125
American Red Cross
Emergency Response
Trauma in Children
Injuries
are the #1 cause of child death in
the United States. Many are from motor
vehicle accidents
Use equipment of the proper size
Do not move an injured child from a safety
seat unless you must to provide further care
Pg 420-422
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Trauma in Children
The
head is often injured, as is the chest
cavity or abdominal cavity
The most important objective is to ensure an
open airway
Children have pliable ribs. There may be
significant injuries without external signs
Abdominal injuries often are not obvious
Large amounts of blood may distend the
abdomen and not be visible
Pg 420-422
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Signs of Child Abuse
Injury that does not fit description of cause
Cigarette burns, whip marks or hand prints
Fractures in children less than 2 years old
Injuries in various stages of healing, especially
bruises and burns
Unexplained lacerations, especially to mouth, lips
and eyes
Injuries to genitalia
More injuries than are typical for child of same
age
Repeated calls to same address
Pg 422-423
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 126
American Red Cross
Emergency Response
Signs and Symptoms of Neglect
Lack
of adult supervision
Malnourished appearance
Unsafe living conditions
Untreated chronic illness
Untreated soft tissue injuries
Pg 423
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 127
American Red Cross
Emergency Response
Responder Debriefing
Even
when uneventful, calls involving
infants and children are some of the more
stress producing situations for first
responders
Care for infants and children with the same
principles as with adults but keep in mind
the differences in developmental
characteristics and anatomy
Pg 423
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
As you approach a scene ...
… have a plan in mind.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 17
American Red Cross
Emergency Response
Scenario 20
Preparing for Childbirth
You are called to respond to a pregnant
woman who is in labor. During your
assessment you find that this is the mother’s
third pregnancy and her contractions are 2
minutes apart. The baby’s head is not yet
crowning, but the mother feels the urge to
move her bowels. How do you respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 128
American Red Cross
Emergency Response
Scenario 21
Delivering the Baby
After you have prepared the mother and
yourself for the imminent delivery of the
baby, the mother tells you that she feels an
urge to push. When you inspect the vaginal
area, you note that the baby’s head is
crowning. What should you do next?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 129
American Red Cross
Emergency Response
Scenario 22
Care of the Newborn
You are called to the scene of a mother who
is in active labor. As you arrive on scene,
the baby has just emerged from the birth
canal. What steps would you take to care
for the newborn?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 130
American Red Cross
Emergency Response
Scenario 23
Post Delivery Care of the Mother
After you have assisted with the
unscheduled delivery of a newborn and
ensured that the baby’s condition is normal,
list the steps in the post delivery care of the
mother
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 131
American Red Cross
Emergency Response
Scenario 24
Assessment of the Child
On your way home from work, you approach your
neighborhood and see a group of people gathered
in the playground. As you approach the scene you
hear someone say that a child fell off the jungle
gym, a height of approximately 10 feet. As you
get closer, you see a child of 8 years old lying on
the ground, crying and you notice blood coming
from a laceration on his forehead. Demonstrate
how to assess the child.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 132
American Red Cross
Emergency Response
Chapter 19
EMS Support and Operations
Phases
of a Response
Air-Medical Considerations
Multiple Casualty Incidents
Incident
Command Structure
Triage
Fundamentals
of Rescue Operations
Hazardous Materials
Water Rescues
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
The EMS Response
Preparation for emergency call
Dispatch
En route to scene
Arrival at scene
Transferring victim to ambulance
En route to receiving facility
Arrival at receiving facility
En route to station
Post run
Pg 428-431
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 133
American Red Cross
Emergency Response
Air Medical Considerations
First
responders may have to assist with air
medical transport
Considerations
Victim
preparation
Landing zone
Safety
Pg 431
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 134
American Red Cross
Emergency Response
Multiple Casualty Incidents
Some
emergency situations may overwhelm
local responding groups
The Incident Command System approaches
an emergency in an organized manner
Triage is the process of sorting victims
according to how ill or injured they are
The START system is an often used triage
method. The letters stand for Simple
Triage And Rapid Treatment
Pg 431-433
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
S.T.A.R.T.
Simple
Triage
And
Rapid
Treatment
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
Emergency Response
American Red Cross
Emergency Response
Incident Command System (ICS)
The
ICS manages a group of people to
achieve a common goal
ICS clearly defines who is in charge, the
scope of authority and responsibility, the
goal and objectives to meet the goal
Pg 433
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Advantages of ICS
Use
of common terms
One big “boss” – Incident Commander
Unified command structure
Integrated communications system
Small, easily managed units
Pg 433
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 135
American Red Cross
Emergency Response
ICS
Incident
Commander -
Directs the response
Appoints chiefs
Operations Section Officer
Planning Section Officer
Puts together plan
Coordinates actions of other leaders
Gather/analyzes information/resources
Provides updates
Logistics Section Officer
Finds resources
Establishes communications
Coordinates crowd control
Evaluates scene if necessary
Pg 434-435
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 136
American Red Cross
Emergency Response
The START System
Injured
are rapidly prioritized to receive
adequate care
Save more lives by sacrificing some victims
who are very severely injured
Classify victims as Immediate treatment - Red Tag
Delay Care - Yellow Tag
Minor - Green Tag
Dead or non-salvageable - Black Tag
Pg 436
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
The START System
Pg 437
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 58
American Red Cross
Emergency Response
Fundamentals of Extrication
First
responders administer necessary care
to minimize further injury
Care
precedes extrication unless
delayed movement would endanger the
victim or rescuer
Personal safety is the #1 priority. Wear
appropriate clothing and safety
equipment.
Pg 438-439
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Gaining Access to Victim
Simple Access
No equipment needed
Try to open each door
Have victim roll down the windows
Have victim unlock doors
Complex Access
Use of tools and equipment
Pg 440
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 137
American Red Cross
Emergency Response
Hazardous Materials
A HAZMAT
is any material that can pose a
threat to the health, safety and property
Dealing with HAZMAT requires special
training
Primary concern is the safety of the crew,
victim(s) and bystanders
Safely obtain as much information as
possible
Pg 445
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
General Procedures for
HAZMAT Situations
Stay
upwind and uphill from incident
Be alert to wind changes
Stay away from area
Keep people away from the danger zone
Look for clues indicating hazardous
materials
Never enter a HAZMAT area unless you are
trained
Pg 446
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 138
American Red Cross
Emergency Response
Scenario 25
Gaining Access
You arrive on the scene of an automobile collision
involving one vehicle that has struck a guard rail
head-on. The car is still running. The driver did not
have on a safety belt and struck the steering column.
He is seated behind the steering wheel, conscious
and complaining of chest and abdominal pain. The
other passenger also was not wearing a safety belt.
She is lying motionless, facedown on the floor of the
vehicle. You see blood around her body. She is
unconscious and not breathing. You are unsure if
she has a pulse.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 139
American Red Cross
Emergency Response
Water Rescues
Throw,
row ... then go
Do not endanger yourself, do not attempt
in-water rescue unless trained
Distressed swimmer may be too tired to get
to shore but can float and call for help
Active drowning victim may thrash to get
out of the water but can’t call for help
If water has entered lungs, near-drowning
victims must go to hospital
Pg 448-451
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Throwing Assists
Keep
your balance
Secure any line attached to device to be
thrown
Throw device beyond victim
Consider wind and current
Once victim grasps device, pull him or her
slowly to safety
Pg 451
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 140
American Red Cross
Emergency Response
As you approach a scene ...
… have a plan in mind.
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
CT 17
American Red Cross
Emergency Response
Video
Putting it all Together
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
American Red Cross
Emergency Response
Scenario 26
Extrication
You arrive at a scene in which a car has plunged
down an embankment, landing on one side at the
bottom. You can see at least two people in the car,
one of whom appears to be conscious. Several
bystanders have just arrived and are staring at the
car. The doors appear to be undamaged, but you
are unable to open them. How should you
respond?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 141
American Red Cross
Emergency Response
Scenario 27
Multiple Casualty Incident
A small commuter airplane carrying eight people
and crew has made a crash landing in a cornfield.
Witnesses say the plane managed to land without
burning, with no smoke visible. When you reach
the scene, fire fighters and other rescue personnel
have already arrived. The plane is severely
damaged but is not of fire. There appear to be
survivors. What should you do?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 142
American Red Cross
Scenario 28
Emergency Response
Multiple Casualty Incident - Triage
You are at the scene of a train derailment. Two cars have
been severely damaged and you are helping with the
victims. The incident commander has assigned you four
victims to triage as rapidly as possible, using the START
system. One of the victims is standing, leaning against a
tree. He says he can walk. Another victim is lying on the
ground moaning. You can see blood around her body.
The third victim is lying on the ground motionless, making
no sound. When you check for his pulse, you cannot find
it. The fourth victim is also lying on the ground
unconscious, but she has a pulse. When you open her
airway, she begins to breathe. How would you proceed?
Copyright © 2000 by the American National Red Cross
All rights reserved
When Help Can’t Wait
TM 143