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Chapter 2
Action 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• Outdated and unproven first aid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 Care
Know When to Call 9-1-1
• Is the victim’s condition life threatening?
• Could the condition get worse on the
way to the hospital?
• Does the victim need the skills or
equipment of EMS?
• Could the distance or traffic conditions
cause delay?
• Is a spinal injury suspected?
Seeking Medical Care
When Is Immediate Transport Necessary?
• Chest pain lasts 2
minutes or more
• Uncontrolled bleeding
• Sudden or severe pain
• Coughing or vomiting
blood
• Difficulty breathing,
shortness of breath
• Sudden dizziness,
weakness, or fainting
• Changes in vision
• Difficulty speaking
• Severe or persistent
vomiting or diarrhea
• Change in mental
status
• Suicidal or homicidal
feelings
• Wounds needing
immediate medical care
Seeking Medical Care
Wounds That Need Immediate Care
• Bleeding from a cut
does not slow during
the first minute of
steady direct pressure.
• Signs of shock occur.
• Breathing is difficult
because of a cut to the
neck or chest.
• A deep cut to the
abdomen causes
moderate to severe
pain.
• There is a cut to the
eyeball.
• A cut amputates, or
partially amputates, an
extremity.
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.
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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-up
In 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 Precautions
Developed by the Centers for Disease Control and
Prevention (CDC)
Assume that all victims are infected and
can spread an organism that poses a risk
from transmission of infectious diseases.
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 alcoholbased 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 Concern
Bloodborne Diseases
Bloodborne diseases are diseases carried
by an infected person’s blood, such as:
• HIV
• Hepatitis B virus (HBV)
• Hepatitis C virus (HCV)
Diseases of Special Concern
Airborne 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.