Lesson 36: Reaching and Moving Victims in the Water.

Lesson 36: Reaching and Moving Victims in the Water

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITIONCopyright © 2006 by The American National Red Cross

All rights reserved.2

Introduction

Water provides people with some of the most enjoyable recreational activities, but water can be dangerous.

Drowning is death by suffocation in water.

Drownings may occur during swimming, boating, hunting, fishing or while taking a bath.



The Risk of Drowning

Children younger than age 5 and young adults ages 15 to 24 have the highest rates of drowning.



Preventing Aquatic Emergencies

The best thing anyone can do to stay safe in, on and around the water is to learn to swim.

The American Red Cross has swimming courses for people of any age and swimming ability. To enroll in a swimming course, contact a local Red Cross chapter.



Preventing Aquatic Emergencies (continued)

Follow these guidelines whenever you are swimming in any body of water (pools, lakes, ponds, quarries, canals, rivers or oceans):

Always swim with a buddy; never swim alone.

Read and obey all rules and posted signs.

Swim in areas supervised by a lifeguard.

Children or inexperienced swimmers should take extra precautions, such as wearing a U.S. Coast Guard-approved life jacket when around the water.



Preventing Aquatic Emergencies(continued)

Watch out for the “dangerous too’s”:

Too tired

Too cold

Too far away from safety

Too much sun

Too much strenuous activity

Be knowledgeable of the water environment and the potential hazards.

Know how to prevent, recognize and respond to emergencies.



Preventing Aquatic Emergencies(continued)

Use a feet-first entry when entering the water.

Enter head-first only when the area is clearly marked for diving and has no obstruction.

Do not mix alcohol with swimming, diving or boating.



Recognizing an Emergency

An emergency can happen to anyone in, on or around the water.

The key to recognizing an emergency is staying alert and knowing the signals that indicate an emergency is happening.



Recognizing an Emergency (continued)

There are two kinds of water emergency situations:

A swimmer in distress

A drowning victim

A distressed swimmer may be too tired to get to the shore or the side of the pool but is able to stay afloat and breathe and may be calling for help.

An active drowning victim is vertical in the water but unable to move forward or tread water. The victim is struggling to keep his or her head above water to breathe.

A passive drowning victim is not moving and will be floating face-down on the bottom or near the surface of the water.



Recognizing an Emergency(continued)

Once you know there is an emergency, you must decide to act and decide how to act.

Follow the emergency action steps: CHECK—CALL—CARE.

Make sure the scene is safe—do not go rushing into a dangerous situation where you too may become a victim.



Recognizing an Emergency(continued)

Always check first to see whether a lifeguard or other trained professional is present.

If you must assist someone who is having trouble in the water, you must have the appropriate equipment.

Send someone else to call 9-1-1 or the local emergency number.



Out-of-Water Assists

You can help a person in trouble in the water by using reaching assists or throwing assists.

Out-of-water assists are safer for you.

Start the rescue by talking to the victim.

Let the victim know help is coming.

Tell the victim what you want him or her to do to help with the rescue.



Reaching Assists

If the victim is close enough, you can use a reaching assist to help him or her out of the water.

If available, use any object that will extend your reach, such as a pole, an oar or paddle, a tree branch, a shirt, a belt or a towel.



Reaching Assists(continued)

If there is equipment available—

1. Brace yourself on a pool deck, pier surface or shoreline.

2. Extend the object to the victim.

3. When the victim grasps the object, slowly and carefully pull him or her to safety. Keep your body low and lean back to avoid being pulled into the water.



Reaching Assists(continued)

If you have no equipment available to perform a reaching assist, you should—

1. Reach with one arm and grasp the victim.

2. Pull the victim to safety.

3. Brace yourself on the pool deck or pier surface.

If you are already in the water—

1. Hold onto the pool ladder, overflow trough, piling or some other secure object with one hand.

2. Extend your free hand or one of your legs to the victim. Do not let go of the secure object and do not swim out into the water.

3. Pull the victim to safety.



Throwing Assists

You can rescue a conscious victim out of reach by using a throwing assist. Use anything that will provide the victim support.



Throwing Assists(continued)

A floating object with a line attached can be used to throw to the victim and pull him or her to safety.

To perform a throwing assist, follow these guidelines:

1. Get into a stride position.

2. Step on your end of the line with your forward foot.

3. Shout to get the victim’s attention.

4. Bend your knees and throw the object to the victim.

5. When the victim has grasped the object or the line, slowly pull him or her to safety.

6. If the object does not reach the victim, quickly pull the line back in and throw again.



Wading Assist with Equipment

To perform a wading assist, follow these steps:

1. Take a buoyant device with you.

2. Wade into the water and extend the object to the victim.

3. When the victim has grasped the object, tell him or her to hold onto the object tightly for support and pull him or her to safety.

A victim who has been lying motionless and face-down in the water for several seconds is probably unconscious.

1. If the water is not over one’s chest, wade into the water carefully with some kind of flotation equipment and turn the person face-up.

2. Bring him or her to the side of the pool or shoreline.

3. Remove the victim from the water.

4. Give care if needed.



Wading Assist with Equipment(continued)

If a victim is discovered on or near the bottom of the pool in deep water, call for trained help immediately.

If in shallow water less than chest deep and a head, neck or back injury is not suspected—

1. Reach down and grasp the victim.

2. Pull the victim to the surface.

3. Turn the victim face-up and bring him or her to safety.

4. Remove the victim from the water.

5. Give care if needed.



Walking Assist

If the victim is in shallow water where he or she can stand, he or she may be able to walk out of the water with some support.

To perform a walking assist, follow these guidelines:

1. Place one of the victim’s arms around your neck and over your shoulder.

2. Grasp the wrist of the arm that is over your shoulder and wrap your free arm around the victim’s back or waist.

3. Maintain a firm grasp and help the victim walk out of the water.



Beach Drag

You may use the beach drag with a victim in shallow water on a sloping shore or beach. This method works well with a heavy or unconscious victim.

To perform the beach drag—

1. Stand behind the victim and grasp him or her under the armpits. Support the victim’s head with your forearms.

2. While walking backward slowly, drag the victim toward the shore.

3. Remove the victim completely from the water or at least get the victim’s head and shoulders out of the water.



Head, Neck, or Back Injury Management in the Water

Most injuries to the head, neck or back occur in shallow water.

These injuries may result from diving into shallow water, diving into above-ground pools and unsupervised diving from starting blocks.

Injuries can also result from head-first entry into the surf at a beach, off a pier at a lake, from a cliff into a water-filled quarry or from falling while surfing or boogie boarding.



Recognizing a Head, Neck or Back Injury

Usually a head, neck or back injury is caused by hitting the bottom or an object in the water.



Recognizing a Head, Neck or Back Injury(continued)

Your major concern is to—

Keep the victim’s face out of the water to let him or her breathe.

Prevent the victim’s head and back from moving further.

Move the victim to safety.

Always check first whether a lifeguard or other trained professional is present.



General Guidelines for Care

Follow these guidelines for a victim with a suspected head, neck or back injury in shallow water:

1. Be sure someone has called 9-1-1 or the local emergency number.

2. Minimize movement of the victim’s head, neck and back.

• Try to keep the victim’s head in line with the body.

• This technique is called manual stabilization.

• Do this without pulling the head.



General Guidelines for Care(continued)

3. Position the victim face-up at the surface of the water.

4. Check for consciousness and breathing once you have stabilized the victim’s head, neck and back using the manual stabilization technique.

• A victim who can talk or is gasping for air is conscious and breathing.

5. Support the victim with his or her head, neck and back immobilized until help arrives.



Specific Immobilization Techniques

The following sections describe two methods for stabilizing the victim’s head, neck and back in the water.



Specific Immobilization Techniques(continued)

Two methods for immobilizing a head, neck or back injury are the hip shoulder support or the head splint technique.

To perform the hip and shoulder support—

1. Approach the victim from the side and lower yourself to chest depth.

2. Slide one arm under the victim’s shoulders and the other arm under the hip bones. Support the victim horizontally, keeping the face clear of the water.

3. Do not lift the victim, but support him or her in the water until help arrives.




To perform the head splint technique—

1. Approach the victim from the side.

2. Gently move the victim’s arms up alongside the head by grasping the victim’s arms midway between the shoulder and elbow.

• Grasp the victim’s right arm with your right hand.

• Grasp the victim’s left arm with your left hand.

3. Squeeze the victim’s arms against his or her head. This helps to keep the head in line with the body.




4. With your body at about shoulder depth in the water, glide the victim slowly forward.

5. Continue moving slowly and rotate the victim toward you until he or she is face-up.

6. Position the victim’s head in the crook of your arm with the head in line with the rest of the body.

7. Maintain this position in the water until help arrives.



Helping Someone Who Has Fallen Through Ice

If a person falls through ice, never go out onto the ice yourself to attempt a rescue.



Helping Someone Who Has Fallen Through Ice(continued)

Follow these guidelines:

1. Send someone to call 9-1-1 or the local emergency number immediately.

2. From a secure place on land, try a reaching or throwing assist.

3. If it is possible to do so safely, pull the victim to shore. If it is not, talk to the victim and make sure he or she is secure as possible with the object until help arrives.



Closing

Many drownings can be prevented by following simple precautions when in, on or around water.

Use the basic methods of reaching, throwing or wading to reach or assist a victim in the water without endangering yourself. Always remember to stay safe.

If there is any chance that you cannot safely and easily help the victim in trouble, call for professional assistance.



Closing(continued)

Further training in water safety and lifeguarding is available through local Red Cross chapters.

Questions?

Lesson 37: People with Special Needs



Introduction

In an emergency, be aware of the special needs and considerations of—

Children.

Older adults.

People with disabilities.

People who do not speak the same language you speak.

Knowing about these needs and considerations will help you give appropriate care.

Being able to communicate with and reassure people with special needs is essential for you to care for them effectively.



Infants and Children

Infants and children have unique needs and require special care.

Assessing a conscious infant’s or child’s condition can be difficult.

At certain ages, infants and children do not readily accept strangers.

Infants and very young children cannot tell you what is wrong.



Communicating with an Ill or Injured Child

You need to reduce the child’s anxiety and panic and gain the child’s trust and cooperation if possible.



Communicating with an Ill or Injured Child(continued)

A child has certain fears. These include—

The unknown.

Being ill or injured.

Being touched by strangers.

Being separated from parents or a guardian.

To interact with an ill or injured infant or child is very important.

Move in slowly.

Keep a calm voice.

Smile at the child.




Ask the child’s name.

Talk slowly and distinctly.

Explain to the child and parents or guardian what you are going to do.

Reassure the child.

Children act differently depending on their age.

Infants (birth to 1 year)

Infants less than 6 months old are relatively easy to approach.

Older infants often exhibit “stranger anxiety.”




Toddlers (1 to 2 years)

Toddlers may not cooperate.

They need reassurance.

A toddler may also respond to praise or be comforted.

Preschoolers (3, 4 and 5 years)

Children in this age group are usually easy to check.

Allow them to inspect items such as bandages.

They need reassurance that you are going to help and will not leave them.

Demonstrate on a stuffed animal or doll what you are going to do to them.




School-age children (6 to 12 years)

School-age children are usually cooperative.

Do not let the child’s general chronological age influence you to expect an injured or ill child to behave in a way consistent with that age.

Be especially careful not to talk down to these children.

Let them know if you are going to do anything that may be painful.

Make every effort to respect their modesty.




Adolescents (13 to 18 years)

Adolescents consider themselves more adult than child.

They respond better when you direct your questions about what happened to them.

They are modest and respond better to responders of the same gender.



Interacting with Parents and Guardians

To interact with an ill or injured child and his or her parents—

Calm the family and the child will often calm down as well.

Get consent to care for the child.

Behave as calmly as possible.



Observing an Infant or Child

Look for signals that indicate changes:

Level of consciousness

Trouble breathing

Apparent injuries and conditions

You can check a conscious child while the parent or guardian is holding him or her.



Observing an Infant or Child(continued)

Use a toe-to-head check.

Ask a young child to point to any place that hurts. An older child can tell you the location of painful areas.

If you need to hold an infant, always support the head when you pick him or her up.



Special Problems

Certain problems are unique to children, such as specific kinds of injury and illness.

Injury

Illness

Poisoning

Child abuse

Sudden Infant Death Syndrome (SIDS)



Injury

Injury is the number one cause of death for children in the United States.

Many of these deaths are the result of motor vehicle crashes.

Severe bleeding must be controlled as quickly as possible.

The head is the most often injured part of the child’s body.



Illness

Certain signals in an infant or child can indicate specific illnesses. Often these illnesses are not life threatening, but some can be.

A high fever in a child often indicates some form of infection.

Your initial care for a child with a high fever is to—

Gently cool the child.

Remove excessive clothing or blankets.

Sponge the child with lukewarm water.

Call a physician at once.

Not give the child aspirin.



Poisoning

Poisoning is the fifth-largest cause of unintentional death in the United States for people ages 1 to 24.

For the youngest of these victims, mainly children under 5 years of age, poisoning often occurs from ingesting household products or medications.



Child Abuse

Child abuse is the physical, psychological or sexual assault of a child, resulting in injury and emotional trauma.

Child abuse involves an injury or pattern of injuries that happen to a child and are not the result of a mishap.

Signals of child abuse include—

An injury that does not fit the description of what caused the injury.

Obvious or suspected fractures in a child younger than 2 years of age or any unexplained fractures.

Bruises and burns in unusual shapes.



Child Abuse(continued)

Injuries in various stages of healing, especially bruises and burns.

Unexplained lacerations and burns, especially to the mouth, lips and eyes.

Injuries to the genitalia; pain when the child sits down.

More injuries than are typical for a child of that age.

The child’s unwillingness to talk about the situation.

If you suspect abuse, explain your concerns to responding police officers or EMS personnel if possible.



Child Abuse(continued)

If you think you have reasonable cause to believe that abuse has occurred, report your suspicions to a community or state agency, such as the Department of Social Services, the Department of Child and Family Services or Child Protective Services.



Sudden Infant Death Syndrome (SIDS)

SIDS is a disorder that causes seemingly healthy infants to stop breathing while they sleep.

SIDS is a leading cause of death among children ages 1 month to 1 year.



Sudden Infant Death Syndrome (SIDS)(continued)

Care for the child as you would other cardiac arrest victims. Perform CPR and have someone call 9–1–1 or the local emergency number.

An incident involving a severely injured or ill infant or child or one who has died can be emotionally upsetting.



Older Adults

Older adults, or the elderly, are generally considered those people over 65 years of age.

Normal aging brings about change. Body functions decline as we age.



The Aging Process

Aging brings about the following changes and decline in function:

Lungs are less efficient.

The amount of blood pumped by the heart decreases.

Heart rate slows down.

Blood vessels harden.

Hearing and vision usually decline.

Reflexes become slower and arthritis may affect joints.



Checking an Older Adult

Checking an older adult may be difficult.

When checking an older adult’s condition—

Learn the victim’s name.

Be respectful.

Position yourself at the victim’s eye level.

Assess the cause of any confusion the victim is experiencing.

Confusion may be a result of impaired vision or hearing loss. Find the victim’s glasses or other aids.

Speak slowly and clearly and look at the person’s face while you talk.



Checking an Older Adult(continued)

Find out if the victim is using medications or has known medical conditions.

Recognize that the victim may minimize signals of an injury for fear of losing his or her independence.



Special Situations

Physical and mental changes can occur as a result of aging. Because of these changes, many older adults are susceptible to certain problems, such as—

Falls.

Head injuries.

Confusion.

Heat and cold emergencies.



People with Disabilities

The absence or loss of motor, sensory or mental function is called a disability.

Impairment is damage or reduction in quality, quantity, value or strength of the function.



People with Disabilities(continued)

General guidelines for approaching an ill or injured person whom you believe is in some way disabled include—

Speaking to the person before touching him or her.

Asking if or how you can help.

Asking the person and any available family or friends for information about his or her condition.

Not removing any physical aids or supports.

Looking for medical alert identification.

Keeping an animal guide with the person.



Hearing Loss

The biggest obstacle you must overcome when caring for a person who has a partial or total loss of hearing is communication.

You may be able to communicate with a person with hearing loss through—

Sign language.

Looking straight at the person while you speak.

The person with hearing loss reading lips (this is called “speech reading”).

Gestures and written messages.



Vision Loss

Vision loss is a partial or total loss of sight.

When caring for a person with vision loss:

Help to reassure him or her.

Stand beside the person, if he or she can walk.

Do not speak loudly or in overly simple terms.

If the victim has a guide dog, try to keep the dog with the person.



Motor Impairment

A person with motor impairment is unable to move normally.

Determining which problems are pre-existing and which are the result of immediate injury or illness can be difficult.

Care for all problems you detect as if they are new.



Mental Impairment

Mental, or cognitive, function includes the brain’s capacity to reason and to process information.

When caring for a person with mental impairment—

Approach the person the same way you would anyone else in that age group.

Listen carefully to what the person says.

Explain who you are and what you are going to do.

If a parent or guardian is present, ask that person to help you care for the victim.



Language Barriers

Getting consent to give care can be difficult with an individual who speaks in a language other than one in which you are fluent.

Find out if any bystanders speak the victim’s language and can help translate.



Language Barriers(continued)

Communicate nonverbally; use gestures and facial expressions.

When you call 9-1-1 or the local emergency number, explain that you are having trouble communicating with the victim and say what nationality you believe the victim is or what language he or she is speaking.



Special Situations

There are some situations in which you should not become involved, such as a crime scene or a hostile victim.

Do not enter the scene of a suicide.

In the case of an unarmed suicidal person—

Do not argue with him or her.

Call 9-1-1 or the local emergency number and the police.

If the scene is safe, listen to him or her and try to keep the person talking until EMS personnel arrive.



Special Situations(continued)

Do not enter the scene of a physical assault or sexual assault or any scene if there is a weapon.

Call 9-1-1 or the local emergency number.

Stay a safe distance away.

If the victim is hostile—

Remove yourself from the potential dangerous situation.

Call 9-1-1 or the local emergency number.

Try to be sympathetic and calm with hostile family members.

Explain what you are trying to do.



Closing

Situations involving people with special needs require your awareness and understanding.

If a situation is in any way unsafe, do not approach the victim. If you have already approached, withdraw to a safe place until EMS personnel arrive.

Questions?

Lesson 38: Childbirth



Introduction Childbirth is a natural process. Thousands of children all over

the world are born each day, without complications, in areas where no medical care is available.

By following a few simple steps, you can effectively assist in the birth process.



Pregnancy

Pregnancy begins when an egg (ovum) is fertilized by a sperm, forming an embryo.

The embryo implants itself within the mother’s uterus.

The embryo is surrounded by the amniotic sac.



Pregnancy(continued)

After about 8 weeks, the embryo is called a fetus.

The embryo receives nutrients from the mother through a specialized organ called the placenta, which is attached to the lining of the uterus.

The placenta is attached to the fetus by a flexible structure called the umbilical cord.

The fetus will continue to develop for approximately 40 weeks, at which time the birth process begins.



Birth Process

The birth process begins with the onset of labor. Labor is the final phase of pregnancy.

Labor begins with the rhythmic contraction of the uterus and the dilation of the cervix.

Dilation allows the baby to travel from the uterus through the birth canal.



Labor

Labor has three distinct stages. The length and intensity of each stage vary:

Stage One—preparation

Stage Two—delivery of the newborn

Stage Three—delivery of the placenta



Assessing Labor

If you must care for a pregnant woman, you will want to determine whether she is in labor.

Is she is in labor, you should determine in what stage of labor she may be and whether she expects any complications.



Assessing Labor(continued)

Ask the following questions:

Has 9-1-1 or the local emergency number been called?

Is this her first pregnancy?

Does she expect any complications?

Is there a bloody discharge?

Has the amniotic sac ruptured (or water broken)?

What are the contractions like? Are they close together? Are they strong?

Does she have an urge to bear down or push?

Is the newborn’s head visible?



Preparing the Mother

You can help the expectant mother cope with the discomfort and pain of labor.

Suggest that the mother try specific physical activities that she can do to relax, such as regulating breathing by—

Deep breathing—inhaling slowly and deeply through the nose and out through the mouth.

Focusing her attention on an object in the room while regulating her breathing.

Stay calm, firm and confident, offering encouragement.



Assisting with Delivery

Assisting with delivery of the newborn is often a simple process.

Begin by positioning the mother.

Establish a clean environment.

Protect yourself.

As crowning begins, place a hand on the top of the newborn’s head and apply light pressure.

Ask the mother to change her breathing pattern.



Assisting with Delivery(continued)

After the head emerges, lower the head and guide one shoulder out at a time.

Do not pull the newborn.

Use a clean towel to catch the newborn.

Place the newborn on its side, between the mother and you.

Note the time the newborn was born.



Caring for the Newborn

You have two priorities at this point.

Your first priority is to see that the newborn’s airway is open and clear.

Clear the nasal passages and mouth thoroughly.

If the baby does not spontaneously breathe or cry, flick the soles of his or her feet to stimulate crying.

If the baby does not begin to breathe on his or her own, begin rescue breathing. If the baby does not have signs of life, begin CPR.



Caring for the Newborn(continued)

Your second priority for the newborn is to maintain normal body temperature.

Dry and wrap the baby in a clean, warm towel or blanket.

Continue to monitor breathing, circulation and skin color.

Place the wrapped baby on the mother’s abdomen.



Caring for the Mother

Help the mother to begin nursing the newborn if possible. This will stimulate the uterus to contract and help slow bleeding.

As the uterus contracts, it will expel the placenta, usually within 30 minutes.

As the placenta emerges, place it in a towel or container for transport with the mother and baby to the hospital.

It is not necessary to separate the placenta from the newborn.



Caring for the Mother(continued)

Gently clean the mother using gauze pads or clean towels.

Place a sanitary pad or a towel over the vagina. Do not insert anything in the vagina.

Gently massage the lower portion of the abdomen.

Keep the mother positioned on her back. Keep her from getting chilled or overheated and continue to monitor her condition.



Scenario

A car pulls into your driveway. The driver jumps out screaming for help for his wife, who is in the back seat. The woman is 35 years old and full term in her pregnancy. Her contractions are less than 2 minutes apart. She says that the baby is coming and she feels the need to push. Her husband tells you this will be their fourth child.

How do you respond?



Complications During Pregnancy

Complications during pregnancy are rare; however, they do occur.

One such complication is miscarriage, or spontaneous abortion.

Concern yourself with recognizing signals that suggest a serious complication during pregnancy.



Complications During Pregnancy(continued)

Two important signals you should be concerned about are vaginal bleeding and abdominal pain.

An expectant mother showing these signals needs to receive advanced medical care quickly. While waiting for EMS personnel—

Place a pad or other absorbent material between the mother’s legs.

Take steps to minimize shock:

Help the expectant mother into the most comfortable position.

Keep the expectant mother from becoming chilled or overheated.



Complications During Childbirth

Complications during childbirth require the help of more advanced medical care.

More common complications include—

Persistent bleeding.

Prolapsed umbilical cord.

Breech birth.

Multiple births.



Closing

Childbirth should occur in a controlled environment under the guidance of health-care professionals trained in labor and delivery.

Unexpected deliveries may occur outside of a controlled environment and may require your assistance.

To assess the mother’s condition before delivery and to assist in the delivery, be familiar with the three stages of labor and understand the birth process.

By knowing how to prepare the expectant mother for delivery, assist in the delivery and give proper care for the mother and newborn, you can help bring a new child into the world.



Closing(continued)

Questions?

Lesson 39: Delayed-Help Situations I



Introduction

Situations in which emergency medical care is delayed for 30 minutes or more are called delayed-help situations.

Areas in which delayed-help situations occur include—

Rural areas.

Wilderness environments.

In delayed-help situations, use the emergency action steps, CHECK—CALL—CARE, as your basic plan of action. However, how you check the scene and the victim, call for help and care for the victim may change.



Types of Delayed-Help Environments

There are three types of environments that can create a delayed-help situation:

Rural areas

Wilderness areas

Disaster situations



Rural Areas

Include country and farm areas.

Response times are often delayed because of long distances and adverse conditions.



Rural Areas(continued)

Emergencies that usually occur involve—

Equipment.

Animals.

Electricity.

Falls.

Fires.

Overturned vehicles.

Chemicals or pesticides.

Agricultural machinery mishaps.



Wilderness

A wilderness is an area that is not settled, is uncultivated and has been left in its natural condition.

A phone and emergency personnel may be miles away.

If an emergency occurs, give care for the victim and consider how you are going to get help.

You may need to send someone to get help or go yourself.

If you decide to go for help, you will have to shelter the victim from the elements.



Disaster Situations

Disasters, such as hurricanes, earthquakes or mass trauma (explosions, acts of terror) are likely create delayed-help situations.

Certain activities such as boating may create delayed-help situations.



Taking Action in a Delayed-Help Situation

In a delayed-help environment, you may have to modify the emergency action steps: CHECK—CALL—CARE.

The CHECK step may need to be more detailed.

The information you gather will be important to developing a plan for getting help and caring for the victim.



Taking Action in a Delayed-Help Situation (continued)

The CALL step may be delayed for a few minutes or a few hours, or in some situations, you may decide it is better to take the victim to help.

The CARE step in a delayed-help environment includes giving care and periodically rechecking the victim’s condition until help arrives.



CHECK

The CHECK step of the emergency action steps includes checking the scene, checking the victim and checking for resources.



CHECK the Scene

Check the entire scene and try to get a general idea of what happened.

Look for hazards or impending problems.



CHECK the Victim

After determining that the scene is safe, approach the victim carefully and check for life-threatening conditions. Care for the conditions you find.



CHECK the Victim(continued)

If the victim has fallen or you do not know how the injury occurred, assume that there is a head, neck or back injury.

Check the victim for any other problems that are non-life-threatening.

Perform a head-to-toe check of the victim.

If possible, write down the information you gather.



CHECK for Resources

Check the scene for resources.

Check the surrounding environment.

Note conditions that would make it difficult for you to get help.

Consider whether you may have to move the victim.



CALL

The CALL step of the emergency action steps is divided into two phases—

Making a plan for getting help.

Executing the plan.



Making a Plan and Getting Help

In a delayed-help situation, you have four options for getting help:

Stay where you are and call, radio or signal for help.

Send someone to go get help or leave the victim alone to go get help.

Transport the victim to help.

Care for the victim where you are.



Making a Plan and Getting Help(continued)

To help you decide on the best approach to getting help and giving care for the victim, ask yourself these questions:

Is advanced medical care needed?

Is there a way to call from the scene for help?

If phone or radio communication is not possible, is there a way to signal for help?

If there is no way to call for help, is it possible to go get help?

Is there a way to transport the victim to help?

Is it possible to give care where you are until the victim can travel?

Is it safe to wait for help where you are?



Making a Plan and Getting Help(continued)

You may discover that there is no “best” plan, but there may be a way to reduce the risks to both you and the victim.

Once you have a plan, you need to execute it.



Calling for Help

Make sure you have gathered information that describes all important aspects:

Victim’s condition

Your location

Any other basic information that EMS or rescue personnel may need



Calling for Help(continued)

Make sure that you give rescuers specific information about where you are.

Identifying prominent landmarks and marking your area can help rescuers find your location.

Consider that some landmarks may not be visible at night.

Be aware of hazards that may arise, such as fires from using flares.



Improvised Distress Signals

If you have no way to call for help and it is dangerous or impractical to use flares or send someone for help, you may have to improvise.



Improvised Distress Signals(continued)

Two of the most widely used distress signals are—

Signals in threes.

Ground-to-air signals.

In addition, smoke, mirrors, flare guns and whistles can create visual or auditory signals to attract responders.



Sending for Help

When you send someone to get help, he or she should have certain written information including—

The victim’s condition and medical information.

A map indicating the victim’s location.

A list of other members in the group.

Available resources.

A description of weather, terrain and access routes if known.



Sending for Help(continued)

Another consideration in going for help is to make sure you can lead rescuers back to the victim.

Use compass readings and maps or charts when possible.

Always mark your way so that you can find your route back.

Make sure that you leave enough people to care for the victim while waiting for help.

Before sending anyone for help, consider whether actions that must be taken at the scene require everyone’s help.



Leaving a Victim Alone

In some situations, if you are the only one present, it may be best to leave the victim and go get help.



Leaving a Victim Alone(continued)

Before leaving a victim, follow these steps: Write down the route, the time you are leaving and

when you expect to be back. Provide for the victim’s needs while you are gone. Make certain that the victim has adequate clothing

and shelter. Recheck any splints or bandages and adjust them if

necessary. If the victim is unconscious or unable to move, place

him or her in the recovery position. Before leaving a conscious victim, make sure he or she

understands you are going for help and let him or her know when you expect to return.



Transporting the Victim to Help

Consider transporting a victim if a vehicle or other means of transportation is available.

Factors to consider when deciding to move the victim include—

The extent of the victim’s injuries.

The distance to be traveled.

Available help.

Do not move or transport a victim with a possible head, neck or back injury unless the scene is not safe or a potential for danger exists.



Transporting the Victim to Help(continued)

If you decide to transport a victim to help, plan the route you will follow.

To minimize pain and injury during the move, immobilize any possible bone or joint injuries.

Select a place in the vehicle for the victim that will be as comfortable as possible.

Transport at a safe speed.

Monitor the victim’s condition.



Closing

Delayed-help situations may occur in areas where people may be able to call 9-1-1 or the local emergency number but may have to wait a long time before EMS personnel arrive or in areas where medical help is unavailable because of distance, travel conditions and communication difficulties.

In a delayed-help environment, you may have to modify the emergency action steps: CHECK—CALL—CARE.

Getting help may involve calling for help, sending for help, leaving the victim alone and going for help, transporting the victim to help or allowing the victim to recover sufficiently so that he or she can walk to help.

Questions?

Lesson 40: Delayed-Help Situations II



Introduction

In delayed-help situations, use the emergency action steps: CHECK—CALL—CARE.

If you are in a delayed-help environment or find yourself in a situation where a phone is not immediately accessible, it is important that you know how to give care.



CARE

In a delayed-help situation, you may need to care for the victim for a long time.

It is important that you remain calm and develop and follow a plan of action.

Provide support and reassurance to the victim until EMS personnel arrive and take over.



Monitoring the Victim

After completing your initial check of the victim and giving initial care, continue to monitor the victim’s condition while waiting for help.

Watch for changes in skin appearance, temperature and level of consciousness.

Recheck any splints or bandages and adjust them if they are too tight.

Keep a written record each time you recheck the victim.

Note any changes you find and the time the changes occur, as well as any care you give.



Fractures and Dislocations

You should not move a victim with a possible fracture unless it is absolutely necessary.

If you must move or transport the victim, splint the injured body part.



Fractures and Dislocations(continued)

Do not attempt to move a person or have the person move without first splinting the injured part.

Be sure to loosen the splint and recheck the limb every 15 minutes.



Bleeding

Most external bleeding can be stopped simply by—

Applying direct pressure.

Applying a pressure bandage.



Bleeding(continued)

A tourniquet is a wide band of cloth or other material placed just above a wound to stop all blood flow to the area below it.

Using a tourniquet is very dangerous. Applying a tourniquet means risking a limb in order to save a life and is a measure of last resort.



Burns

General steps for caring for a burn in a delayed-help environment are the same as in other settings:

Stop the burning by removing the victim from the source of the burn.

Cool the burned area to stop the burning.

Cover the burned area.

Prevent infection.

Minimize shock.



Sudden Illness

When caring for a victim of sudden illness, follow the same procedures as if you were not in a delayed-help situation.

For a victim recovering from an episode of low blood sugar—

Have the victim rest after eating or drinking something sweet.

If he or she shows no signs of improvement within 5 minutes, you need to give the victim water.

Transport him or her to a medical facility.

Never give an unconscious victim anything to eat or drink.



Sudden Illness(continued)

To care for someone who has experienced a seizure—

Do no further harm and complete a detailed check for injuries after the seizure is over.

Maintain the victim’s body temperature and help to prevent shock.



Shock

In a delayed-help situation, it is likely you will have to give care to minimize shock.



Shock(continued)

If you or someone you are with is susceptible to a severe form of anaphylaxis or anaphylactic shock as a result of a bite or sting—

Be sure someone knows the location of necessary medication.

Quickly transport a person who shows signals of anaphylactic shock.

If medical care is more than 2 hours away, give preventive care for shock.

Give a conscious victim frequent small amounts of cool water or clear juices.



Shock(continued)

Do not give fluids if—

The victim is unconscious.

The victim is having seizures.

The victim has a serious head or abdominal injury.

Vomiting is frequent and sustained.

If you give fluids and the victim starts to vomit, wait before giving the victim any more to drink.

Remember to keep the victim from becoming chilled or overheated.



Head, Neck and Back Injuries

If you suspect a head, neck or back injury, prevent further injury by providing manual stabilization.

If you are alone and need to free yourself from maintaining manual stabilization of the victim’s head and neck, place two heavy objects wrapped in clothing next to each side of the head to hold it in line.

It is important to help the victim maintain normal body temperature.



Difficult Decisions

One of the most stressful and emotionally draining situations you can be faced with is dealing with a life-threatening condition when medical care is not easily obtainable.



Difficult Decisions(continued)

You may be faced with the difficult question of how long to continue resuscitation efforts.



Difficult Decisions(continued)

CPR can limit brain damage in case the heart starts and may even improve the chance that the heart will start. In such a case, CPR should be continued until—

The heart starts beating.

You are relieved by another trained responder.

EMS personnel arrive and take over.

The situation becomes unsafe.



Protection from the Weather

Protecting the victim from environmental conditions such as heat, cold, wind, rain, sleet or snow is critical.

A shelter may need to be constructed for the victim using whatever materials you have on hand.



Protecting the Victim

Keep the victim from getting chilled or overheated. Provide some type of insulation to protect the victim.

If the ground is dry, use cloth items, such as towels, blankets, clothing or sleeping bags.

In cold weather, lying on the ground draws heat away from the body and increases the chances of hypothermia.

If the ground is too hot, the heat from the ground will travel to the body and raise the victim’s temperature.



Protecting the Victim(continued)

If the ground is wet, put a waterproof tarp, raincoat or poncho between the insulating material and the ground.

If the victim is exposed to hot sun, rain, snow or chilling wind, provide an appropriate shelter.



Constructing a Shelter If you are caring for the victim for an extended period of time or

if you must leave the victim while you go for help, you may have to construct a shelter.



Constructing a Shelter(continued)

There are four common types of shelters:

Natural shelters

Artificial shelters

Snow shelters

Tents and bivouac bags

A car can also be an effective shelter.



Preparing for Emergencies

People who live or work in a delayed-help environment or plan to be in one should develop a plan for how to respond to emergencies that may arise.



Types of Preparation

There are three general types of preparation that can help you in a delayed-help environment:

Knowledge

Skills

Equipment



Ensuring Adequate Preparation

Your preparation needs will vary with the activities you plan, the weather and the special needs or skills you and your companions have.



Ensuring Adequate Preparation(continued)

Planning for emergencies is an important part of preparation for any trip or activity. These include—

The level of first aid training among group members.

The distance you will be away from medical help.

The duration of the trip or activity.

The level of risk associated with activity or environment.

Group-related factors, such as pre existing medical or physical conditions.

Any special equipment or supply requirements.

The size of the group.



Ensuring Adequate Preparation(continued)

Get additional training that will help prepare you for your specific activity.

Find out about local weather conditions.

Find out about local emergency resources in the area.

Plan your route and write it down. Leave it with someone who is not going to accompany you.



Closing

Emergencies do not always happen in locations where it is quick and easy for you to call 9-1-1 or the local emergency number.

As with all emergencies, use the emergency action steps: CHECK—CALL—CARE, as your basic plan of action.



Closing(continued)

Generally, the care you give the victim in a delayed-help situation is no different from what you do in other situations. You may, however, have to spend more time caring for the victim.

If you are planning to venture into a delayed-help environment or if you live or work in one, you should think about how you can reduce the risk of emergencies.

Questions?

Lesson 41: A Safer and Healthier Life



Introduction

Injuries and illness have a significant impact on our society.

The cost in lost wages, medical expenses, insurance, property damage and other indirect costs is staggering—many billions of dollars a year.

Illness and injury are not simply unpleasant facts of life to be shrugged off as inevitable.

Often, illness and injury can be prevented by taking safety precautions and choosing a lifestyle that promotes optimal health.



Injury

Each year in the United States, an estimated 1 in 12 people require medical treatment for an injury.

An estimated 150,000 people die from the injuries they receive.

Injury is the leading cause of death for people ages 1 to 39 years old.



Factors Affecting Risk of Injury

A number of factors affect risk or injury:

Age

Gender

Geographic location

Economic status

Alcohol use and abuse



Reducing Your Risk of Injury

Strategies to prevent injuries include the following:

Encourage people at risk to change their behavior.

Require people at risk to change their behavior, such as with laws requiring people to wear safety belts.

Provide products that offer automatic protection, such as air bags, designed to reduce the risk of injuries.



Reducing Your Risk of Injury(continued)

Taking the following steps reduces your risk of injury:

Know your risk.

Take measures that make a difference. Change behaviors that increase your risk of injury and the risk of others.

Think safety.

Learn and use first aid skills.



Vehicle Safety

Wear a safety belt.

Infants and children should always ride in approved safety seats.

Do not leave objects loose in your vehicle.

Do not drink and drive.



Fire Safety

Cooking is the leading cause of home fires in the United States.

Fires are also caused by heating equipment, appliances, electrical wiring and careless smoking.

Install a smoke detector on every floor of your home.

Fire escape plans should include the following considerations:

Escape routes from each room

The location of a meeting place upon exiting the building

A designated person who will call the fire department and from which phone



Safety at Home

About 8 million disabling injuries occur in homes each year in the United States.

Three leading causes of accidental death include the following:

Falls

Poisoning

Fire



Safety at Home(continued)

Taking the following steps will help make your home a safer place:

Post emergency numbers.

Make sure that stairways and hallways are well lit.

Equip stairways with handrails, and use nonslip tread or securely fastened rugs on stair steps.

Secure rugs to the floor with double-sided tape.

If moisture accumulates in damp spots, correct the cause of the problem. Clean up spills promptly.

Keep medicines and poisons locked up and out of the reach of children.




Keep medicines in their original containers, with safety caps.

Keep heating and cooling systems and appliances in good working order.

Read and follow manufacturer’s instructions for electrical tools, appliances and toys.

Turn off the oven and other appliances when they are not in use.

Make sure that your home has at least one working, easily accessible fire extinguisher and that everyone knows how to use it.

Keep any firearms so that they are not accessible to unauthorized persons.




Have an emergency fire escape plan and practice it.

Try crawling around your home to see it as an infant or young child sees it.

Turn pot handles toward the back of the stove.

Ensure that the cords for lamps and other items are not placed where someone can trip over them.



Safety at Work

Most people spend approximately one-third of their day at work.

To improve safety at work, you should be aware of the following:

Fire evacuation procedures

How to activate your emergency response team and how to call 9-1-1 or the local emergency number

The location of the nearest fire extinguisher and first aid kit

If you work in an environment where hazards exist—

Wear recommended safety equipment and follow safety procedures.

Inspect equipment and ladders.

Check for worn or loose parts.



Safety at Play

Safety in a recreational setting may be enhanced through the following suggestions:

When cycling, wear an approved helmet.

Keep off roads that are busy or have no shoulder.

Wear reflective clothing and make sure you have a head- and taillight and reflectors on your bicycle wheels if you cycle at night.

Make sure your bicycle and your child’s bicycle are in good condition and the brakes and headlights work.



Safety at Play(continued)

Wear protective goggles when appropriate.

Wear appropriate footwear.

Learn how to swim or always wear a Coast Guard approved flotation device when in, on and around the water.

Take lessons to learn the skill when beginning an unfamiliar sport and make sure your equipment is in good condition.



Reducing Your Risk of Illness

Making good choices about your lifestyle can affect your health and general well-being.

Informed choices can reduce or eliminate your chances of cancer, stroke, cardiovascular disease, pneumonia, diabetes, HIV infection and liver disease.



Nutrition

Nutrition is the science that deals with the food you eat and how your body uses it.

Studies indicate that poor diet is a contributing factor to many diseases.



Food Labels

Food labels describing the product’s nutritional value are required by law.

Food is made up of six classes of nutrients:

Carbohydrates

Fats

Proteins

Vitamins

Minerals

Water



Food Labels(continued)

Food labels include the following information:

Calories

Calories from fat

Total fat

Saturated fat

Trans fat

Cholesterol

Sodium



Food Labels(continued)

Total carbohydrates

Dietary fiber

Sugars

Protein

Vitamins and minerals



A Healthy Diet

Parts pf the pyramid include:

- Grains - Milk

- Vegetables - Meat and beans

- Fruits

Fats, oils and sweetsUSE SPARINGLY

Meat, Poultry, Fish, Dry Beans, Eggs & Nuts Group2-3 Servings

Fruit Group2-4 Servings

Bread, Cereal, Rice & Pasta Group6-11 Servings

Milk, Yogurt & Cheese Group2-3 ServingsDiscretionary calories - Physical Activities

Vegetable Group2-5 Servings

MyPyramid: symbolizes physical exercise, moderation, personalization, proportionality and variety.



Weight

Obesity is defined as a condition characterized by excess body fat.

Obesity contributes to certain diseases, such as heart disease, high blood pressure and gallbladder disease.

Weight loss and weight gain depend on the balance of caloric intake and energy output.

A planned weight loss or weight gain should always be combined with regular exercise.



Fitness

Fitness involves cardiorespiratory endurance, muscular strength, muscular endurance and flexibility.



Exercise

Be sure to warm up to prepare the body before vigorous exercise and cool down afterward.

When possible, add exercise or activities that strengthen the muscles to your fitness routine.

You should exercise for a minimum of 30 minutes a day, at least three times a week.

The benefits of exercise include weight loss, more disease resistance, stress reduction and increased energy.



Cardiorespiratory Endurance

Cardiorespiratory endurance—the foundation of total fitness—is the ability to take in, deliver and extract oxygen for physical work.

Cardiorespiratory endurance is best accomplished through aerobic exercise.

To achieve cardiorespiratory endurance, you must exercise your heart and lungs.

To do this, you should exercise at least three to five times a week for a minimum of 30 to 45 minutes at your appropriate target heart rate range.



Stress

Stress is a physiological or psychological response to real or imagined influences that alter an existing state of physical, mental or emotional balance.

The reaction to stress can take on various forms, such as—

Muscle tension. • Anger.

Dizziness. • Excitement.

Increased heart rate. • Energy

Acute Anxiety. • Joy.

Sleeplessness.



Stress(continued)

A stressor is an event or condition that triggers the stress response.

Positive, or “good,” stress is productive.

“Bad” stress (distress) can result in negative responses.

Any stressful situation has an effect on the body.



Stress(continued)

You need to be aware of the physical and mental signals of stress.

Some of the physical indicators of negative stress include—

Severe headaches.

Sweating.

Lower back pain.

Weakness.

Sleep disturbance.

Shortness of breath.



Managing Stress

Stress management is a person’s planned attempt to cope or deal with stress.

Managing potentially harmful stress may require using a variety of techniques, including using time effectively, exercise and evaluating the activities that are important for you and establishing achievable goals.

Relaxation techniques can be helpful in reducing or avoiding the negatives of dealing with stress.



Smoking

Every year, more than 342,000 Americans die of lung disease.

Smoking costs the United States over $150 billion each year in health-care costs.

Cigarettes contain at least 69 distinct cancer-causing chemicals.

Consider that smokers are at risk for—

Lung cancer.

Emphysema and chronic bronchitis.

Heart attack and sudden cardiac arrest.

Cancer of the esophagus, pancreas, bladder and larynx.

Increased incidence of still births and low-birth-weight babies.



Alcohol

Alcohol is the most popular drug in Western society.

In addition to the hazardous relationship between drinking alcohol and driving, consuming alcohol in large amounts has other unhealthy effects on the body.

A blood alcohol concentration (BAC) of 0.05 percent or higher impairs judgment and reflexes and makes activities such as driving unsafe.



Alcohol(continued)

Whether hosting a party or participating in one, you can act responsibly by keeping alcohol consumption under control by following these guidelines:

Drink slowly.

As a host, make nonalcoholic beverages available to your guests.

Do not drink before a party.

Avoid drinking when angry or depressed.

Eat plenty of food before and while drinking.

Avoid salty foods.



Alcohol(continued)

Do not play or promote drinking games.

When mixing drinks, measure out the amount of alcohol.

As a host, do not have an open bar or serve someone who has had too much to drink and avoid serving salty foods.

Stop serving and drinking alcohol 1 hour before the party is over.

Do not drink and drive.



Closing

You can help prevent injury and disease by taking safety precautions and making lifestyle choices that promote health.

To reduce your risk of injury, it is important to take safety precautions in vehicles, at work, at play and in your home.

To reduce your risk of illness, make healthy choices about your lifestyle.

Eating a healthy diet, exercising regularly, avoiding harmful substances and managing stress all contribute to a person’s health and well-being.

Questions?

Lesson 42: Putting It All Together III/ Course Review



The Plan of Action

Did the group’s plan follow the emergency action steps: CHECK—CALL—CARE?

Did the plan involve bystanders appropriately?

Did the plan demonstrate proper care?



Scenario 1Unknown Unconscious Victim

It is a perfect day for a cookout! You could not have asked for better weather. A friend has arrived early to help you prepare for the hungry crowd that will soon descend. Just when everything seems to be falling in place, you are distracted by a faint, distant call for help. It sounds like your neighbor’s grandson. You and your friend run toward the voice. As you arrive in your neighbor’s front yard, you see your neighbor, an older woman, lying on the ground. She had been gardening. She appears to be unconscious and to have vomited. A container of pesticides is nearby.



You would like to help. How do you respond?

Scenario 1Unknown Unconscious Victim



Scenario 2Sudden Illness with Chest Pain

The game you and your dad have waited for all season is about to begin. The outcome will determine who will play for this year’s national championship. As you both begin to settle in front of the TV for the next couple of hours, you notice that your dad is acting strangely. He does not appear to feel well. When you question him, he denies that anything is wrong. After 20 minutes or so, you notice that your dad is not paying attention to the game. He seems to be feeling worse. He is pale, sweating and appears to be having trouble breathing. He insists that it is only indigestion.




Scenario 2Sudden Illness with Chest Pain



Scenario 3Injury

As you ride along the bike trail, you are tired but relaxed. You must have ridden at least 10 miles. Then, as you round a sharp curve, you abruptly swerve to avoid a young woman sprawled in the middle of the path. She appears to have been roller blading and fallen. She is in obvious pain and is cradling her bent arm close to her chest. You stop your bike.




Scenario 3Injury



Closing

Questions?

Lesson 36: Reaching and Moving Victims in the Water.

Documents

Transcript of Lesson 36: Reaching and Moving Victims in the Water.