EMT’s and Injury Prevention

Advocates for Childrenand

Safety

EMT-BASIC SUPPLEMENT

•OSDH APPROVED 10/98•ALL EMT-BASIC COURSES•EMT-BASIC REFRESHER•WITHIN WELL BEING OF EMT

Learning ObjectivesLearning Objectives

Describe how EMT’s can be effective community activists.

Describe the Problem. Leading causes of

death and injury to kids.

Describe the Haddon Matrix and how to use it.

Discuss specific strategies for prevention.

Identify Resource Agencies.

List sources for Injury Data.

Describe methods for evaluating prevention programs.

What is an “What is an “ACCIDENT ACCIDENT ”?”?

The term “accident ” suggestssomething unpredictable,random and

therefore not preventable.

How many injuries have you responded to

that were truly from an “accident ” andnot from a “preventable incident ” ?

Injury Prevention in EMSInjury Prevention in EMS

Secondary Prevention Primary PreventionSecondary Prevention Primary Prevention

Prevention of Death Prevention ofPrevention of Death Prevention of

and Disability from Injuryand Disability from Injury

Injury Injury

A change of focus from:A change of focus from:

This is called a Paradigm This is called a Paradigm ShiftShift

Kids and Injury Kids and Injury PreventionPrevention

Children are truly our future and ourChildren are truly our future and our

legacy!legacy! Yet we fail to care for our children Yet we fail to care for our children

by providing them safe environments toby providing them safe environments to

grow up in. For the last forty years grow up in. For the last forty years InjuriesInjuries

have been the have been the leading cause of deathleading cause of death in in

children. Accounting for over children. Accounting for over 20,000 20,000 deathsdeaths

per year. per year.

Why Do Kids Get Hurt?Why Do Kids Get Hurt?

It’s Age and Development It’s Age and Development RelatedRelated Physical Attributes are varied.Physical Attributes are varied.

Motorskills haven’t fully developed.Motorskills haven’t fully developed.

Cognitive and Behavioral Cognitive and Behavioral development isn’t complete either.development isn’t complete either.

Anatomic & Physiologic differences Anatomic & Physiologic differences alter injury patterns and severity in alter injury patterns and severity in comparison to adults.comparison to adults.

InfantsInfants

BehaviorsBehaviors• Unable to Unable to

communicate verbally.communicate verbally.• Explores by mouth.Explores by mouth.• Rapid changes in Rapid changes in

motor abilities and motor abilities and mobility.mobility.

• Completely dependent Completely dependent on the care giver to on the care giver to meet needs.meet needs.

Injury RisksInjury Risks

•FallsFalls

•Suffocation & Suffocation & aspiration from aspiration from FBAO.FBAO.

•Child AbuseChild Abuse

•BurnsBurns

Toddlers & Toddlers & PreschoolersPreschoolers

Injury RisksInjury Risks• FallsFalls• Scald BurnsScald Burns• DrowningDrowning• PoisoningsPoisonings• Child AbuseChild Abuse

BehaviorsBehaviors• Curious, exploratory, Curious, exploratory, unaware of dangersunaware of dangers

• Increased mobilityIncreased mobility

• Higher center of Higher center of gravitygravity

Elementary Elementary School AgeSchool Age

BehaviorsBehaviors• Improved Motor SkillsImproved Motor Skills• Recognizes dangerRecognizes danger• Lacks experience and Lacks experience and

judgementjudgement• Increased mobility & Increased mobility &

independence independence

Injury RisksInjury Risks•Bicycle InjuriesBicycle Injuries

•Pedestrian InjuriesPedestrian Injuries

•Playground InjuriesPlayground Injuries

AdolescentsAdolescents

BehaviorsBehaviors• Risk TakersRisk Takers• Strong Peer InfluenceStrong Peer Influence• Increased IndependenceIncreased Independence• ImpulsiveImpulsive• Increased Increased

Experimentation Experimentation BehaviorsBehaviors

Injury RisksInjury Risks• Auto/Motorcycle Auto/Motorcycle CrashesCrashes

•Sports injuriesSports injuries

•Violence Related Violence Related InjuriesInjuries

•Substance AbuseSubstance Abuse

•SuicideSuicide

Anatomic & Physiologic Anatomic & Physiologic DifferencesDifferences

• General: sGeneral: surface to volume ratiourface to volume ratio , slow , slow developing coordination and motor skills.developing coordination and motor skills.

• Airway: Airway: smaller, flexible, easily smaller, flexible, easily obstructed. Tongue is larger.obstructed. Tongue is larger.

• Head: Head: larger in proportion to body. larger in proportion to body. Higher center of gravity Higher center of gravity increased falls. increased falls.

• Trunk: Trunk: chest wall is less rigid allowing for chest wall is less rigid allowing for greater compression, abdominal organs greater compression, abdominal organs are less protected also.are less protected also.

What can What can EMSEMS do to do to Help?Help?

What What EMS EMS Already Already DoesDoes

• Bystander CareBystander Care• CPRCPR•Seat Belt SafetySeat Belt Safety•First-AidFirst-Aid•Calling Calling EMS - 911EMS - 911

What Else Can We Do?What Else Can We Do?

• Identifying Risks Identifying Risks Seat-belt Use, Bicycle Helmet Use, Drunk Drivers, Seat-belt Use, Bicycle Helmet Use, Drunk Drivers,

Injuries from Airbags, etc.Injuries from Airbags, etc.

• DOCUMENT! DOCUMENT! DOCUMENT!DOCUMENT! DOCUMENT! DOCUMENT!• Speaking UP, Speaking OUT Speaking UP, Speaking OUT Traffic Control Issues, Public Access Defib, Water SafetyTraffic Control Issues, Public Access Defib, Water Safety

YOU ARE AN EXPERT!!YOU ARE AN EXPERT!!

Public EducationPublic Education• ““Make the Right Call”Make the Right Call”• Bystander CareBystander Care• CPR - Early DefibCPR - Early Defib• Public Service Public Service

AnnouncementsAnnouncements• Newspaper ArticlesNewspaper Articles• Public SpeakingPublic Speaking

BREAK TIMEBREAK TIME

Next: Principles of Injury Next: Principles of Injury ControlControl

Principles of Principles of Injury ControlInjury Control

Scope of the Scope of the ProblemProblem• Nationally:Nationally: Injuries are the leading cause of Injuries are the leading cause of

death in agesdeath in ages1-44,1-44, and the third leading and the third leading cause of death in all age groups.cause of death in all age groups.

• Most at risk are:Most at risk are: Children, minorities, those Children, minorities, those living in rural areas & with low income.living in rural areas & with low income.

• Dollars lost:Dollars lost: Lifetime costs per death Lifetime costs per death caused by injuries are almost 4 times caused by injuries are almost 4 times greater than deaths from Cancer and 6 greater than deaths from Cancer and 6 times greater than those from times greater than those from Cardiovascular Diseases. Estimates of cost Cardiovascular Diseases. Estimates of cost are $45 billion per year.are $45 billion per year.

Scope of the Scope of the ProblemProblem

In OklahomaIn Oklahoma• Death Rates areDeath Rates are HIGHER HIGHER (92 vs. 64 per (92 vs. 64 per

100,00)100,00)

• Motor Vehicle Crashes are the Motor Vehicle Crashes are the #1 #1 cause cause of death in kids aged15-19 in Oklahoma of death in kids aged15-19 in Oklahoma and the third leading cause of death in the and the third leading cause of death in the 0-1 age group. 0-1 age group.

Injuries Injuries requiring requiring treatment at a treatment at a Medical FacilityMedical Facility

Scope of the Scope of the ProblemProblem

Death is only the Death is only the ““tiptip

of the icebergof the iceberg”,”,

injuries that requireinjuries that require

treatment at atreatment at a

medical facility aremedical facility are

400400 times greater. times greater.

Injuries that Injuries that result in result in deathdeath

Who Pays for all of Who Pays for all of this?this?

WE DO!!!WE DO!!!

The 4 E’s of Injury The 4 E’s of Injury PreventionPrevention

EducationEducation

EnforcementEnforcement

EngineeringEngineering

Environmental ModificationEnvironmental Modification

EducationEducation

Changing behaviors through Changing behaviors through education is a slow process and education is a slow process and can take several years to occur.can take several years to occur.

Identify a “Target” group.Identify a “Target” group.

Education is used to increase Education is used to increase the publics’ awareness.the publics’ awareness.

EnforcementEnforcementA Great Behavior ModifierA Great Behavior Modifier

Examples:Examples:Seatbelt Compliance LawsSeatbelt Compliance Laws

Manufacturers Compliance in Manufacturers Compliance in Product SafetyProduct Safety

Product Liability AccountabilityProduct Liability Accountability

EngineeringEngineering

Technological AdvancementsTechnological Advancements

Design Changes: (Airbags)Design Changes: (Airbags)

User ProtectionUser Protection

EnvironmentalEnvironmental ModificationsModifications

Elimination or Reduction Elimination or Reduction of Riskof Risk

Community based Community based changes in behaviorschanges in behaviors

SynergySynergy

When you combine When you combine all all fourfour of the of the E’E’s,s, their their total impact is greater total impact is greater than the sums of each than the sums of each one . one . 4+4=104+4=10

The Haddon MatrixThe Haddon Matrix

EVENT Host orIndividual

Agent orVehicle

Enviroment

Pre-Event

Event

Post-Event

FactorsFactors

PP

hh

aa

ss

ee

ss

The Haddon MatrixThe Haddon MatrixPhasesPhases

Pre-event:Pre-event: Actions that can be taken Actions that can be taken prior to an events occurrence to prior to an events occurrence to prevent it from occurring.prevent it from occurring.

Event:Event: The injury causing incident and The injury causing incident and controls that are already in place to controls that are already in place to lessen the severity of the injury.lessen the severity of the injury.

Post-event:Post-event: What EMS does currently, What EMS does currently, as well as other measures designed to as well as other measures designed to stop or lessen the injury process.stop or lessen the injury process.

The Haddon MatrixThe Haddon MatrixFactorsFactors

Host:Host: Who’s involved in the injury. Who Who’s involved in the injury. Who gets hurt.gets hurt.

Agent: Agent: What objects or persons are What objects or persons are involved with the injuries occurrence. involved with the injuries occurrence. May be contributors to the injury May be contributors to the injury process or protective mechanisms.process or protective mechanisms.

Environment: Environment: Things within the Things within the community that have an influence good community that have an influence good or bad on the injury process.or bad on the injury process.

Practice Practice Session:Session:Break into Break into

workgroups and workgroups and solve an injury solve an injury

prevention problemprevention problem

Project Project DevelopmenDevelopmen

tt

Getting StartedGetting Started

• Identify the injury problem, it’s size Identify the injury problem, it’s size and severity. Data Sources ?????and severity. Data Sources ?????

• What is your target population and What is your target population and what do you know about them?what do you know about them?

• Are there existing programs in place Are there existing programs in place for this problem or it’s target for this problem or it’s target population?population?

• Don’t reinvent the wheel- look for Don’t reinvent the wheel- look for existing programs that have been existing programs that have been successful. successful.

The Planning StageThe Planning Stage• Gather together stakes holders - people Gather together stakes holders - people

with an interest in the issue. with an interest in the issue. • Include community leaders - shakers Include community leaders - shakers

and movers. They can get things done.and movers. They can get things done.• Convene a meeting on neutral turf for Convene a meeting on neutral turf for

everyone. Let it be a brain storming everyone. Let it be a brain storming session. session.

• Set goals both short and long range Set goals both short and long range with specific timelines for each.with specific timelines for each.

• Anticipate opposition and plan to Anticipate opposition and plan to overcome.overcome.

• Stay Focused!!!Stay Focused!!!

ImplementationImplementation• Convene the “Convene the “Grassroots” Grassroots” network.network.• Now involve the power brokers of the Now involve the power brokers of the

community.community.• Plan for and create early successes - Plan for and create early successes -

this breeds future success.this breeds future success.• Pick your fights carefully, if at all.Pick your fights carefully, if at all.• Involve the media and keep them Involve the media and keep them

updated on your activities.updated on your activities.• Continually seek to improve the Continually seek to improve the

program. program.

Tweak! Tweak! Tweak!Tweak! Tweak! Tweak!

A Primer on A Primer on PresentationsPresentations

A Primer for A Primer for PresentationsPresentations

• Keep the presentation age appropriateKeep the presentation age appropriate• Plan around the audiences ability to Plan around the audiences ability to

understand and reason.understand and reason.• Use age appropriate words and Use age appropriate words and

examples.examples.

KISS!!!!KISS!!!!• Modify the length of the presentation Modify the length of the presentation

to fit the audiences attention span.to fit the audiences attention span.• Each of us learn in different ways, Each of us learn in different ways,

impact all of them with your message. impact all of them with your message.

Presentation MethodsPresentation Methods

RR= = reviewreview

OO= = overviewoverview

PP= = presentpresent

EE= = exerciseexercise

SS= = summarizesummarize

Visual AidsVisual AidsA picture is worth a thousand wordsA picture is worth a thousand words

CRASCRAS

HH

Bike Bike SafetySafety

Head InjuryHead Injury

Skull Fracture

Skull Fracture

HelmetsHelmets

DeatDeathh

Brain Brain

InjuryInjury

CRASHCRASH

Death

Death

DeatDeat

hh

CRASHCRASH

CRASHCRASH

Skull Fracture

Skull Fracture

Skull Fracture

Skull Fracture

Bike SafetyBike Safety

Bike Bike

SafetySafety

Bike SafetyBike Safety

Bike Bike SafetySafety

Helmet

Helmet

ss

Helmets

Helmets

HelmetsHelmets

Head InjuryHead Injury

Head Head

InjuryInjury

Head Injury

Head Injury

Scene Size UpScene Size UpReading the AudienceReading the Audience

• SMILE, be friendlySMILE, be friendly• Move around, don’t hide behind a Move around, don’t hide behind a

podium.podium.• Make and maintain EYE contactMake and maintain EYE contact• Facilitate Group ParticipationFacilitate Group Participation

RememberRemember ATTITUDEATTITUDE is is everythingeverything

Be ProfessionalBe Professional

Remember the Boy Scout Remember the Boy Scout Motto:Motto:

BE BE PREPAREDPREPARED

The EndThe End