1. Emergency Response American Red Cross Instructor: Joel Bass MS ATC 1995 USDOT First Responder Curriculum

2. Course Syllabus Course Syllabus Textbook Textbook American Red Cross Emergency Response American Red Cross Emergency Response Workbook Workbook American Red Cross Emergency Response Workbook American Red Cross Emergency Response Workbook Course Completion Requirements Course Completion Requirements Correctly demonstrate the skills taught in the course Correctly demonstrate the skills taught in the course Correctly answer at least 80 percent of the final written examination questions. Correctly answer at least 80 percent of the final written examination questions.

3. “The purpose of this course is to train first responders, people like you, who will often be the first trained individuals with a duty to provide care at the scene of an emergency. The course content and activities will prepare you to better recognize emergencies, make decisions, and provide care. This course teaches the skills you will need to manage emergency situations until more advanced medical personnel, such as EMTs, arrive.”

4. How You Will Learn Lectures Lectures Discussions Discussions Readings Readings Group Activities Group Activities Skill Practice Skill Practice

5. Assignments You should have already read: “About This Course” in the textbook and chapters 1&2 You should have already read: “About This Course” in the textbook and chapters 1&2 You should have already completed: workbook Units 1 & 2 (please turn them in next week) You should have already completed: workbook Units 1 & 2 (please turn them in next week)

6. The Emergency Medical Services (EMS) System and The First Responder

7. Emergency Medical Services (EMS) Network of community resources to provide care to victims of sudden illness or injury Network of community resources to provide care to victims of sudden illness or injury First developed in 1973 First developed in 1973 10 components of an effective EMS system (DOT) 10 components of an effective EMS system (DOT) Regulation and Policy Regulation and Policy Resource Management Resource Management Human Resources and Training Human Resources and Training Transportation Transportation Facilities Facilities Communication Communication Public Information and Education Public Information and Education Medical Oversight Medical Oversight Trauma Systems Trauma Systems Evaluation Evaluation Access to the EMS system is through the “Chain of Survival” Access to the EMS system is through the “Chain of Survival”

8. Links in the Chain of Survival Citizen Response Rapid activation of EMS First responder care Advanced out-of Hospital care Hospital care Rehabilitation

9. First Responders Fire Fighters Fire Fighters Law enforcement personnel Law enforcement personnel Lifeguards Lifeguards Ski patrollers Ski patrollers Industrial response team Industrial response team Athletic Trainers Athletic Trainers Disaster team members Disaster team members First aid station attendants First aid station attendants

10. Levels of Training DOT recognizes four levels of training for the out-of-hospital providers: DOT recognizes four levels of training for the out-of-hospital providers: First Responder First Responder EMT-B EMT-B EMT-I EMT-I EMT-P EMT-P

11. The In-Hospital Care System Out-of-hospital care ends when EMT’s arrive at the hospital and the ER staff take over. Out-of-hospital care ends when EMT’s arrive at the hospital and the ER staff take over. ER staffs consist of physicians, nurses, and other allied health professionals. ER staffs consist of physicians, nurses, and other allied health professionals. Rehabilitation may also be needed to return to pre-incident level of health. Rehabilitation may also be needed to return to pre-incident level of health.

12. Roles and Responsibilities of The First Responder

13. First Responder Characteristics Video (The First Responder) Video (The First Responder) Maintains caring and professional attitude Maintains caring and professional attitude Controls fears Controls fears Presents professional appearance Presents professional appearance Maintains skills and knowledge Maintains skills and knowledge Stays healthy Stays healthy Recognizes and keeps victim’s needs as priority Recognizes and keeps victim’s needs as priority

14. Primary Responsibilities of First Responders Ensure safety of self and others Ensure safety of self and others Gain access to victim Gain access to victim Identify life-threatening conditions Identify life-threatening conditions Summon more advanced medical personnel when necessary Summon more advanced medical personnel when necessary Provide care Provide care Assist more advanced medical personnel Assist more advanced medical personnel

15. Secondary Responsibilities of First Responders Summon additional help Summon additional help Control and direct bystanders Control and direct bystanders Keep records Keep records Reassure others at scene Reassure others at scene

16. Medical Oversight Medical Director Medical Director Physician Physician Assumes responsibilities for care given Assumes responsibilities for care given Direct medical control Direct medical control EMTs speak directly with the physician EMTs speak directly with the physician Indirect medical control Indirect medical control Protocols Protocols Standing orders Standing orders

17. Break-out Session Identify several possible situations in which a critically injured or ill victim might not receive the appropriate care because of a break in one of the links in the chain of survival.

18. 10 Minute Break

19. THE WELL-BEING OF THE FIRST RESPONDER

20. Emotional Aspects of Emergency Care

21. Stressful Situations The first responder will experience personal stress, as well as encounter victims and bystanders under severe stress The first responder will experience personal stress, as well as encounter victims and bystanders under severe stress Multiple casualty incidents Multiple casualty incidents Trauma to infants or children Trauma to infants or children Traumatic injuries Traumatic injuries Infant/child/elder/spouse abuse Infant/child/elder/spouse abuse Death/injury of a co-worker or other public safety personnel Death/injury of a co-worker or other public safety personnel

22. Emotional Crises Everyone involved in a serious injury, sudden illness, or death will face an emotional crisis. Everyone involved in a serious injury, sudden illness, or death will face an emotional crisis. Everyone is affected by death, and response to a death is highly individualized. Everyone is affected by death, and response to a death is highly individualized. Predictable grieving stages involve: Predictable grieving stages involve: Anxiety Anxiety Denial Denial Anger Anger Bargaining Bargaining Guilt/depression Guilt/depression Acceptance Acceptance

23. Emotional Crises Steps that will help the first responder to deal with a dying victim and his or her family members. Steps that will help the first responder to deal with a dying victim and his or her family members. Recognizing that the victims needs include sharing, communication, privacy, and control. Recognizing that the victims needs include sharing, communication, privacy, and control. Allowing family members to express emotions Allowing family members to express emotions Listening empathetically Listening empathetically Not giving false reassurance Not giving false reassurance Using a gentle tone of voice Using a gentle tone of voice Letting the victim know that everything that can be done to help will be done Letting the victim know that everything that can be done to help will be done Using a reassuring touch Using a reassuring touch Comforting the family Comforting the family

24. Warning Signs of Stress Irritability Irritability Inability to concentrate Inability to concentrate Difficulty sleeping/nightmares Difficulty sleeping/nightmares Anxiety Anxiety Guilt Guilt Loss of interest in work Loss of interest in work

25. What is Critical Incident Stress? A Critical incident is a specific situation that causes a first responder to have an unusually strong emotional reaction that interferes with his or her ability to function immediately and later on. This reaction can produce stress called Critical Incident Stress

26. Critical Incident Stress Strong emotional reaction that interferes with ability to function Strong emotional reaction that interferes with ability to function Can build-up over days, weeks, months, or years Can build-up over days, weeks, months, or years May require counseling May require counseling A critical incident stress debriefing (CISD) is a type of meeting held within 24 to 72 hours of an incident. A critical incident stress debriefing (CISD) is a type of meeting held within 24 to 72 hours of an incident. During a CISD, participants are encouraged to have an open discussion of feelings, fears, and reactions triggered by the incident. During a CISD, participants are encouraged to have an open discussion of feelings, fears, and reactions triggered by the incident. Defusing Defusing Less formal and less structured Less formal and less structured

27. The Emergency Scene

28. At The Scene, Evaluate- Location of the emergency Location of the emergency Extent of the problem Extent of the problem Apparent scene dangers Apparent scene dangers Apparent number of victims Apparent number of victims Behavior of victims and bystanders Behavior of victims and bystanders Need for additional assistance Need for additional assistance

29. Ensure Your Safety By- Evaluation of present and potential dangers Evaluation of present and potential dangers Wearing proper protective gear Wearing proper protective gear Doing only what your are trained to do Doing only what your are trained to do Summoning additional resources Summoning additional resources

30. Possible Dangers at an Emergency Scene Crime Crime Traffic Traffic Fire Fire Electricity Electricity Water/ice Water/ice Hazardous materials Hazardous materials Unstable structures/vehicles Unstable structures/vehicles Natural disasters Natural disasters Multiple victims Multiple victims Hostile situations Hostile situations

31. Break-out Session Fire fighters arrive to help with a motor vehicle collision in which a pedestrian has been struck. The location is a dangerous intersection. The time is rush hour. The problem is compounded by heavy fog and rain. The vehicle has struck a utility pole, resulting in a downed wire. There appears to be two people in the car and one pedestrian in the roadway close to the downed wire. The driver of the vehicle is slumped over the steering wheel. The passenger is screaming for help, and the pedestrian is not moving. Bystanders are gathering; several are moving toward the vehicle to help but do not appear to see the downed wire.

32. Assignments Reading Assignment: Read Chapters 3, 4 & 5 Reading Assignment: Read Chapters 3, 4 & 5 Workbook Units 3, 4 & 5 Workbook Units 3, 4 & 5 (Turn in at the beginning of class)