3. 4 Emergency Readiness  Identify causes of emergencies.  Distinguish safety and emergency signs, codes, and symbols.  Summarize how to respond to various disasters.  Summarize fire prevention and fire safety practices.  Demonstrate the appropriate response to an emergency fire situation.

4. 4 Emergency Readiness  Assess what is wrong with an injured or sick person.  Apply knowledge to an initial assessment and a focused exam.  Demonstrate cardiopulmonary resuscitation (CPR) for the one-rescuer adult, child, and infant and the two-rescuer adult.  Practice responsive and unresponsive foreign body airway obstruction (FBAO) for adult, child, and infant.  Practice 16 first-aid and CPR procedures.

5. 4.1 Emergency Readiness 4.1 Emergency Readiness Topics 0 Medical Emergencies 0 First Aid 0 Contacting EMS 0 Safety and Emergency Signs 0 Bioterrorism and Disasters

6. 4.1 Emergency Readiness Medical Emergencies 0 A medical emergency is any situation in which a person suddenly becomes ill or sustains an injury that requires immediate help by a healthcare professional.

7. 4.1 Emergency Readiness First Aid 0 First Aid is the initial help given to a sick or injured person. 0 First aid may include: 0 Dialing 911 0 Providing cardiopulmonary resuscitation CPR ( A series of ventilations (breaths) and chest compressions used on a person who has stopped breathing or whose heart has stopped.)

8. 4.1 Emergency Readiness Contacting EMS 0 STEPS 0 Speak clearly. 0 Speak calmly. 0 Provide all important information. 0 Do not hang up until the dispatcher gives you permission to do so.

9. Contacting EMS Practice 0 911 : What is your Emergency? 0 What is your location and phone number? 0 Which entrance will we go in? 0 Important information:

10. 4.1 Emergency Readiness Safety and Emergency Signs 0 To maintain safety and be prepared for an emergency, it is essential to recognize safety insignia. 0 Most healthcare facilities use emergency codes that are defined by color.

11. 4.1 Emergency Readiness Safety and Emergency Signs

14. 4.1 Emergency Readiness Bioterrorism and Disasters 0 Bioterrorism is the intentional release of a biologic agent with the intent to cause harm. 0 A healthcare professional must be familiar with the steps for responding to all disasters. 0 A healthcare facility should have evacuation and shelter-in-place plans. 0 Maps of the facility with escape routs clearly marked should be posted.

16. 4.1 Emergency Readiness What is cardiopulmonary resuscitation (CPR)?

17. 4.1 Emergency Readiness A series of ventilations (breaths) and chest compressions used on a person who has stopped breathing or whose heart has stopped. What is cardiopulmonary resuscitation (CPR)?

18. 4.2 Fire Safety 4.2 Fire Safety Concepts 0 Fire Triangle 0 Types of Extinguishers 0 How to Use a Fire Extinguisher 0 When a Fire Emergency Occurs 0 Emergency Fire Rules

19. 4.2 Fire Safety Fire Triangle 0 Fire can occur in any setting when three elements are present. The elements necessary for a fire risk to occur are 0 fuel (something that will burn), 0 heat (a temperature high enough to allow the fuel to burn), and 0 oxygen (to feed the fire).

20. Fire Extinguishers Class A (Water) B (Carbon dioxide) C (K bicarbonate) D ABC (Chemical) Common combustibles Flammable liquids Electrical Combustible metals (magnesium) All ABC fires Application Types of Extinguishers 0 5 types are available, with ABC being the most common.

21. 4.2 Fire Safety How to Use a Fire Extinguisher 0 Remember the key word PASS: 0 P = Pull the pin. 0 A = Aim at the base of the fire. 0 S = Squeeze handle. 0 S = Sweep nozzle from side to side to displace oxygen away from the fire.

22. 4.2 Fire Safety When a Fire Emergency Occurs 0 Remember the key word RACE: 0 R = Rescue. 0 A = Alarm. Assign someone to pull the alarm. 0 C = Contain. Close the windows and doors. 0 E = Evacuate.

23. 3 rd Floor Plan 4.2 Fire Safety Emergency Fire Rules 0 Be prepared! Know your responsibilities. 0 Know when and how to evacuate. 0 Know where the fire alarms are located and how to activate them. 0 Keep fire extinguishers in plain view and readily accessible.

24. 4.2 Fire Safety Emergency Fire Rules (cont.) 0 Keep areas uncluttered. 0 Evacuate ambulatory patients first, then the wheel- chair bound, then the bed-bound. 0 If possible, never leave a patient alone in a fire emergency. 0 Never use an elevator in a fire situation. 0 Never open windows. 0 Never open a door that feels hot.

25. 4.2 Fire Safety How should you operate a fire extinguisher?

26. 4.2 Fire Safety P = Pull the pin. A = Aim at the base of the fire. S = Squeeze handle. S = Sweep nozzle from side to side to displace oxygen away from the fire. How should you operate a fire extinguisher?

27. 4.3 Basics of First Aid 0 Consent 0 Responsibilities of First-Aid Providers 0 Evaluating the Scene 0 The Primary Assessment 0 The Secondary Assessment

28. Basics of First Aid 0 First aid is the initial help and care provided to a sick or injured person. It is not a replacement for medical help. 4.3 Basics of First Aid

29. Consent 0 Consent must be obtained before applying first aid to a conscious adult. 0 Consent is implied for an unconscious person. 4.3 Basics of First Aid

30. Responsibilities of First-Aid Providers 0 Recognize an emergency based on the patient’s appearance, behavior, or surroundings. 0 Make a decision to help. 0 Call EMS if the situation dictates. 4.3 Basics of First Aid

31. Responsibilities of First-Aid Providers (cont.) 0 Safely gain access to the patient and determine what is wrong. 0 Provide first aid. 0 Stay with the patient until EMS arrives. 4.3 Basics of First Aid

32. Evaluating the Scene 0 Determine the possibility of threats to yourself, the patient, and bystanders. 0 Determine the nature or cause of the illness or injury. 0 Determine the number of sick or injured. Then call EMS if necessary, and report your findings. 4.3 Basics of First Aid

33. 4.3 Basics of First Aid The Primary Assessment 0 For a conscious and responsive patient, introduce yourself by name, state that you know first aid, and ask if you can help. 0 Based on the patient’s response, you can perform an initial assessment.

34. 4.3 Basics of First Aid The Primary Assessment (cont.) 0 Form an impression of the patient by asking yourself the following questions: 0 How does the patient look? 0 How is the patient behaving? 0 Does the patient appear to be in distress or pain? 0 Do you see any bleeding? 0 What color is the patient?

35. 4.3 Basics of First Aid The Primary Assessment (cont.) 0 For an unresponsive patient, follow these steps: 0 Assuming no neck or back injuries, position the patient on his or her back. 0 Check for responsiveness by lightly tapping the patient on the shoulder and speaking to him or her. If no response, continue with the ABCs.

36. 4.3 Basics of First Aid The Primary Assessment (cont.) 0 ABCs of an initial assessment 0 A – make sure the airway is open. 0 B – check for breathing. 0 C – check circulation by taking pulse.

37. 4.3 Basics of First Aid The Primary Assessment (cont.) 0 Airway – check by using the head tilt-chin lift method. For suspected neck or back injury use the jaw thrust maneuver. 0 Breathing – check for breathing using the look, listen, and feel method. 0 Circulation – check for signs of circulation.

38. 4.3 Basics of First Aid Secondary Assessment 0 Conduct a focused exam unless the patient requires resuscitation. 0 The focused exam immediately follows the initial assessment. 0 Focused exams need not be performed on patients with minor injuries or illness. 0 NEVER move a patient with suspected neck or back injuries.

39. 4.3 Basics of First Aid Secondary Assessment (cont.) 0 Have someone hold the patient’s head, then perform the following steps: 0 Head – look at and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling.

40. 4.3 Basics of First Aid Secondary Assessment (cont.) 0 Eyes – gently open the eyes and compare the pupils. They should be the same size. 0 Neck – look and feel for deformities, bruises, depressions, open wounds, tenderness, and swelling. Check for a medical alert necklace.

41. Secondary Assessment (cont.) 0 Chest – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. 0 Abdomen – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. 4.3 Basics of First Aid

42. Secondary Assessment (cont.) 0 Pelvis – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. 0 Legs – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. Compare the skin color, temperature, and size of both legs. 4.3 Basics of First Aid

43. Secondary Assessment (cont.) 0 Arms – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. Compare the skin color, temperature, and size of both arms. 0 Back – slide your hand under the back as far as it will go, without moving the patient. Look and feel for bleeding, deformities, bruises, open wounds, depressions, tenderness, and swelling. 4.3 Basics of First Aid

44. 4.3 Basics of First Aid Obtaining Information From a Patient 0 Use the memory aid SAMPLE to gather information relating to the patient’s symptoms and medical history. 0 S = Signs and Symptoms: “What seems to be bothering you today?” or “What is wrong?” 0 A = Allergies: “Are you allergic to any medications?” “What are they?” 0 M = Medications: “What prescription or over-the-counter medications, vitamins, or herbal remedies are you taking?” 0 P = Pertinent Past Medical History: “Have you ever had this problem before?” “What was it?” “What other medical problems or conditions do you have?” 0 L = Last Oral Intake: “When was the last time you ate or drank something?” “What was it?” 0 E = Event preceding: “What were you doing when this happened?” “How did it happen?” 0 If possible, write down the findings of your primary and secondary assessments and history to give to EMS providers when they arrive.

45. 4.3 Basics of First Aid When should you move a patient with a neck or back injury?

46. 4.3 Basics of First Aid NEVER move a patient when you think that the patient has a neck or back injury. When should you move a patient with a neck or back injury?

47. 4.4 Cardiopulmonary Resuscitation 0 The Chain of Survival 0 Using Barrier Devices and Face Masks 0 Using a Bag-Valve Mask 0 Cardiopulmonary Resuscitation 0 Foreign Body Airway Obstruction

48. 4.4 Cardiopulmonary Resuscitation The Chain of Survival 0 Sudden cardiac arrest occurs when the heart suddenly stops beating. 0 Ventricular fibrillation (VF) occurs when the heart stops beating and just quivers.

49. 4.4 Cardiopulmonary Resuscitation The Chain of Survival (cont.) 0 Five links in the chain of survival: 0 Early access to EMS. 0 Early CPR with an emphasis on chest compressions. 0 Rapid defibrillation. 0 Effective advanced life support. 0 Integrated post-cardiac arrest care.

50. 4.4 Cardiopulmonary Resuscitation Using Barrier Devices and Face Masks 0 Follow appropriate infection control procedures, including use of latex or vinyl gloves and barrier devices.

51. 4.4 Cardiopulmonary Resuscitation Using a Bag-Valve Mask 0 A bag-valve mask (BVM) consists of a self-inflating bag and a one-way valve attached to a face mask. 0 A BVM is most effective when two first-aiders work together and use supplemental oxygen.

52. 4.4 Cardiopulmonary Resuscitation 0 Three “red flags” for victims of sudden cardiac arrest: 0 No response when spoken to or touched. 0 No signs of circulation such as coughing, movement, or pulse. 0 No breathing or inadequate breathing.

53. 4.4 Cardiopulmonary Resuscitation Foreign Body Airway Obstruction 0 Foreign body airway obstruction (FBAO) can occur in patients of all ages. 0 Perform abdominal thrusts or chest thrusts until object is expelled.

54. 4.4 Cardiopulmonary Resuscitation Name the five links in the chain of survival.

55. 4.4 Cardiopulmonary Resuscitation 1.Early access to EMS. 2.Early CPR. 3.Rapid defibrillation. 4.Effective advanced live support. 5.Integrated post-cardiac arrest care. Name the four links in the chain of survival.

56. Injuries to bones, joints, and muscles Diabetic emergencies Heat emergencies Cold-related emergencies Poisons Heart attack Stroke Minor wounds External bleeding Internal bleeding Shock Anaphylaxis Burns 4.5 First Aid for Specific Emergencies Emergencies 0 The most common types of emergencies are:

57. 4.5 First Aid for Specific Emergencies What are four signs or symptoms of an injured extremity?

58. 4.5 First Aid for Specific Emergencies 1.Deformity 2.Pain and tenderness 3.Swelling 4.Bruising What are four signs or symptoms of an injured extremity?

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