1. Chapter 2
Action at an Emergency

2. Emergencies Are: dangerous. unusual and rare.
different from one another.
unforeseen.
urgent.

3. Bystander Actions (1 of 4)
A bystander is a vital link between emergency medical services (EMS) and the victim.

4. Bystander Actions (2 of 4)
The bystander must make a series of decisions quickly and reliably.
Recognize the emergency.
Decide to help.
Call if EMS is needed.
Check the victim.
Give first aid.

5. Bystander Actions (3 of 4)
Bystanders are less likely to offer help in public places because they:
lack knowledge.
are confused about what is an emergency.
are influenced by the characteristics of the emergency.

6. Bystander Actions (4 of 4)
The quality of help provided by bystanders can be inadequate or potentially dangerous.
Poor decisions can be made.
Outdated and unproven first aid procedures may be used.

7. What Should Be Done? Recognize the Emergency
Severity
Physical distance
Relationship
Time exposed

8. What Should Be Done? Deciding to Help
Appreciate the importance of bystander help.
Feel confident enough about helping.
Be willing to take the time to help.
Put the potential risks of helping in perspective.
Feel comfortable about taking charge.
Feel comfortable about seeing or touching a victim who is bleeding, is vomiting, or appears dead.

9. What Should Be Done? Deciding Not to Help
It could be harmful.
Helping doesn’t matter.
Obstacles can prevent helping.
No other bystanders are helping.

10. What Should Be Done? Call 9-1-1 if EMS is needed. Check the victim.
Wrong decisions include:
Delay
Bypassing EMS
Check the victim.
Give first aid.

11. Seeking Medical Care Know When to Call 9-1-1
Is the victim’s condition life threatening?
Could the condition get worse on the way to the hospital?
Does the victim need the skills or equipment of EMS?
Could the distance or traffic conditions cause delay?
Is a spinal injury suspected?

12. Seeking Medical Care When Is Immediate Transport Necessary?
Chest pain lasts 2 minutes or more
Uncontrolled bleeding
Sudden or severe pain
Coughing or vomiting blood
Difficulty breathing, shortness of breath
Sudden dizziness, weakness, or fainting
Changes in vision
Difficulty speaking
Severe or persistent vomiting or diarrhea
Change in mental status
Suicidal or homicidal feelings
Wounds needing immediate medical care

13. Seeking Medical Care Wounds That Need Immediate Care
Bleeding from a cut does not slow during the first minute of steady direct pressure.
Signs of shock occur.
Breathing is difficult because of a cut to the neck or chest.
A deep cut to the abdomen causes moderate to severe pain.
There is a cut to the eyeball.
A cut amputates, or partially amputates, an extremity.

14. Call First
Many victims should be moved only by trained personnel.
EMS personnel know what to do and are in radio contact with hospital physicians.
EMS care can increase a victim’s chances of survival and rate of recovery.
An EMS ambulance can get a victim to the hospital quicker.

15. How to Call EMS (1 of 3)
Most communities dial to receive emergency assistance.
Emergency numbers are usually listed on the inside front cover of telephone directories.
©AbleStock

16. How to Call EMS (2 of 3) Speak slowly and clearly.
Give the victim’s location.
Give the phone number you are calling from and your name.
Describe what happened.
Give the number of people needing help.
Describe the victim’s condition.
Do not hang up until instructed to do so.

17. How to Call EMS (3 of 3) Important Tips
Teach children when and how to use
If you called accidentally, explain why. Do not hang up.
Add EMS, fire, and police numbers to a list by your phone.

18. Rescuer Reactions
It is not unusual to have adverse physical reactions during an emergency.
First aiders must stay alert and working.
Desensitization can be effective in eliminating fears and anxieties.
Posttraumatic stress disorder (PTSD) is a feeling of emotional letdown.

19. Scene Size-up In 10 seconds, look for: hazards.
cause of the injury or illness.
number of victims.
Courtesy of Lara Shane/FEMA

20. Disease Precautions
First aiders must understand the risks of infectious diseases.
A communicable disease is a disease that can spread from one person to another.

21. Standard Precautions Developed by the Centers for Disease Control and Prevention (CDC)
Assume that all victims are infected and can spread an organism that poses a risk from transmission of infectious diseases.

22. Handwashing (1 of 2) Wash before and after contact with a victim.
Use soap and water if possible.
Rub hands together for 15 to 20 seconds.
Wash wrists, palms, backs of hands, and fingers.
Rinse.
Dry completely with a clean towel.

23. Handwashing (2 of 2)
Use an alcohol-based hand sanitizer if soap and water are not available.
Apply gel.
Rub hands together until hands are dry.

24. Personal Protective Equipment (PPE)
Provides a barrier between the first aider and victim
Exam gloves
Most common PPE
Should always be worn

25. How to Remove Gloves (1 of 4)
Partially remove the first glove by pinching at the wrist.

26. How to Remove Gloves (2 of 4)
Remove the second glove by pinching the exterior with the partially gloved hand.

27. How to Remove Gloves (3 of 4)
Pull the second glove inside-out toward the fingertips.

28. How to Remove Gloves (4 of 4)
Grasp both gloves with your free hand, touching only the clean, interior surfaces.

29. Other Personal Protective Equipment
Mouth-to-barrier devices
Recommended when administering CPR
Eye protection
Gowns/aprons

30. Cleaning Up Wear heavier gloves than lightweight latex or vinyl.
Use absorbent barriers to soak up blood and other materials.
Clean the area using soap and water.
Disinfect.
Discard contaminated materials properly.

31. Exposure to Blood or Body Fluids
Wash contaminated area with soap and water.
Report incident to supervisor.
Contact personal physician.
Seek medical care if exposure was significant.

32. Diseases of Special Concern Bloodborne Diseases
Bloodborne diseases are diseases carried by an infected person’s blood, such as:
HIV
Hepatitis B virus (HBV)
Hepatitis C virus (HCV)

33. Diseases of Special Concern Airborne Diseases
Airborne diseases are transmitted through the air by coughing or sneezing.
Tuberculosis
Severe acute respiratory syndrome (SARS)

34. Death and Dying (1 of 3) To assist a dying person:
Avoid negativity.
Assure the victim you will locate and inform his or her family.
Allow some hope.
Do not volunteer information to others.
Offer simple, clear, honest information if asked.
Use a gentle tone.
Use a reassuring touch.
Indicate that everything that can be done to help will be.

35. Death and Dying (2 of 3) The grieving process Denial Anger Bargaining
Depression
Acceptance

36. Death and Dying (3 of 3) To deal with a family member:
Leave the confirmation of death to a physician.
Allow survivors to grieve.
Provide simple, honest, clear information.
Offer support and comfort.
Do not leave an individual survivor alone, but respect privacy.
Use a gentle tone.
Use a reassuring touch.