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First Aid “When in doubt, treat any body fluid as if contaminated: “If it is wet, sticky, and not yours, do not touch it.” www.RossyParker.com.

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Presentation on theme: "First Aid “When in doubt, treat any body fluid as if contaminated: “If it is wet, sticky, and not yours, do not touch it.” www.RossyParker.com."— Presentation transcript:

1 First Aid “When in doubt, treat any body fluid as if contaminated: “If it is wet, sticky, and not yours, do not touch it.”

2 Identify the role of the Emergency Medical Services System (EMS) when preparing to respond to a medical emergency. Ensures the safety of victims and bystanders Ensures the safety of victims and bystanders Gains access to patients Gains access to patients Provides basic first aid Provides basic first aid Alerts the EMS system. Alerts the EMS system.

3 EMS system It is a network of trained professionals linked to provide advanced, out-of-hospital care for victims of sudden traumatic injury or illness. It is a network of trained professionals linked to provide advanced, out-of-hospital care for victims of sudden traumatic injury or illness.

4 Identify how the roles and responsibilities of the criminal justice first aid provider differ from other professionals within the EMS system. At the scene of a medical emergency, the police officer can be the first person providing basic first aid. At the scene of a medical emergency, the police officer can be the first person providing basic first aid. However, advanced, specialized training prepares paramedics, emergency medical technicians (EMTs). However, advanced, specialized training prepares paramedics, emergency medical technicians (EMTs).

5 First Responder airway care with use of adjunctive equipment airway care with use of adjunctive equipment patient assessment patient assessment CPR CPR bleeding control bleeding control stabilization of injuries to the spine and extremities stabilization of injuries to the spine and extremities care for medical and trauma emergencies care for medical and trauma emergencies use of limited amount of equipment use of limited amount of equipment assistance to other EMS providers assistance to other EMS providers other skills or procedures as local or state regulations permit other skills or procedures as local or state regulations permit

6 EMT—Basic performs all techniques of a first aid provider and a first responder performs all techniques of a first aid provider and a first responder performs complex immobilization procedures performs complex immobilization procedures restrains patients restrains patients staffs and drives ambulance staffs and drives ambulance

7 EMT—Paramedic performs all functions of previous two levels performs all functions of previous two levels administers medications administers medications performs advanced techniques, including cardiac monitoring performs advanced techniques, including cardiac monitoring

8 Uphold responsibilities for medical treatment in accordance with CJSTC when responding to a medical emergency. Protect your safety, the safety of the patient, and the safety of bystanders. This is your first priority. Wear personal protective equipment. You cannot help the patient if you are injured. Injury forces other rescuers to rescue you. After ensuring safety at the scene, you must make the patient’s needs your primary concern. Protect your safety, the safety of the patient, and the safety of bystanders. This is your first priority. Wear personal protective equipment. You cannot help the patient if you are injured. Injury forces other rescuers to rescue you. After ensuring safety at the scene, you must make the patient’s needs your primary concern. Gain access to the patient. In some emergencies, you may need to move one patient to reach a more critically injured patient. Gain access to the patient. In some emergencies, you may need to move one patient to reach a more critically injured patient. Determine life-threatening emergencies. As soon as possible, perform an initial assessment to identify and correct Airway, Breathing, and Circulation (ABCs) problems. Determine life-threatening emergencies. As soon as possible, perform an initial assessment to identify and correct Airway, Breathing, and Circulation (ABCs) problems.

9 Maintain composure. Communicate clearly with the patient and responding EMS personnel so that nothing is misunderstood. Working efficiently and avoiding undue haste can prevent mistakes or misunderstandings. Maintain composure. Communicate clearly with the patient and responding EMS personnel so that nothing is misunderstood. Working efficiently and avoiding undue haste can prevent mistakes or misunderstandings. Keep your appearance neat, clean, and professional. Keep your appearance neat, clean, and professional. Maintain a caring attitude. Maintain a caring attitude. Alert EMS. When a patient requires transport to advanced medical facilities. Alert EMS. When a patient requires transport to advanced medical facilities. Provide care based on your assessment. Provide care based on your assessment. Assist EMS personnel. Assist EMS personnel. Keep your skills current. Keep your skills current. Participate in the record keeping and data collection your agency requires. Participate in the record keeping and data collection your agency requires. Act as liaison with other public safety personnel. Personnel include local, state, and federal law enforcement, fire department personnel, and other EMS providers. Act as liaison with other public safety personnel. Personnel include local, state, and federal law enforcement, fire department personnel, and other EMS providers.

10 Identify legal and ethical issues for a criminal justice first aid provider when responding lawfully to a medical emergency. Make the patient’s physical and emotional needs a priority. Respect their needs without regard to nationality, race, gender, or age. Practice your skills, continue your education, and uphold professional standards. Make the patient’s physical and emotional needs a priority. Respect their needs without regard to nationality, race, gender, or age. Practice your skills, continue your education, and uphold professional standards. Show respect for the competence of others in the medical field. Show respect for the competence of others in the medical field. Review your performance; seek ways to improve your actions and communication skills. Review your performance; seek ways to improve your actions and communication skills. Maintain patient confidentiality, unless the law requires you reveal it. Maintain patient confidentiality, unless the law requires you reveal it. Work in accord with other medical professionals to reach a positive outcome to the emergency. Work in accord with other medical professionals to reach a positive outcome to the emergency.

11 Duty to act: “A duty to take some action to prevent harm to another and for the failure of which one may be liable depending on the relationship of the parties and the circumstances.” “A duty to take some action to prevent harm to another and for the failure of which one may be liable depending on the relationship of the parties and the circumstances.”

12 Breach of duty: occurs when you either fail to act or act inappropriately. occurs when you either fail to act or act inappropriately.

13 Identify how the duty to act applies to the criminal justice first aid provider. Duty to act refers to your contractual or legal obligation to provide care. Duty to act refers to your contractual or legal obligation to provide care. While on duty as a correctional officer or correctional probation officer, you have an obligation to provide care to a patient in your custody who needs and consents to care. While on duty as a correctional officer or correctional probation officer, you have an obligation to provide care to a patient in your custody who needs and consents to care. As a law enforcement officer, you have a duty to act 24/7 within your jurisdictional boundaries. As a law enforcement officer, you have a duty to act 24/7 within your jurisdictional boundaries. Refer to your agency policy and procedure as jurisdictional boundaries can extend due to a mutual aid agreement. Refer to your agency policy and procedure as jurisdictional boundaries can extend due to a mutual aid agreement.

14 Standard or Scope of Care: “In the law of negligence, the degree of care that a reasonable person should exercise; under the law of negligence, the conduct demanded of a person in a given situation. Typically, this involves a person’s giving attention both to possible dangers, mistakes, and pitfalls and to ways of ensuring that these risks do not materialize.” “In the law of negligence, the degree of care that a reasonable person should exercise; under the law of negligence, the conduct demanded of a person in a given situation. Typically, this involves a person’s giving attention both to possible dangers, mistakes, and pitfalls and to ways of ensuring that these risks do not materialize.”

15 . Identify how the standard or scope of care applies to the criminal justice first aid provider. It is a care that you are expected to provide to the same patient under the same conditions as would any criminal justice first aid provider who received the same level of training. It is a care that you are expected to provide to the same patient under the same conditions as would any criminal justice first aid provider who received the same level of training. For example, providing CPR while performing open-heart surgery is not. For example, providing CPR while performing open-heart surgery is not.

16 Identify how the Good Samaritan Act affects the criminal justice first aid provider. Florida has the Good Samaritan Act that also protects first aid providers. Florida has the Good Samaritan Act that also protects first aid providers. The Good Samaritan Act protects a civilian first aid provider from liability for medical care performed in good faith or medical care similar to that expected of another first aid provider with equal training. The Good Samaritan Act protects a civilian first aid provider from liability for medical care performed in good faith or medical care similar to that expected of another first aid provider with equal training. Medical care includes using an automated external defibrillator (AED) Medical care includes using an automated external defibrillator (AED) The Good Samaritan Act does not stop someone from filing a lawsuit; The Good Samaritan Act does not stop someone from filing a lawsuit; However, it does provide a defense if you performed according to the standard of care for a first aid provider. However, it does provide a defense if you performed according to the standard of care for a first aid provider. Always render care to the best of your ability. Always render care to the best of your ability. Do not go beyond the scope and level of your training. Maintain the patient’s best interests. Do not go beyond the scope and level of your training. Maintain the patient’s best interests. According to the Advisory Legal Opinion (89–62), the Good Samaritan Act does not apply to law enforcement officers within their jurisdiction. According to the Advisory Legal Opinion (89–62), the Good Samaritan Act does not apply to law enforcement officers within their jurisdiction. However, the Good Samaritan Act does apply to correctional officers unless they deal with persons reduced to their custody. However, the Good Samaritan Act does apply to correctional officers unless they deal with persons reduced to their custody.

17 Identify the implications of abandonment, for the criminal justice first aid provider. Abandonment is: “The relinquishing of a right or interest with the intention of never again claiming it.” Abandonment is: “The relinquishing of a right or interest with the intention of never again claiming it.” You must continue providing emergency first aid until another medical professional with the same or higher-level You must continue providing emergency first aid until another medical professional with the same or higher-level

18 Identify the implications of negligence for the criminal justice first aid provider. “The failure to exercise the standard of care that a reasonably prudent person would have exercised in a similar situation; any conduct that falls below the legal standard established to protect others against unreasonable risk of harm, except for conduct that is intentionally, wantonly, or willfully disregardful of other’s rights.” “The failure to exercise the standard of care that a reasonably prudent person would have exercised in a similar situation; any conduct that falls below the legal standard established to protect others against unreasonable risk of harm, except for conduct that is intentionally, wantonly, or willfully disregardful of other’s rights.”

19 Negligence occurs if all these conditions are present: Duty to act—You were supposed to be there. Duty to act—You were supposed to be there. Breach of standard of care—What you did was wrong. Breach of standard of care—What you did was wrong. Causation—What you did caused the injury. Causation—What you did caused the injury. Damages—The patient suffered an injury; the injury is additional to the original injury. Damages—The patient suffered an injury; the injury is additional to the original injury.

20 Negligence: Legal Liability If patient care deviates from accepted standards and causes further injury, negligence can become a legal liability. Your best defense against negligence is to conduct yourself with a professional attitude and demeanor, provide consistently high standards of care within the scope of your training, and document the care you provide. If patient care deviates from accepted standards and causes further injury, negligence can become a legal liability. Your best defense against negligence is to conduct yourself with a professional attitude and demeanor, provide consistently high standards of care within the scope of your training, and document the care you provide.

21 Identify the implications of battery for the criminal justice first aid provider. “The use of force against another resulting in harmful or offensive contact; an intentional and offensive touching of another without lawful justification—also termed tortuous battery”. “The use of force against another resulting in harmful or offensive contact; an intentional and offensive touching of another without lawful justification—also termed tortuous battery”. It is unlawful physical contact. It is unlawful physical contact. When you provide emergency care without the patient’s consent, you can face a battery charge if you touch a patient’s body or clothes. When you provide emergency care without the patient’s consent, you can face a battery charge if you touch a patient’s body or clothes.

22 Consent “Agreement, approval, or permission as to some act of purpose, especially given voluntarily by a competent person”. “Agreement, approval, or permission as to some act of purpose, especially given voluntarily by a competent person”.

23 Identify the legal and ethical considerations of patient consent for a criminal justice first aid provider. Gain the patient’s consent, or permission, before providing emergency first aid. For consent to be valid, the patient must be competent and the consent informed. As a criminal justice first aid provider, you are responsible for fully explaining the care you plan to render, and its possible related risks. Gain the patient’s consent, or permission, before providing emergency first aid. For consent to be valid, the patient must be competent and the consent informed. As a criminal justice first aid provider, you are responsible for fully explaining the care you plan to render, and its possible related risks. To refuse medical care, a patient must be competent. To refuse medical care, a patient must be competent. A competent adult is one who can make an informed decision about medical care. The patient must understand your question and the implications of decisions made about medical care. A competent adult is one who can make an informed decision about medical care. The patient must understand your question and the implications of decisions made about medical care. Consider an adult incompetent if he or she is under the influence of alcohol or drugs and meets the criteria for a Marchman Act. Consider an adult incompetent if he or she is under the influence of alcohol or drugs and meets the criteria for a Marchman Act. An incompetent adult can be in an altered mental state and meet the criteria of a Baker Act. An incompetent adult can be in an altered mental state and meet the criteria of a Baker Act. Consider an adult incompetent if he or she is seriously ill, has an injury that affects judgment, and/or is mentally ill or mentally challenged. Consider an adult incompetent if he or she is seriously ill, has an injury that affects judgment, and/or is mentally ill or mentally challenged. You must have a responsive, competent adult’s consent before rendering first aid. You must have a responsive, competent adult’s consent before rendering first aid. To obtain consent from an adult, begin by identifying yourself. State your level of training. Carefully explain to the patient what first aid you need to render. Explain your plan for rendering aid in terms the patient understands. Be sure to state possible risks involved. The patient needs a clear idea of all factors that may affect a reasonable person’s decision to either accept or refuse. To obtain consent from an adult, begin by identifying yourself. State your level of training. Carefully explain to the patient what first aid you need to render. Explain your plan for rendering aid in terms the patient understands. Be sure to state possible risks involved. The patient needs a clear idea of all factors that may affect a reasonable person’s decision to either accept or refuse.

24 Types of consent: expressed consent expressed consent implied consent implied consent informed consent informed consent

25 expressed consent —“Consent that is clearly and unmistakably stated” —“Consent that is clearly and unmistakably stated” Expressed consent is affirmative consent, such as verbal or physical assertion of the affirmative. For example, persons expressly invited officers into a hotel room where they found contraband. Expressed consent is affirmative consent, such as verbal or physical assertion of the affirmative. For example, persons expressly invited officers into a hotel room where they found contraband.

26 implied consent “Consent inferred from one’s conduct rather than from one’s direct expression”. Implied consent “may be found by circumstantial evidence suggesting implicit consent.” “Consent inferred from one’s conduct rather than from one’s direct expression”. Implied consent “may be found by circumstantial evidence suggesting implicit consent.” You make assumptions of implied consent. You may assume that the unresponsive patient is at risk of death, disability, or deterioration of condition and/or would agree to care if able to consent. Implied consent may also apply to conscious patients who do not stop you from providing treatment, refuse care, and then become unresponsive and/or are not competent to refuse care. You make assumptions of implied consent. You may assume that the unresponsive patient is at risk of death, disability, or deterioration of condition and/or would agree to care if able to consent. Implied consent may also apply to conscious patients who do not stop you from providing treatment, refuse care, and then become unresponsive and/or are not competent to refuse care.

27 informed consent —“A person’s agreement to allow something to happen made with full knowledge of the risks involved and the alternatives”. —“A person’s agreement to allow something to happen made with full knowledge of the risks involved and the alternatives”.

28 When a patient chooses a treatment or a procedure, he or she makes this choice after a physician or other healthcare provider discloses whatever information a reasonably prudent provider in the medical community would provide to a patient about the risks involved in the proposed treatment. When a patient chooses a treatment or a procedure, he or she makes this choice after a physician or other healthcare provider discloses whatever information a reasonably prudent provider in the medical community would provide to a patient about the risks involved in the proposed treatment. In Florida, children under age 18 are minors. You must have a parent or legal guardian’s permission before providing care. In Florida, children under age 18 are minors. You must have a parent or legal guardian’s permission before providing care. However, if the parent or legal guardian is not available in life-threatening or disabling emergencies, provide emergency care based on the principle of implied consent. However, if the parent or legal guardian is not available in life-threatening or disabling emergencies, provide emergency care based on the principle of implied consent. An emancipated minor is one who is married, an active member of the military, or financially independent and/or lives away from home with court permission. You do not need a parent or legal guardian’s permission to treat an emancipated minor. The minor’s consent is sufficient. An emancipated minor is one who is married, an active member of the military, or financially independent and/or lives away from home with court permission. You do not need a parent or legal guardian’s permission to treat an emancipated minor. The minor’s consent is sufficient. The mentally ill are not competent to give expressed consent. Therefore, you must have a legal guardian’s permission to treat a mentally ill person. If the legal guardian is not available and the emergency is life threatening, act on the principle of implied consent, and provide care. The mentally ill are not competent to give expressed consent. Therefore, you must have a legal guardian’s permission to treat a mentally ill person. If the legal guardian is not available and the emergency is life threatening, act on the principle of implied consent, and provide care. Competent adults have the right to refuse treatment for themselves and their children. Inform them of the treatment and the possible risks involved in refusing it. Competent adults have the right to refuse treatment for themselves and their children. Inform them of the treatment and the possible risks involved in refusing it. A competent adult may refuse verbally or physically by pulling away, pushing you away, or shaking his or her head in a negative manner. A competent adult may refuse verbally or physically by pulling away, pushing you away, or shaking his or her head in a negative manner. Competent adults also have the right to withdraw from treatment after it begins. This is true for patients who consent and then change their minds. Competent adults also have the right to withdraw from treatment after it begins. This is true for patients who consent and then change their minds. It also applies to a patient who is unconscious when treatment begins, regains consciousness and mental competence, and asks you to stop. Refusal of first aid must follow the rules of expressed consent. Make every effort to persuade the patient to consent to treatment. Be sure the patient is able to make a competent, rational decision. It also applies to a patient who is unconscious when treatment begins, regains consciousness and mental competence, and asks you to stop. Refusal of first aid must follow the rules of expressed consent. Make every effort to persuade the patient to consent to treatment. Be sure the patient is able to make a competent, rational decision. A person involved in a traumatic incident such as an auto accident may be emotionally, intellectually, and/or physically impaired. A person involved in a traumatic incident such as an auto accident may be emotionally, intellectually, and/or physically impaired. If the person continues to refuse treatment, keep him or her under observation. If the patient loses consciousness, and you believe a life-threatening situation exists, immediately begin first aid. If the person continues to refuse treatment, keep him or her under observation. If the patient loses consciousness, and you believe a life-threatening situation exists, immediately begin first aid. For situations involving minors in life-threatening emergencies needing medical care against parental consent, refer to your agency policy and procedure and Florida Statute § for guidance. Notify the Department of Children and Family Services by calling ABUSE. For situations involving minors in life-threatening emergencies needing medical care against parental consent, refer to your agency policy and procedure and Florida Statute § for guidance. Notify the Department of Children and Family Services by calling ABUSE.

29 Identify the role of a Do Not Resuscitate (DNR) Order (DNRO) for a criminal justice first aid provider in patient refusal of care. A terminally ill patient may have a directive in place, written in advance, and signed by both the patient and a physician. A terminally ill patient may have a directive in place, written in advance, and signed by both the patient and a physician. The DNR documents the terminally or chronically ill patient’s wish to refuse resuscitation. An advanced directive documents the patient’s request to withhold specific medical care. The DNR documents the terminally or chronically ill patient’s wish to refuse resuscitation. An advanced directive documents the patient’s request to withhold specific medical care. Criminal justice first aid providers do not have authorization to honor a DNR Order or an advanced directive. You cannot withhold resuscitation or first aid. You must immediately begin first aid. Licensed medical professionals, EMTs, or paramedics, however, can honor a DNR Order or advanced directive. Criminal justice first aid providers do not have authorization to honor a DNR Order or an advanced directive. You cannot withhold resuscitation or first aid. You must immediately begin first aid. Licensed medical professionals, EMTs, or paramedics, however, can honor a DNR Order or advanced directive.

30 Medic Alert You may have a patient who wears an identification bracelet or necklace or carries a card in his or her wallet that alerts you to a specific medical condition such as an allergy, epilepsy, or diabetes. You may have a patient who wears an identification bracelet or necklace or carries a card in his or her wallet that alerts you to a specific medical condition such as an allergy, epilepsy, or diabetes.

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