Chapter 1

1. Chapter 1 Background Information

2. Agree or Disagree? (1 of 3) 1. Rub snow on frostbitten skin. 2. Put butter on burned skin. 3. Immediately soak a sprained ankle in warm water. 4. Cut and suck the poison out of a snakebite.

3. Agree or Disagree? (2 of 3) 5. Those “struck dead” by lightning cannot be resuscitated. 6. Do not let someone with a head injury go to sleep. 7. Clean a wound by soaking it in water. 8. Avoid using ointments on burns.

4. Agree or Disagree? (3 of 3) 9. Kill germs in wounds by using hydrogen peroxide. 10. Induce vomiting in all ingested poison cases. 11. Legally, you must help an injured person.

5. Need for First Aid Training • At some point in their lives, everyone will have to make the decision to help in an emergency or not. • It’s better to know it and not need it, than to need it and not know it.

6. Reason for First Aid Training Each year unintentional injuries: • Are the number one cause of death of people between the ages of 1 and 38. • Are the number five cause of death in the entire population.

7. What is First Aid? • First = immediate • Aid = care • Deals with injuries or sudden illness • DOES NOT replace the need for medical care

8. Purpose of First Aid • Find it • Fix it

9. Consent • Consent — permission to help • Expressed consent — verbal confirmation or head nod • Implied consent • Unresponsive victim • Minors • Mentally incompetent

10. Victim Refuses Aid • Rarely happens • Reasons why it occurs • Religious beliefs • Fear of physical pain • Victim would prefer a doctor’s care

11. Negligence Criteria • Duty to Act existed • Breach of that duty • Injury and damage occurred

12. Good Samaritan Laws Immunity generally applies when: • Rescuer acted in an emergency • Rescuer acted in good faith • Rescuer acted without compensation • Rescuer did not commit gross negligence

13. Introduction to EMS Systems • The EMS System • Components of the EMS System • Activating the EMS System • In-Hospital Care System • Medical Oversight • Roles and Responsibilities of the First Responder • First Responder Skills • Equipment, Tools, and Supplies

14. The EMS System A network of resources to provide emergency care and transport to victims of sudden illness and injury.

15. The Emergency Scene

16. Recognition of Accident and Activation of EMS

17. EMS Dispatch

18. Arrival of First Responders

19. Care Given at the Scene

20. Arrival of Additional EMS

21. Care During Transport

22. Transfer to Hospital Emergency Department

23. Components of the EMS System • Human Resources • Medical Oversight • Communications • Facilities • Transportation • Resource Management • Regulation and Policy • Public Education • Evaluation

24. Activating the EMS System • Enhanced 9-1-1 • 9-1-1 • Non 9-1-1

25. In-Hospital Care System • Emergency Department • Specialty Facilities • Trauma Centers • Burn Centers • Pediatric Centers • Hospital Personnel • Physicians • Nurses • Allied Personnel

26. Medical Oversight The First Responder may be a designated agent of the physician. Care rendered may be considered an extension of the medical director’s authority.

27. Medical Oversight A formal relationship between the EMS providers and the physician responsible for the prehospital emergency medical care provided in a community.

28. Medical Direction Given by On-line Orders

29. Medical Oversight • Indirect Medical Control • System Design • Protocols • Education • Quality Management

30. Levels of Training • EMT-Paramedic • EMT-Intermediate • EMT-Basic • First Responder

31. Roles and Responsibilities • Personal health and safety • Neat, clean, and professional appearance • Competency in knowledge and skills • Caring attitude • Maintain composure

32. Patient-Related Duties • Size up the scene. • Find out what is wrong with the patient. • Lift or move the patient only when it is necessary. • Transfer the patient and patient information. • Protect the patient’s privacy and maintain confidentiality. • Be the patient’s advocate.

33. Skills • As a First Responder, you should be able to: • Assess and control the scene of a simple incident. • Gain access to patients. • Evaluate a scene for safety. • Properly use all items of personal safety. • Gather information from patients and bystanders. • Conduct a patient assessment. • Relate signs and symptoms to illnesses and injuries. • Determine vital signs. • Document. • Perform airway management. • Perform Cardiopulmonary Resuscitation. • Operate an Automatic External Defibrillator. • Control bleeding.

34. Skills • As a First Responder, you should be able to: • Assess and care for shock. • Assess and provide care for closed injuries and open injuries. • Carry out basic dressing and bandaging techniques. • Assess and care for painful, swollen, deformed extremities. • Assess and care for possible injuries of the head, neck, and spine. • Assess and care for cardiac and medical emergencies. • Identify and care for poisoning cases. • Classify and provide care for burns. • Identify and care for smoke inhalation.

35. Skills • As a First Responder, you should be able to: • Assess and care for environmental emergencies. • Assist a mother in delivering her baby. • Provide initial care for the newborn. • Identify and care for drug-abuse and alcohol-abuse patients. • Perform non-emergency and emergency patient moves when required. • Perform triage at a multiple-patient emergency scene. • Work under the direction of an Incident Commander. • Work under the direction of EMTs.

36. Skills • In some systems that have very special needs, First Responders may be required to: • Determine blood pressure. • Use a bag-valve-mask resuscitator (ventilator). • Deliver oxygen using appropriate devices. • Apply or assist in applying a traction splint. • Apply or assist in applying an extrication collar. • Assist in securing a patient to a long spine board (backboard) or other device used to immobilize the patient’s spine.

37. Equipment, Tools, and Supplies • First Responders should know how to use, and have available whenever possible: • Appropriate barriers (masks and gloves) • Triangular bandages • Roller-type bandages • Gauze pads and trauma dressings • Occlusive dressings (for airtight seals)

38. Equipment, Tools, and Supplies • First Responders should know how to use, and have available whenever possible: • Adhesive tape • Bandage shears • Eye protector (paper cup or cone) • Stick (for tourniquet) • Blanket and pillow • Upper and lower extremity splint sets

39. Equipment, Tools, and Supplies • Optional items First Responders may use: • Blood pressure cuff and a stethoscope • Oxygen delivery systems • Suctioning equipment • The First Responder should be comfortable with the use of common hand and power tools.

40. Summary • The EMS System • Components of the EMS System • Activating the EMS System • In-Hospital Care System • Medical Oversight • Roles and Responsibilities of the First Responder • First Responder Skills • Equipment, Tools, and Supplies

41. Well-Being of the First Responder • Emotional Aspects of Emergency Care • First Responders and Stress • Critical Incident Stress Management • Body Substance Isolation (BSI) • Scene Safety • Hazardous Materials Incidents • Rescue Operations • Violence and Crime Scenes

42. Emotional Aspects of Emergency Medical Care • First Responders and Stress: • Stress contributes to: • Cardiovascular disease • Stroke • Diabetes • Cancer • Arthritis • Gastrointestinal conditions • Neurological disorders • Emotional disorders

43. Emotional Aspects of Emergency Medical Care • First Responders and Stress: • Physical demands • Psychological demands • Personnel must respond quickly to emergencies. • Personnel must react instantly to situations.

44. Emotional Aspects of Emergency Medical Care Emergencies can be stressful.

45. Stressful Situations The First Responder will experience personal stress as well as encounter patients and bystanders in severe stress.

46. Common Causes of Stress • Multiple-casualty incidents • Pediatric patients • Death • Violence • Abuse and neglect • Death or injury of a coworker

47. Multiple-Casualty Incident

48. Burnout • A reaction to cumulative stress or exposure to multiple critical incidents • The signs of burnout include: • Loss of enthusiasm and energy • Feelings of frustration • Hopelessness • Low self-esteem • Isolation • Mistrust

49. Death and Dying • As a First Responder, you will at some time have to deal with a patient who has a terminal illness or injury. • Patients, their families, and the providers will have many different reactions to the illness or injury.

50. The Grieving Process • The five stages include the following: • Denial, or “not me” • Anger, or “why me?” • Bargaining, or “OK, but first let me . . . ” • Depression • Acceptance