Emergency First Aid for the Community and Workplace

1. Emergency First Aid for the Community and Workplace American Health & Safety Institute Training Center

2. About the Instructor • Jason Roosevelt • National Registry of Emergency Medical Technicians • Certified for 14 years • Adjunct Faculty at Phoenix College • Teaching for 8 years • ASHI/AHA CPR instructor trainer • Teaching for 8 years • Phoenix Fire Department • Fire Communications Lead • 8 Years

3. Background • If you are the first on the scene of accident that results in an injury or serious illness, you may be the only link between a victim and emergency medical care. Your role is to take action, whether by providing first aid, seeking medical help or calling 911. Your actions may improve the victims chance of recovery. • The following slides will provide specific information from The American Safety & Health Institute (ASHI) on basic first aid procedures.

4. Need for Training • The important of this training is for the first person on the scene of an accident or emergency illness to know the steps to keep the patient alive: • HELP UNTIL QUALIFIED HELP ARRIVES!

5. Reasons for Learning Basic First Aid • At work, injuries, and illnesses kill more than two million people in the world each year. • 1 death every fifteen seconds. • 6000 people a day. • By focusing on safe practices and making healthy choices we can prevent this horrible tally of injury, illness, disease, and death.

6. Reasons for Learning Basic First Aid • Once injury or sudden illness has occurred, providing effective first aid can make the difference between life and death, rapid vs. prolonged recovery, and temporary vs. permanent disability. • This program focuses on what you must know and do in order to maintain your composure and provide confident, effective first aid care.

7. Skill Requirements for Successful Completion • METHOD: Physical skill demonstration by student in classroom and assessed by ASHI authorized instructor • Demonstrate Proper Removal of Contaminated Gloves • Perform the Emergency Action Steps for an Unresponsive and Responsive Victim • Place a Victim in a Recovery Position • Control Severe Bleeding and Manage Shock • Manually Stabilize an Injured Limb • Manually Stabilize a Suspected Spinal Injury

8. Safety and Health

9. Safety and Health • Infectious Illnesses • There have been no documented cases where use of training manikins has been responsible for transmission of bacterial, fungal, or viral diseases. • ASHI authorized instructors routinely and thoroughly clean and disinfect training manikins. • To prevent spread of infectious illnesses, both instructors and students should clean their hands often, using alcohol-based hand sanitizers or soap and water.

10. Safety and Health • Infectious Illnesses Please do not participate if: • Your hands, mouth, or lips have skin lesions. • You are ill.

11. Safety and Health • To prevent injury during skill practices: • Avoid awkward or extreme postures of the body. • Do not practice moving simulated victims if you have a history of back problems. • Practice of these moves may aggravate previous back injuries.

12. Legal Considerations

13. Legal Considerations • Reason for Learning • Common legal issues are an important element of care and a frequent concern of First Aid Providers.

14. It’s the law ! • Always identify yourself prior to requesting permission to treat them. • Good Samaritan Law - By treating the patient to the best of your ability, treating within your level of your training, are neither reckless or negligent and are acting in good faith, reduces the chance you will be sued. • This does not protect you from gross negligence. • “Act as any prudent person would.”

15. Legal Considerations Good Samaritan Principle and Laws • Legal principle/law based on Biblical story. • Prevents a rescuer who has voluntarily helped a stranger in need from being sued for 'wrongdoing.' • Designed to encourage people to help in emergencies. • Generally protect you from liability as long as you: • Are reasonably careful • Act in “good faith” (not for reward) • Do not provide care beyond your skill level

16. Legal Considerations • Good Samaritan Laws and Principles • Different from state to state, province to province, and country to country. • You should be familiar with Good Samaritan laws in the state where you live and in other states or countries where you work or travel.

17. Legal Considerations • Obtain Consent • Consent means permission • A responsive adult must agree to receive first aid care. • Expressed Consent means responsive victim gives his or her permission to receive care. • Implied Consent means that permission to perform first aid care on an unresponsive victim is assumed.

18. Legal Considerations • Special Consent Situations • Children • Consent must be obtained from a parent or guardian prior to administering any care. • DO NOT delay treatment if a parent or guardian can not be located. • Mentally Challenged • Attempt to obtain verbal consent. If not able to communicate effectively, follow implied consent rules. • Intoxicated or Under the Influence • If a person has an altered level of consciousness, or is too intoxicated to make rational decisions, implied consent applies.

19. Legal Considerations When Caring for Older Persons • An elderly person suffering from a disturbance in normal mental functioning, like Alzheimer's disease, may not understand your request for consent. • Expressed consent must be gained from a family member or legal guardian. • When life-threatening situations exist and a family member or legal guardian is not available for consent, care should be given based on implied consent.

20. Legal Considerations Prevention • No evidence of a single successful lawsuit in the United States against a person providing first aid in good faith. • Still, it’s necessary to use common sense. • Never attempt skills that exceed your training. • Don't move a victim unless their life is in danger. • Call for an ambulance immediately, even if you decide not to give first aid. • Always ask a responsive victim for permission before giving care. • Once you have started first aid don't stop until qualified help arrives.

21. Legal Considerations • Refusing Treatment • A conscious, mentally competent adult has the right to refuse treatment. • Try to persuade the patient to accept treatment. • Confidentiality - Keep all patient information confidential. • Abandonment – DO NOT leave your patient prior to transfer of care to another trained person.

22. Wrap up scenario A 5-year-old child suddenly turns blue and stops speaking while eating. No parent or legal guardian is present. • Do you need permission to care for the child? • Why or why not? • What is the legal term for this? A 37-year-old trips and falls. His right forearm is painful, swollen, and looks broken. • Do you need permission to care for the victim? • Why or why not? • What is the legal term for this?

23. SCENE SAFETY

24. Safety First ! • Your safety must be your first priority. • You can’t help anyone if you become injured. • Make sure the scene of the accident or illness is safe before you enter. • If the scene is not safe then wait for trained help with the proper equipment and/or personnel to safe make it safe.

25. PREVENTION OF THE TRANSMISSION OF DISEASES

26. Risks of First Aid • NOTE: First Aiders must be aware of the risks associated with emergency medical care. • Diseases can be air borne or blood borne. • Any body fluid can carry diseases.

27. Prevention of Disease Reasons for Learning • Bloodborne pathogens are viruses or bacteria that are carried in blood and can cause disease in people. • Risk of getting disease while giving first aid is extremely low. • Observing universal precautions for victims of all ages will make it lower.

28. Prevention of Disease • The best prevention of transmitting any disease is the use of “Protective Barriers”. • The use of gloves, face masks and eye protection is recommended. • These items should be part of any First Aid Kit. • After treating any patient you should always wash your hands. • One of the most effective ways of preventing transmission of a disease is to wash your hands after restroom.

29. Prevention of Disease • Cover all cuts, scrapes, hangnails, rashes, etc. • Minimize splashing of body fluids • Handle sharp objects with caution • Not handle food, cigarettes, make-up, etc. when around bodily fluids • Use bleach 1:10 solution to clean up any spills or bodily fluids • 1oz bleach to each 10oz of hot water

30. Body Substance Isolation

31. Body Substance Isolation • Universal Precautions is a way to limit the spread of disease by preventing contact with blood and body fluids. • To “observe universal precautions” means that whether or not you think the victim’s blood or body fluid is infected, you act as if it is. • Observe universal precautions for victims of all ages.

32. Body Substance Isolation Personal protective equipment • A barrier between you and victim’s blood or body fluid. • Wear disposable, protective gloves when performing first aid. If a glove is damaged, don't use it! • Goggles or safety glasses with side protection should be used to help protect your eyes. • If you find yourself in a first aid situation without standard personal protective equipment, improvise.

33. Body Substance Isolation • Use an alcohol-based hand rub to clean your hands and other exposed skin after providing first aid. • If an alcohol-based hand rub is not available, wash with soap and water. • Decontaminate all surfaces, equipment and other contaminated objects as soon as possible

34. Body Substance Isolation • Workers designated by employers to give first aid must be provided appropriate personal protective equipment and receive additional training on how to eliminate or reduce exposure and what to do if exposed to blood or other potentially infectious materials (OSHA Standard 1910.1030).

35. Wrap Up Scenario You are called to attend to a 45-year-old coworker who is bleeding profusely from the neck after being struck with a pry bar thrown from the intake chute of a rock crusher. The victim is slumped in a corner of the lower platform of the machine with the pry bar in his lap. • Should you “observe universal precautions”? Why or why not? • What protective equipment should you wear/use?

36. Responding to Emergencies

37. Assess – Alert - Attend • Experience has led to the development of 3 simple steps • Assess – Whenever you recognize an emergency, you should: • Assess the emergency scene for safety. Is it safe to approach the victims? If not safe, alert EMS for help. Look for additional bystanders for assistance and make them aware of any safety concerns • If you can approach, assess the victim(s) for life-threatening conditions. Assess victims for breathing, circulation or hemorrhaging (severe bleeding)

38. Assess – Alert - Attend • Experience has led to the development of 3 simple steps • Alert – • EMS for medical assistance if necessary • Attend – Complete a “head to toe” exam and provide necessary care until advanced medical help arrives and takes over.

39. Rescue and Transfer

40. Rescue and Transfer • Emergency rescue is a procedure for moving a victim from a dangerous location to a place of safety • In most cases, a First Aid Provider should not move an injured person. • Emergency services personnel are the best trained and equipped to do this, and you should use them. • However, in a life-threatening emergency or catastrophic disaster, there may not be time to wait for professional help. • In these cases, it may be necessary to perform an emergency move.

41. Immediate rescue situations • Fire or danger of explosion • Danger of asphyxia due to lack of Oxygen or presence of gas • Serious traffic hazard • Risk of drowning • Exposure to cold / heat • Possibility of injury from collapsing walls or building • Electrical injury or potential injury • Pinning by machinery

42. Moving the patient • Avoid unnecessary disturbances • Ensure open airway • Control Bleeding • Check for Injury • Immobilize injured parts before moving • Transport

43. Methods of transfer • Pulling the Victim • Lifting the Victim • Supporting the Victim • Chair Carry • Two Man Carry • Blanket Lift • Three Man Hammock Carry

44. Methods of transfer Drags • Drag victim in the direction of the long axis of the body to protect spine as best as possible. • Never pull victim sideways or pull head away from neck and shoulders.

45. Methods of transfer

46. Wrap up scenario Sparks from a grinding operation has caused an explosion and fire, knocking a nearby coworker off a suspended scaffold. The 12-foot fall has knocked the worker unconscious. The scene is not safe. and there is no time to wait for professional help. • Should you perform an emergency move? • If no, why? • If yes, how?

47. When to Call Emergency Medical Services • Call 9-1-1 or your number local emergency when you suspect any type of serious injury or illness. • When in doubt, CALL 911 !!! • Know your location, phone number and what the exact emergency is.

48. Ambulance Priorities Paramedics and Emergency Medical Technicians are trained to prioritize their patients and make the transportation decision based on the patient s injuries.

49. Triage • If there is more than one victim at the scene of an emergency, the first aid providers should prioritize or classify the injured victims. This process is called triage. It is the best way to help and provide care that would benefit the greatest number of victims. The first aid provider(s) should classify the victim’s priority status into one of four groups:

50. Triage- Critical • Life-threatening injuries or illnesses that may be corrected or treated successfully. • Respiratory arrest or obstruction • Suspected heart attack • severe bleeding • unconscious or unresponsive • severe head injuries • open chest wound • suspected spinal injury • abdominal wounds • severe burns or severe shock • Assessment Time is critical. The first aid provider should assess victims in a rapid manner. • Less than 1 minute