Chapter 2Action at an Emergency

Emergencies

Are:• dangerous.• unusual and rare. • different from one

another.• unforeseen.• urgent.

Bystander Actions (1 of 4)

A bystander is a vital link between emergency medical services (EMS) and the victim.

Bystander Actions (2 of 4)

The bystander must make a series of decisions quickly and reliably. • Recognize the emergency.• Decide to help.• Call 9-1-1 if EMS is needed.• Check the victim.• Give first aid.

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.

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The quality of help provided by bystanders can be inadequate or potentially dangerous.• Poor decisions can be made.• Outdated and unproven first aid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.

What Should Be Done?Recognize the Emergency

• Recognize:• Severity• Physical

distance• Relationship• Time exposed

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.

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.

What Should Be Done?

• Call 9-1-1 if EMS is needed. • Wrong decisions include:

• Delay• Bypassing EMS

• Check the victim.• Give first aid.

Seeking Medical CareKnow 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?

Seeking Medical CareWhen 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

Seeking Medical CareWounds 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.

Call 9-1-1 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.

How to Call EMS (1 of 2)

• Most communities dial 9-1-1 to receive emergency assistance.

• Emergency numbers are usually listed on the inside front cover of telephone directories.

©AbleStock

How to Call EMS (2 of 2)

• 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.

How to Call EMS Important Tips

• Teach children when and how to use 9-1-1.

• If you called 9-1-1 accidentally, explain why. Do not hang up.

• Add EMS, fire, and police numbers to a list by your phone.

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.

Scene Size-upIn 10 seconds, look for:

• hazards. • cause of the injury or

illness.• number of victims.

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.

Standard PrecautionsDeveloped 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.

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.

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.

Personal Protective Equipment (PPE)

• Provides a barrier between the first aider and victim

• Exam gloves• Most common PPE• Should always be worn

How to Remove Gloves (1 of 4)

• Partially remove the first glove by pinching at the wrist.

How to Remove Gloves(2 of 4)

• Remove the second glove by pinching the exterior with the partially gloved hand.

How to Remove Gloves(3 of 4)

• Pull the second glove inside-out toward the fingertips.

How to Remove Gloves(4 of 4)

• Grasp both gloves with your free hand, touching only the clean, interior surfaces.

Other Personal Protective Equipment

• Mouth-to-barrier devices • Recommended

when administering CPR

• Eye protection• Gowns/aprons

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.

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.

Diseases of Special ConcernBloodborne Diseases

Bloodborne diseases are diseases carried by an infected person’s blood, such as:

• HIV• Hepatitis B virus (HBV)• Hepatitis C virus (HCV)

Diseases of Special ConcernAirborne Diseases

Airborne diseases are transmitted through the air by coughing or sneezing.

• Tuberculosis• Severe acute respiratory syndrome (SARS)

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.

Death and Dying (2 of 3)

The grieving process• Denial• Anger• Bargaining• Depression• Acceptance

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.