1. Before Giving Care and Checking an Ill or Injured Person
Chapter One
Before Giving Care and Checking an Ill or Injured Person

2. The EMS System
Network of community resources and medical personnel that provides emergency care to victims of injury or sudden illness

3. The Lay Responder
Someone who recognizes an emergency and decides to help
First aid – is immediate care given to a victim of injury or sudden illness until more advanced care can come
In other words – this is you doing what you have learned

4. The EMS Dispatcher
The dispatcher is the person who receives the call from the citizen responder
This person determines what help is needed
Some are trained to give the caller instructions until EMS comes
In other words, the person who answers when you call 9-1-1

5. First Responder
This is the first person to arrive on the scene who is trained to provide a higher level of care
They are often close to the scene and have the appropriate equipment and supplies to give care

6. The Emergency Medical Technician
The EMT is capable of providing more advanced care and life support techniques
EMT Basic Level – all ambulance personnel have this basic training
EMT Paramedics – at this level they can give medication, IV fluids, and provide advanced airway care. They are the highest level of care outside of the hospital

7. Hospital & Rehabilitation
Hospital – once the victim arrives at the hospital, the personnel there takes over
Rehabilitation – the goal of rehab is to return the victim to his/her previous state of health

8. Your Role in the EMS System
Recognize that an emergency exists
Decide to act
Activate the EMS system
Give care until help arrives

9. Step 1: Recognizing an Emergency
Unusual Noises
Unusual Sights
Unusual Odors
Unusual Appearance and
Behavior

10. Step 2: Deciding to Act

11. Barriers to Action Definition - Things that would stop you from helping a victim.
Panic of fear of doing something wrong
Being unsure of the person’s condition and what to do
Assuming someone else will take action
The type of injury or illness
Fear of catching a disease
Fear of being sued
Being unsure when to call 9-1-1

12. The Good Samaritan Law
Usually protects citizens who act the same way that a “reasonable and prudent person” would if that person were in the same situation.
Good Samaritan laws were developed to encourage people to help others in emergency situations.

13. Examples of being “reasonable and prudent” include -
Moving a person only if the person’s life were in danger.
Asking a conscious person for permission, also called consent, before giving care.
Checking the person for life-threatening conditions before giving further care.
Calling
Continuing to give care until a trained responder takes over.

14. Disease Transmission
Infectious diseases – spread from one person to another when germs enter the body and cause illness.
Bacteria – can live outside the body and do not need other organisms for life. Treated with antibiotics.
Viruses – depend on other organisms to live. They have few medications for treatment.

15. Disease Transmission
Direct contact – germs from another person’s body fluids pass directly into your body through breaks in the skin or mucus membranes.
Indirect contact – germs pass through shared objects like spoons, doorknobs and pencils which have been exposed to infected droplets.

16. Disease Transmission
In order to get a disease the following conditions must be present –
The victim must be infected with a disease
The rescuer must be exposed to the infected victim’s body substance
The rescuer must come in contact with the substance through an entry site
There must be a sufficient amount of the infected body substance to cause infection

17. Preventing Disease Transmission Standard Precautions - practices used to prevent spread of diseases
Avoid contact
Use breathing barriers
Use disposable gloves
Cover any of your own open wounds before putting on personal protective equipment (PPE)
Do not eat, drink or touch your face when giving care or before washing your hands after care has been given
Avoid touching your personal items while giving care
Do not touch objects that may have come in contact with body fluids
Wash your hands thoroughly after care
Tell EMS personnel or your doctor if you come in contact with a victim’s body fluids

18. Cleaning Up Blood Spills
Clean up the spill immediately or as soon as possible after it occurs.
Use disposable gloves and other PPE when cleaning.
Wipe up the spill with paper towels.
After the area has been wiped up, flood the area with a disinfectant – 1 ½ cups bleach to 1 gallon of water.
Dispose and label “biohazard”

19. Step 3: Activate the EMS System

20. Step 4: Give Care Until Help Arrives
Consent – getting permission to give care
You must tell the victim –
Your name
Your training
What you think is wrong
What you plan to do
Expressed consent – when a conscious person who understands your questions and what you plan to do gives you permission to give care
If the victim is an infant or a child, get permission from the parent or guardian

21. Denied Consent
Do not touch or give care to a conscious person who refuses care.
If the person refuses care or withdraws consent at any time, step back and call

22. Implied Consent Definition – assumption that if the person could respond, he or she would agree to care.
Consent is implied when –
If an adult is unconscious
If an adult is conscious but too seriously injured or ill to respond
If an infant or child has a life threatening condition and the parent or guardian is not present

23. Giving Care Until Help Arrives
In general, you should give the appropriate care to an ill or injured person until:
You see an obvious sign of life, such as breathing
Another trained responder takes over
You are too exhausted to continue
The scene becomes unsafe

24. Taking Action Emergency Action Steps
Check the scene and the person
Call 9-1-1
Care for the person

25. Check
Is the scene safe?
Chemicals, traffic, fire, smoke, extreme weather
Avoid confined areas with no ventilation
If you can’t get near the victim, call 9-1-1

26. Check Is there immediate danger involved?
Do not move seriously injured victims unless there is immediate danger or you have to move the person to give proper care such as CPR.
Make sure bystanders do not move the victims.

27. Check What happened? Look for clues to what caused the emergency.
Nearby objects, broken glass, spilled bottle

28. Is anyone else available to help?
Check
How many people were involved?
Look carefully for more than one person.
If one person is bleeding or screaming you may not notice an unconscious person.
In an emergency with more than one victim you may have to prioritize care.
Is anyone else available to help?

29. Check What is wrong? Try to find out what is wrong.
Look for signals of life threatening emergencies.
Unconscious, no breathing, no pulse, severe bleeding
Use all senses to try to notice if anything is abnormal

30. Call
Often times the most important thing you can do is call

31. When to call - Unconscious or altered level of consciousness
Breathing problems
Persistent chest pain
Persistent abdominal pain or pressure
Severe external bleeding
Severe burns
Suspected poisoning
Vomiting blood or passing blood
Seizures
Stroke
Injuries to the head, neck, or back
Suspected broken bone or an open fracture

32. Also call for these situations -
Fire or explosion
Downed electrical wires
Swiftly moving or rapidly rising water
Presence of poisonous gas
Serious car accident
Injured or ill person who cannot be moved easily

33. Call First or Care First?
You should always CALL FIRST for –
An unconscious adult or adolescent (12 y/o)
A witnessed sudden collapse of a child or infant
An unconscious infant or child known to be at high risk for heart problems
These are all possible cardiac emergencies therefore time is crucial

34. Call First or Care First?
You should CARE FIRST for –
An unwitnessed collapse of an unconscious person younger than 12 years old
Any victim of a drowning
Conscious person who is choking
These situations are more likely to be breathing emergencies

35. Call Provide information requested by the dispatcher
Location
Description of person’s condition
Do not hang up first
Whenever possible have a bystander make the call for you

36. Care
Do no further harm
Monitor the person’s breathing and consciousness
Help the person rest in the most comfortable position
Keep the person from getting chilled or overheated
Reassure the person
Give any specific care needed

37. Give Care Until Help Arrives
If you are trained in first aid, you can give help that can save a life in the first few minutes
Get bystanders to help by –
Calling 9-1-1
Clearing the scene
Directing EMS personnel when they arrive
Helping provide care
Providing information about the victim
Comforting and reassuring victims

38. Should you just take them to the hospital yourself?
Never transport a person –
When the trip might cause greater damage to the person
When the person may develop a life threatening condition
If you are unsure of the injury or illness
If you take the person to the hospital –
Take someone with you and the victim
Pay attention to any changes in the victim while en route

39. Why would you move a victim?
Only move the ill or injured person if –
You are faced with immediate danger
You have to get to another person who may have a more serious problem
You have to move the person to give them proper care

40. Emergency Moves Two Person Seat Carry Walking Assist Pack Strap Carry
Blanket Drag

41. Emergency Moves
Clothes Drag
Foot Drag
Throwing Assist
Reaching Assist

42. Conscious Ill or Injured Person - no immediate life threatening conditions
Two Basic Steps –
Step One
Interview the victim and bystanders
What happened?
Do you feel pain or discomfort anywhere?
Do you have any allergies?
Do you have any medical conditions or are you taking any medication?
Write down the information and give it to EMS personnel when they arrive.

43. Conscious Ill or Injured Person - no immediate life threatening conditions
Two Basic Steps –
Step Two
Do a Head to Toe Check of the Victim
Do not move areas of the body that hurt.
Look for cuts, bruises, bumps, and depressions.
Watch for changes in consciousness and breathing.
Notice how the skin looks and feels.
Look over the body.
Look for a medical ID tag.

44. Checking an Ill or Injured Infant or Child – What You May Do Differently
Start your check at the victim’s feet instead of their head.
Check the victim while he or she is seated in his or her parent’s or guardian’s lap.

45. Shock
A condition in which the circulatory system fails to circulate oxygen rich blood to all parts of the body.
When vital organs do not get oxygen rich blood they do not work properly.
Vital organs – brain, heart, lungs

46. Shock Three conditions must be present for adequate blood flow –
The heart must be working well.
An adequate amount of oxygen-rich blood must be circulating in the body.
Blood vessels must be intact and able to adjust blood flow.

47. Signs & Symptoms of Shock
Restlessness or irritability
Altered level of consciousness
Nausea or vomiting
Pale, ashen or grayish, cool, moist skin
Rapid breathing or pulse
Excessive thirst

48. Care for Shock CALL 9-1-1 Have the person lie down
Control any external bleeding
Maintain normal body temperature
Do not give the person anything to eat or drink
Reassure the person
Continue to monitor the person’s breathing

49. Checking an Unconscious Person
If you think someone is unconscious –
Tap their shoulder and ask if they are ok
Infant – tap shoulder or flick the bottom of their foot
If they do not respond CALL 9-1-1
Check to see if the person –
Has an open airway and is breathing
Is bleeding severely

50. Signs of Life
Consciousness, normal breathing and circulation and skin characteristics are referred to as signs of life.

51. Checking an Unconscious Person
As easy to remember as ABC!
Airway – open the airway
Breathing – check for movement or breathing
Circulation – check for severe bleeding

52. Checking the Airway & Breathing
Head Tilt/Chin Lift
Technique used to open a victim’s airway
Moves the tongue away from the back of the throat, allowing air to enter

53. Checking the Airway & Breathing
Look, listen, and feel for breathing for no more than 10 seconds.
Agonal breath is irregular, gasping or shallow. Someone with agonal breathing should be treated like a non-breathing victim.

54. If the victim is not breathing -
Adult – begin CPR immediately
Child or Infant – give 2 rescue breaths
Child – pinch nose, complete seal over mouth and give 2 rescue breaths each lasting 1 second
Infant – complete seal over mouth and nose and give 2 rescue breaths each lasting 1 second

55. Special Situations Air in the Stomach
Avoid forcing air into the person’s stomach by keeping the person’s head tilted back.
Air in the stomach can cause the victim to vomit.
Choking
Harder to breathe

56. Special Situations
Vomiting
H.A.IN.E.S.
Clear it out
Continue care

57. Special Situations Mouth to Nose Breathing
Close the mouth by pushing on the chin
If possible, open the victim’s mouth between rescue breaths to let the air out

58. Special Situations Mouth to Stoma Breathing
Expose the person’s neck down to the breastbone
Keep the airway in neutral position
If the tube is blocked, remove the inner tube
If partial breather, rescuer must seal the mouth and nose

59. Special Situations Head, Neck, and Spinal Injuries
If a child is in a car seat, do not remove the child from the seat
Minimize movement when opening the airway
Tilt the head and left the chin just enough to open the airway

60. Special Situations Drowning Victim
For an adult, give 2 rescue breaths as you would for a child or infant once you determine the victim is not breathing
Give 2 minutes of care before calling for an unconscious person who has been submerged
Do not go in the water to rescue someone unless you are trained to do so

61. What to do next -
Vomit, fluids blocking the airway, or if you must leave the victim, place the person in the H.A.IN.E.S. recovery position.

62. Incident Stress
Definition - a condition caused by acute stress which overwhelms a person to the point that they are unable to cope with the stress.
If not appropriately managed, this stress can lead to PTSD.

63. Signals of Incident Stress
Anxiousness and unable to sleep
Nightmares
Restlessness
Confusion
Low attention span, poor concentration
Denial, guilt, anger, depression
Nausea
Increased or decreased eating
Change in interactions with others
Uncharacteristic, excessive humor or silence
Unusual behavior
Difficulty performing day to day tasks (job, school)

64. Guidelines for Coping with Incident Stress
Seek help
Use relaxation techniques
Eat a balanced diet
Avoid alcohol and drugs
Get enough sleep
Participate in some type of physical activity