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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!


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?

Could their condition worsen?

Could moving the person cause more injury?


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?


Why people fail to get involved

Afraid of law suits

Afraid of doing something wrong

Afraid of cooties


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:


ACT IN GOOD FAITH.

ARE NOT RECKLESS OR NEGLIGENT.

ACT AS A PRUDENT PERSON WOULD.

DO NOT EXCEED YOUR SCOPE OF TRAINING.


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

BANDAGES / DRESSINGS.

FACE SHIELD/POCKET MASK.

ICE PACKS.

SCISSORS / TWEEZERS.

ANTISEPTIC.

TAPE.


BLEEDING CONTROL.

SEIZURES.

DIABETES.

FALLS / FRACTURES.

SYNCOPE / FAINTING.

ALLERGIC REACTIONS.

BURNS.

CPR / AED

Blood Borne Pathogens


Diabetes Allergic Reactions

Breathing difficulties Shock

Fainting

Seizures

Heart Attacks

Strokes


*Sprains / Strains

*Lacerations

*Fractures

*Amputations

*Shock

*Burns


RECOGNIZE AN ILL OR INJURED PERSON.

ASSESS THE SCENE FOR SAFETY.

DON’TPANIC!

ASSESSTHE VICTIM.

ALERT EMS!


ATTEND TO THE VICTIM:

CHECK ABC’S.

EXAMINE THE PATIENT.

CHECK FOR BLEEDING.

TREAT THE VICTIM.

ASK BYSTANDERS.

7) REMAIN WITH THE VICTIM.


ARE YOU TAKING ANY MEDS?

DO YOU HAVE ANY ALLERGIES?

DO YOU HAVE ANY MEDICAL PROBLEMS?

WHAT HURTS?

MEDIC ALERTS!


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.


Disease Producing Organisms

  • Virus

    • Generally only live inside the cells of another organism

  • Bacteria

    • Capable of living outside the cells of another organism


  • Parasite

    • Live within a host and feed upon it

  • Fungus

    • Generally live on the outside of a host


  • 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


  • 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


Modes Of Transmission

  • Food borne

    • Ingested by eating or drinking

  • Air borne

    • Droplets inhaled


  • Blood borne

    • Piercing of the skin barrier

    • Contamination of mucous membranes


Mucous Membranes

Eyes

Nose

Mouth

Vagina

Anus


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.


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


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


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


Hepatitis

Inflammation of the liver

Chronic

Acute

Leads to cell damage resulting in cirrhosis or cancer


Hepatitis - Strains

  • HAV

    • Fecal/oral

    • Acute

  • HBV

    • Blood, semen, vaginal fluids

    • Chronic

    • Interferon effective in 35-45% of cases


Hepatitis - Strains

  • HCV

    • Blood

    • Chronic

    • Interferon is effective in 10-20% of cases


Hepatitis – Strains

  • HDV

    • Blood, semen,vaginal fluids

    • Chronic

    • Only infects persons with HBV

  • HEV

    • Fecal/oral

    • Acute


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


Hepatitis – Signs and Symptoms

Light stools

Dark urine

fatigue

Fever

Jaundice


Meningitis

  • There is a viral strain

  • Highly contagious

  • Signs/Symptoms

    • Fever

    • Severe headache

    • Stiff neck

    • Sore throat

  • Children with undiagnosed fever may be meningitis


Hazards in the Workplace

Cleanliness in station

Patient care equipment in station living area

Co-workers

Body fluids on scenes

Sharp objects on scenes


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


Exposure Control Plan Contains

  • Personal Protective Equipment

    • Gloves

    • Eye protection

    • Respiratory protection

    • Sharps containers

      • Sharps shuttles

      • Sharps boxes

    • Pocket masks


Exposure Control Plan

  • Scene Operations

    • Scene control

    • Wash hands

    • No eating, drinking, smoking, etc

    • No recapping of needles

    • CPR

    • Respiratory protection

    • Medical information


Exposure Control Plan

  • Post Response

    • Location for cleaning of equipment

    • Disinfection with bleach

    • No eating, drinking, smoking, etc

    • Durable equipment

    • Delicate equipment


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


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.


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


SOME DIABETICS TAKE PROCESS SUGAR. THIS IS CAUSED BY A DEFICIENCY IN INSULIN PRODUCTION.INSULIN SHOTS. THIS ALLOWS THE BODY TO PROCESS SUGAR INTO THE CELLS.

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


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.


SIGNS & SYMPTOMS INCLUDE: INSULIN. THIS CAUSES THE SUGAR LEVEL TO DROP. (HYPOGLYCEMIA)

CONFUSION,DIZZINESS, DROWSINESS.

FEELING OR LOOKING ILL.

ABNORMAL PULSE (RAPID/WEAK).

PROFUSE SWEATING.


LOOK FOR A MEDIC ALERT TAG! INSULIN. THIS CAUSES THE SUGAR LEVEL TO DROP. (HYPOGLYCEMIA)

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

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


IF THE PERSON IS UNCONSCIOUS: INSULIN. THIS CAUSES THE SUGAR LEVEL TO DROP. (HYPOGLYCEMIA)

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

MONITOR THE PATIENT.


CAUSED BY A TEMPORARY REDUCTION OF BLOOD FLOW TO THE BRAIN. INSULIN. THIS CAUSES THE SUGAR LEVEL TO DROP. (HYPOGLYCEMIA)

MANY PATIENTS FALL, CAUSING INJURY.


SOME CAUSES OF SYNCOPE: INSULIN. THIS CAUSES THE SUGAR LEVEL TO DROP. (HYPOGLYCEMIA)

STRESSFUL EVENT (SIGHT OF BLOOD).

PAIN.

HEART DISEASE.

SUDDEN STANDING.

SOME CAUSES MAY BE SERIOUS!


SIGNS/SYMPTOMS INCLUDE: INSULIN. THIS CAUSES THE SUGAR LEVEL TO DROP. (HYPOGLYCEMIA)

PALE SKIN.

NAUSEA.

DIZZINESS.

SWEATING.

VISION DISTURBANCE.


TREATMENT: INSULIN. THIS CAUSES THE SUGAR LEVEL TO DROP. (HYPOGLYCEMIA)

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


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


MANY CAUSES, SOME VERY SERIOUS OR LIFE THREATENING. ANYONE THAT FAINTS SHOULD CONTACT THEIR PHYSICIAN OR BE EVALUATED AT A HOSPITAL.

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


COMMON ANYONE THAT FAINTS SHOULD CONTACT THEIR PHYSICIAN OR BE EVALUATED AT A HOSPITAL.

INSTIGATORS:

BEES

SHELLFISH

MEDICINES

PLANTS


CALL 911! ANYONE THAT FAINTS SHOULD CONTACT THEIR PHYSICIAN OR BE EVALUATED AT A HOSPITAL.

KEEP PATIENT CALM.

BENADRYL MAY BE GIVEN.

EPI-PEN.


A DISRUPTION OF THE ELECTRICAL ACTIVITY OF THE BRAIN. ANYONE THAT FAINTS SHOULD CONTACT THEIR PHYSICIAN OR BE EVALUATED AT A HOSPITAL.

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


EPILEPSY ANYONE THAT FAINTS SHOULD CONTACT THEIR PHYSICIAN OR BE EVALUATED AT A HOSPITAL.: 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!


HEAD INJURY: ANYONE THAT FAINTS SHOULD CONTACT THEIR PHYSICIAN OR BE EVALUATED AT A HOSPITAL. FROM FALLS, MVA’S, ETC. MAY NOT OCCUR UNTIL DAYS AFTER THE EVENT.

MENINGITIS: INFECTION.

BRAIN TUMORS.


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

CONFUSION AFTER THE EVENT.

DROWSINESS.

INCONTINENCE.

EYES ROLLING BACK.


REMAIN CALM! PART OF THE BODY.

CALL 911.

CLEAR AREA FROM AROUND THE PATIENT, TO PREVENT INJURY.

PROTECT PATIENTS’ HEAD FROM THE FLOOR.


DO NOT PART OF THE BODY.PLACE 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.


REMEMBER! PART OF THE BODY.

MANY INDIVIDUALS THAT HAVE SEIZURES FALL AND INJURE THEMSELVES.

TRY NOT TO MOVE THE PERSON ANYMORE THAN NECESSARY.


Causes PART OF THE BODY.

Asthma

Emphysema

COPD

Bronchitis

Hyperventilation


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.


Place patient in position of comfort. an inhaler or other prescribed medications.

Do not agitate / argue.

Give oxygen if allowed and possible.

If unconscious check ABC, Start CPR


Also known as MI’s, (Myocardial Infarctions) an inhaler or other prescribed medications.

MEN:

chest pain

sweating

shortness of breath

pain in arms, jaw, neck, back


WOMEN: an inhaler or other prescribed medications.

indigestion

unusual fatigue

weakness

possibly chest / back pain

shortness of breath


CARE an inhaler or other prescribed medications.

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.


Stroke: Any vascular injury to the brain an inhaler or other prescribed medications.

Also known as “cerebrovascular accident” (CVA)

80% are ischemic (blockage)

20% are hemorrhagic (bleeding)

(ruptured aneurysm, trauma


750,000 strokes per year in the United States an inhaler or other prescribed medications.

4,000,000 stroke survivors in the US

#1 cause of disability

#3 cause of death (#2 World)


Major Risk Factors an inhaler or other prescribed medications.


Bleeding into the subarachnoid space an inhaler or other prescribed medications.

Commonly results from aneurysmal rupture

Rapid onset of symptoms

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


Weakness an inhaler or other prescribed medications.

Unable to walk

Unable to talk

Dizzy

Numbness

Found down

Confused

ANY OF THESE COMPLAINTS COULD BE A STROKE!


PLACE PT. IN POSITON OF COMFORT. an inhaler or other prescribed medications.

CALL 911

BE PREPARED DO CONDUCT CPR

CONDUCT STROKE ASSESMENT

PTS. MAY BE CONFUSED,


A-B-C an inhaler or other prescribed medications.

SAMPLE HISTORY

VITALS

DURATION OF SYMPTOMS

MONITOR AIRWAY

O2 IF INDICATED

IMMOBILIZE ?

911!


ARTERIAL BLEED an inhaler or other prescribed medications.

(SPURTS)

CAPILLARY BLEED

(OOZES)

VENOUS BLEED

(DRIPS)


PPE! an inhaler or other prescribed medications.

DIRECT PRESSURE.

ELEVATION.

PRESSURE BANDAGE.

PRESSURE POINTS.

TOURNIQUET.


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.


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.


Approximately 8000 people die each year from choking. THIS IS NORMAL, AND USUALLY GOES AWAY IN A SHORT TIME.

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


Ask can you speak? THIS IS NORMAL, AND USUALLY GOES AWAY IN A SHORT TIME.

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.


After 5 thrusts an object has not expelled THIS IS NORMAL, AND USUALLY GOES AWAY IN A SHORT TIME.

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


CLASSIFIED AS: THIS IS NORMAL, AND USUALLY GOES AWAY IN A SHORT TIME.

1ST DEGREE / SUPERFICIAL. (SUNBURN)

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

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


ENSURE SCENE SAFETY! THIS IS NORMAL, AND USUALLY GOES AWAY IN A SHORT TIME.

REMOVE PATIENT FROM SOURCE!

DO NOT BECOME A VICTIM YOURSELF!

CALL 911!


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.


SIGNS AND SYMPTOMS PATIENT.:

DEFORMITY.

SWELLING / DISCOLORATION.

PAIN.

INABILITY TO MOVE INJURED AREA.

BONE EXPOSED.


TREATMENT: PATIENT.

IMMOBILIZE AREA TO STOP MOVEMENT.

ELEVATE THE EXTREMITY.

ICE PACKS.

WATCH FOR SHOCK.


2005 American Heart Association Guidelines: PATIENT.

Infant…………0-1yr.

Child………….1-8 yrs

Adult………….8yrs >

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


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.


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.


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.


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.



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