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RULE NUMBER 1: DON’T PANIC!. RULE NUMBER 2: CALL 911!. RULE NUMBER 3: DO NOT TOUCH BLOOD OR BODY FLUIDS UNLESS PROTECTED!. RULE NUMBER 4: REMEMBER RULE NUMBER 1!. Should You Drive or Call Ambulance?. Ask these questions: Does the persons condition appear to be life threatening?

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RULE NUMBER 1: DON’T PANIC!

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Rule number 1 don t panic

RULE NUMBER 1:

DON’T PANIC!


Rule number 1 don t panic

RULE NUMBER 2:

CALL 911!


Rule number 1 don t panic

RULE NUMBER 3:

DO NOT TOUCH BLOOD OR BODY FLUIDS UNLESS PROTECTED!


Rule number 1 don t panic

RULE NUMBER 4:

REMEMBER RULE NUMBER 1!


Rule number 1 don t panic

Should You Drive or Call Ambulance?

Ask these questions:

Does the persons condition appear to be life threatening?

Could their condition worsen?

Could moving the person cause more injury?


Rule number 1 don t panic

Questions cont-

Does the person need the attention or equipment that first responders provide?

Would traffic conditions cause a delay in getting to the hospital?


Rule number 1 don t panic

Why people fail to get involved

Afraid of law suits

Afraid of doing something wrong

Afraid of cooties


Rule number 1 don t panic

A LAYPERSON HAS NO LEGAL DUTY TO HELP A VICTIM.

IF YOU DECIDE TO OFFER HELP, YOU ARE COVERED UNDER THE GOOD SAMARITAN LAW, WHICH WILL GENERALLY PROTECT YOU FROM LIABILITY, AS LONG AS YOU:


Rule number 1 don t panic

ACT IN GOOD FAITH.

ARE NOT RECKLESS OR NEGLIGENT.

ACT AS A PRUDENT PERSON WOULD.

DO NOT EXCEED YOUR SCOPE OF TRAINING.


Rule number 1 don t panic

LATEX GLOVES. (P.P.E.).

BANDAGES / DRESSINGS.

FACE SHIELD/POCKET MASK.

ICE PACKS.

SCISSORS / TWEEZERS.

ANTISEPTIC.

TAPE.


Rule number 1 don t panic

BLEEDING CONTROL.

SEIZURES.

DIABETES.

FALLS / FRACTURES.

SYNCOPE / FAINTING.

ALLERGIC REACTIONS.

BURNS.

CPR / AED

Blood Borne Pathogens


Rule number 1 don t panic

DiabetesAllergic Reactions

Breathing difficultiesShock

Fainting

Seizures

Heart Attacks

Strokes


Rule number 1 don t panic

*Sprains / Strains

*Lacerations

*Fractures

*Amputations

*Shock

*Burns


Rule number 1 don t panic

RECOGNIZE AN ILL OR INJURED PERSON.

ASSESS THE SCENE FOR SAFETY.

DON’TPANIC!

ASSESSTHE VICTIM.

ALERT EMS!


Rule number 1 don t panic

ATTEND TO THE VICTIM:

CHECK ABC’S.

EXAMINE THE PATIENT.

CHECK FOR BLEEDING.

TREAT THE VICTIM.

ASK BYSTANDERS.

7) REMAIN WITH THE VICTIM.


Rule number 1 don t panic

ARE YOU TAKING ANY MEDS?

DO YOU HAVE ANY ALLERGIES?

DO YOU HAVE ANY MEDICAL PROBLEMS?

WHAT HURTS?

MEDIC ALERTS!


Rule number 1 don t panic

29 CFR 1910.1030

  • Originally issued December 6, 1991.

  • Places responsibility for protection of personnel on to the employer:

    • Mandatory in-service training.

    • Work practice controls/engineering controls.

    • Incident reporting/treatment protocols.

    • Hepatitis B vaccinations.


Rule number 1 don t panic

Disease Producing Organisms

  • Virus

    • Generally only live inside the cells of another organism

  • Bacteria

    • Capable of living outside the cells of another organism


Rule number 1 don t panic

  • Parasite

    • Live within a host and feed upon it

  • Fungus

    • Generally live on the outside of a host


Rule number 1 don t panic

  • Infectious disease

    • Caused by micro-organisms

    • Not transmissible from person to person

  • Communicable disease

    • Caused by micro-organisms

    • May be transmitted from person to person


Rule number 1 don t panic

  • Direct Transmission

    • Contact with the blood or body fluids directly from another person

  • Indirect Transmission

    • Contact with blood or body fluids or micro-organisms on an object


Rule number 1 don t panic

Modes Of Transmission

  • Food borne

    • Ingested by eating or drinking

  • Air borne

    • Droplets inhaled


Rule number 1 don t panic

  • Blood borne

    • Piercing of the skin barrier

    • Contamination of mucous membranes


Rule number 1 don t panic

Mucous Membranes

Eyes

Nose

Mouth

Vagina

Anus


Rule number 1 don t panic

AIDS – The Process

HIV enters body and attaches to the T-cells.

HIV reprograms T-cells to produce more HIV.

T-cells produce HIV until they burst and spread more HIV.

New HIV seeks out more T-cells.


Rule number 1 don t panic

AIDS - Stages

  • HIV Primary Infection (Asymptomatic)

    • From infection to symptoms – up to 10 years

  • HIV (Symptomatic)

    • From symptoms to specific T-cell count (200 cells per micro-liter)

  • AIDS

    • From specific T-cell count (200 cells per micro-liter) till death


Rule number 1 don t panic

AIDS - Transmission

  • IS transmitted by:

    • Sexual contact

    • Sharing of needles and syringes with infected person

    • Blood transfusion

    • Exposure to blood or body fluid of infected person

  • NOT transmitted by:

    • Sitting next to an infected person

    • Shaking hands with an infected person

    • Eating in public areas

    • Using public restrooms

    • mosquitoes


Rule number 1 don t panic

No known cure at this time

Treatments

Anti-viral drugs

Immune system booster drugs

Surgery

Radiation

Other drug treatment

AIDS – Cure?

  • Early diagnosis and treatment are the keys to survival


Rule number 1 don t panic

Hepatitis

Inflammation of the liver

Chronic

Acute

Leads to cell damage resulting in cirrhosis or cancer


Rule number 1 don t panic

Hepatitis - Strains

  • HAV

    • Fecal/oral

    • Acute

  • HBV

    • Blood, semen, vaginal fluids

    • Chronic

    • Interferon effective in 35-45% of cases


Rule number 1 don t panic

Hepatitis - Strains

  • HCV

    • Blood

    • Chronic

    • Interferon is effective in 10-20% of cases


Rule number 1 don t panic

Hepatitis – Strains

  • HDV

    • Blood, semen,vaginal fluids

    • Chronic

    • Only infects persons with HBV

  • HEV

    • Fecal/oral

    • Acute


Rule number 1 don t panic

Hepatitis - Vaccines

  • Hepatitis A

    • Only recommended for persons in the risk groups who are leaving the United States

  • Hepatitis B

    • Offered free to all department personnel

    • Series of three shots

    • Extremely effective, even post-exposure


Rule number 1 don t panic

Hepatitis – Signs and Symptoms

Light stools

Dark urine

fatigue

Fever

Jaundice


Rule number 1 don t panic

Meningitis

  • There is a viral strain

  • Highly contagious

  • Signs/Symptoms

    • Fever

    • Severe headache

    • Stiff neck

    • Sore throat

  • Children with undiagnosed fever may be meningitis


Rule number 1 don t panic

Hazards in the Workplace

Cleanliness in station

Patient care equipment in station living area

Co-workers

Body fluids on scenes

Sharp objects on scenes


Rule number 1 don t panic

Exposure Control Plan

Identifies which personnel are at risk

Provides procedures for investigation of exposures

Provides engineering and work practice controls

Mandates Hepatitis B vaccinations and record keeping

Outlines post-exposure procedures and record keeping


Rule number 1 don t panic

Exposure Control Plan Contains

  • Personal Protective Equipment

    • Gloves

    • Eye protection

    • Respiratory protection

    • Sharps containers

      • Sharps shuttles

      • Sharps boxes

    • Pocket masks


Rule number 1 don t panic

Exposure Control Plan

  • Scene Operations

    • Scene control

    • Wash hands

    • No eating, drinking, smoking, etc

    • No recapping of needles

    • CPR

    • Respiratory protection

    • Medical information


Rule number 1 don t panic

Exposure Control Plan

  • Post Response

    • Location for cleaning of equipment

    • Disinfection with bleach

    • No eating, drinking, smoking, etc

    • Durable equipment

    • Delicate equipment


Rule number 1 don t panic

Exposure Control Plan

  • Post Exposure

    • Report Any

      • Needle sticks

      • Break in skin

      • Splash into mucous membranes

      • Mouth-to-mouth

      • Other exposure

    • To your Immediate Supervisor


Rule number 1 don t panic

REMEBER

Washing hands and utilizing proper Personal Protective equipment is the best method.

If it is not your body fluid, then do not touch it.

If exposed wash as soon as possible and use hand cleaner.

Skin is largest organ and natural protector keep in tack.


Rule number 1 don t panic

DIABETES IS CAUSED BY THE BODY’S INABILITY TO PROPERLY PROCESS SUGAR. THIS IS CAUSED BY A DEFICIENCY IN INSULIN PRODUCTION.


Rule number 1 don t panic

SOME DIABETICS TAKE INSULIN SHOTS. THIS ALLOWS THE BODY TO PROCESS SUGAR INTO THE CELLS.

ANOTHER TYPE OF DIABETES IS CONTROLLED BY DIET AND / OR ORAL MEDICATIONS.


Rule number 1 don t panic

SOMETIMES A DIABETIC MAY NOT EAT ENOUGH AFTER TAKING THEIR INSULIN. THIS CAUSES THE SUGAR LEVEL TO DROP. (HYPOGLYCEMIA) Most Common

SINCE THE BRAIN RUNS ON SUGAR, A LOW SUGAR LEVEL WILL CAUSE CONFUSION, OR UNCONSCIOUSNESS.


Rule number 1 don t panic

SIGNS & SYMPTOMS INCLUDE:

CONFUSION,DIZZINESS, DROWSINESS.

FEELING OR LOOKING ILL.

ABNORMAL PULSE (RAPID/WEAK).

PROFUSE SWEATING.


Rule number 1 don t panic

LOOK FOR A MEDIC ALERT TAG!

IF THE PERSON IS CONSCIOUS , GIVE THEM FLUIDS CONTAINING SUGAR.

WATCH THE PERSON CAREFULLY, THEY MAY LOSE CONSCIOUSNESS OR COME COMBATIVE.


Rule number 1 don t panic

IF THE PERSON IS UNCONSCIOUS:

CALL 911, AND ENSURE THAT THE PATIENT HAS AN OPEN AIRWAY.

MONITOR THE PATIENT.


Rule number 1 don t panic

CAUSED BY A TEMPORARY REDUCTION OF BLOOD FLOW TO THE BRAIN.

MANY PATIENTS FALL, CAUSING INJURY.


Rule number 1 don t panic

SOME CAUSES OF SYNCOPE:

STRESSFUL EVENT (SIGHT OF BLOOD).

PAIN.

HEART DISEASE.

SUDDEN STANDING.

SOME CAUSES MAY BE SERIOUS!


Rule number 1 don t panic

SIGNS/SYMPTOMS INCLUDE:

PALE SKIN.

NAUSEA.

DIZZINESS.

SWEATING.

VISION DISTURBANCE.


Rule number 1 don t panic

TREATMENT:

NORMALLY SELF-CORRECTING IN A SHORT PERIOD OF TIME.

IF THE PATIENT FALLS, KEEP PATIENT STILL TO INSURE NO FURTHER INJURY.

RAISE FEET APPROX. 12” OFF FLOOR


Rule number 1 don t panic

SYNCOPE CAN BE A SIGN OF A MORE SERIOUS MEDICAL CONDITION. ANYONE THAT FAINTS SHOULD CONTACT THEIR PHYSICIAN OR BE EVALUATED AT A HOSPITAL.


Rule number 1 don t panic

MANY CAUSES, SOME VERY SERIOUS OR LIFE THREATENING.

SYMPTOMS INCLUDE: HIVES, SWELLING, SHORTNESS OF BREATH, DECREASED B/P, REDNESS, HOARSENESS.


Rule number 1 don t panic

COMMON

INSTIGATORS:

BEES

SHELLFISH

MEDICINES

PLANTS


Rule number 1 don t panic

CALL 911!

KEEP PATIENT CALM.

BENADRYL MAY BE GIVEN.

EPI-PEN.


Rule number 1 don t panic

A DISRUPTION OF THE ELECTRICAL ACTIVITY OF THE BRAIN.

THIS DISRUPTION CAN CAUSE LOSS OF BODY CONTROL, KNOWN AS A SEIZURE.


Rule number 1 don t panic

EPILEPSY: CHRONIC CONDITION THAT CAUSES SEIZURES, CONTROLLED BY MEDICATION.

FEVER: CAUSED BY FEVERS >102 DEGREES, USUALLY OCCUR IN CHILDREN < 5 YEARS OLD.

PREGNANCY: THESE CAN BE VERY SERIOUS, EVEN LIFE THREATENING!


Rule number 1 don t panic

HEAD INJURY: FROM FALLS, MVA’S, ETC. MAY NOT OCCUR UNTIL DAYS AFTER THE EVENT.

MENINGITIS: INFECTION.

BRAIN TUMORS.


Rule number 1 don t panic

“JERKING MOTIONS”; MAY INVOLVE ENTIRE BODY OR JUST A PART OF THE BODY.

CONFUSION AFTER THE EVENT.

DROWSINESS.

INCONTINENCE.

EYES ROLLING BACK.


Rule number 1 don t panic

REMAIN CALM!

CALL 911.

CLEAR AREA FROM AROUND THE PATIENT, TO PREVENT INJURY.

PROTECT PATIENTS’ HEAD FROM THE FLOOR.


Rule number 1 don t panic

DO NOTPLACE ANYTHING IN THE PATIENT’S MOUTH!

THE PATIENT MAY BE VIOLENT! THIS CANNOT BE HELPED, BE CAREFUL!

WHEN THE SEIZURE STOPS, POSITION THE PATIENT ON THEIR SIDE.


Rule number 1 don t panic

REMEMBER!

MANY INDIVIDUALS THAT HAVE SEIZURES FALL AND INJURE THEMSELVES.

TRY NOT TO MOVE THE PERSON ANYMORE THAN NECESSARY.


Rule number 1 don t panic

Causes

Asthma

Emphysema

COPD

Bronchitis

Hyperventilation


Rule number 1 don t panic

Most individuals that have chronic breathing problems carry an inhaler or other prescribed medications.

Most are metered doses and only work after 1 or 2 sprays.


Rule number 1 don t panic

Place patient in position of comfort.

Do not agitate / argue.

Give oxygen if allowed and possible.

If unconscious check ABC, Start CPR


Rule number 1 don t panic

Also known as MI’s, (Myocardial Infarctions)

MEN:

chest pain

sweating

shortness of breath

pain in arms, jaw, neck, back


Rule number 1 don t panic

WOMEN:

indigestion

unusual fatigue

weakness

possibly chest / back pain

shortness of breath


Rule number 1 don t panic

CARE

CALL 911, DO NOT HESITATE!

PLACE PT. IN POSITION OF COMFORT.

OBTAIN HISTORY (ASPIRIN)?

GIVE OXYGEN IF AVAILAE AND QUALIFIED.

BE PREPARED FOR CPR / AED.


Rule number 1 don t panic

Stroke: Any vascular injury to the brain

Also known as “cerebrovascular accident” (CVA)

80% are ischemic (blockage)

20% are hemorrhagic (bleeding)

(ruptured aneurysm, trauma


Rule number 1 don t panic

750,000 strokes per year in the United States

4,000,000 stroke survivors in the US

#1 cause of disability

#3 cause of death (#2 World)


Rule number 1 don t panic

Major Risk Factors


Rule number 1 don t panic

Bleeding into the subarachnoid space

Commonly results from aneurysmal rupture

Rapid onset of symptoms

Results in severe sudden headache due to marked increase in pressure around the brain


Rule number 1 don t panic

Weakness

Unable to walk

Unable to talk

Dizzy

Numbness

Found down

Confused

ANY OF THESE COMPLAINTS COULD BE A STROKE!


Rule number 1 don t panic

PLACE PT. IN POSITON OF COMFORT.

CALL 911

BE PREPARED DO CONDUCT CPR

CONDUCT STROKE ASSESMENT

PTS. MAY BE CONFUSED,


Rule number 1 don t panic

A-B-C

SAMPLE HISTORY

VITALS

DURATION OF SYMPTOMS

MONITOR AIRWAY

O2 IF INDICATED

IMMOBILIZE ?

911!


Rule number 1 don t panic

ARTERIAL BLEED

(SPURTS)

CAPILLARY BLEED

(OOZES)

VENOUS BLEED

(DRIPS)


Rule number 1 don t panic

PPE!

DIRECT PRESSURE.

ELEVATION.

PRESSURE BANDAGE.

PRESSURE POINTS.

TOURNIQUET.


Rule number 1 don t panic

USING A 4X4 DRESSING, PINCH BOTH NOSTRILS AND LEAN PATIENT FORWARD.

SOME NOSEBLEEDS CAN BE SEVERE, AND SHOULD BE EVALUATED BY A PHYSICIAN.

VARIOUS CAUSES.


Rule number 1 don t panic

THE PATIENT WILL BE VERY DISORIENTED, CONFUSED, AND TIRED. THIS IS NORMAL, AND USUALLY GOES AWAY IN A SHORT TIME.

SOME BLEEDING MAY BE SEEN FROM THE MOUTH.


Rule number 1 don t panic

Approximately 8000 people die each year from choking.

Someone choking needs immediate attention or they will go unconscious and need CPR.


Rule number 1 don t panic

Ask can you speak?

If so encourage to cough and prepare to give abdominal thrust (Heimlich Maneuver).

Stand behind patient, place hands just above belly button and give 5 quick thrusts inward and upward.


Rule number 1 don t panic

After 5 thrusts an object has not expelled

continue until object is freed or pt. goes

Unconscious.

When pt goes unconscious

Lower to the floor an start cycles

Of CPR. Looking in the

Airway after compressions

Make sure 911 has been called


Rule number 1 don t panic

CLASSIFIED AS:

1ST DEGREE / SUPERFICIAL. (SUNBURN)

2ND DEGREE / PARTIAL THICKNESS (BLISTERS, VERY PAINFUL.)

3RD DEGREE / FULL THICKNESS (SKIN DESTROYED, MAY BE PAINLESS!)


Rule number 1 don t panic

ENSURE SCENE SAFETY!

REMOVE PATIENT FROM SOURCE!

DO NOT BECOME A VICTIM YOURSELF!

CALL 911!


Rule number 1 don t panic

CHEMICAL BURNS: FLUSH THOROUGHLY WITH WATER, AWAY FROM THE PATIENT.

IF EYES INVOLVED, FLUSH WITH COPIOUS AMOUNTS OF WATER.

FOR THERMAL BURNS, COOL AREA WITH WATER AND WET CLOTHS.


Rule number 1 don t panic

SIGNS AND SYMPTOMS:

DEFORMITY.

SWELLING / DISCOLORATION.

PAIN.

INABILITY TO MOVE INJURED AREA.

BONE EXPOSED.


Rule number 1 don t panic

TREATMENT:

IMMOBILIZE AREA TO STOP MOVEMENT.

ELEVATE THE EXTREMITY.

ICE PACKS.

WATCH FOR SHOCK.


Rule number 1 don t panic

2005 American Heart Association Guidelines:

Infant…………0-1yr.

Child………….1-8 yrs

Adult………….8yrs >

A cycle of CPR is 2 minutes or 5 cycles of 30:2


Rule number 1 don t panic

Compression Rates / Ratios: Compressions 100 per minute at a ratio of 30:2 infants, children, and adults.

Compression depths; 1/3 to 1/2 the chest thickness for infant, 1” to 1 ½ for a child, and 1 ½ to 2” for an adult depending on size of patient.


Rule number 1 don t panic

Determine unresponsiveness, if infant and child perform 2 minutes of CPR prior to calling 911 if alone.

Adult; determine level of responsiveness, call 911, then start the cycles of CPR if needed or place in recovery position, and wait for emergency crews.

Get AED if available.


Rule number 1 don t panic

If AED available and patient was witnessed going into cardiac arrest place AED on patient immediately, if unwitnessed arrest, conduct 2 minutes or 5 cycles of CPR prior to placement of AED.


Rule number 1 don t panic

Do not place pads on a conscious patient only having chest pains.

If in cardiac arrest; open unit, place pads in designated location, turn on unit, and follow prompts, if no shock continue CPR for appropriate time, AED will count down, reanalyze and indicate shock or no shock, continue CPR.

If AED indicates shock, clear patient and press shock button.


Rule number 1 don t panic

??QUESTIONS??


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