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Ch 6 Lifeguarding Before Providing Care & Victim Assessment Lesson Objectives • Describe what precautions can be taken to prevent disease transmission when providing care. • Describe the general procedures for injury or sudden illness on land. • Demonstrate proper removal of disposable gloves. • Demonstrate an initial assessment. • Understand how to safely and effectively move a victim on land Before Providing Care • Infectious disease are spread from infected people and from animals, insects or objects that have been in contact with them. • Lifeguards must protect themselves and others from infectious diseases. Blood Borne Pathogens • Are bacteria and viruses present in blood and body fluids, which cause disease to humans. • Bacteria can live outside the body • Viruses are in the body and difficult to kill • Are spread through direct or indirect contact • The primary concern for professional rescuers are hepatitis B, hepatitis C and HIV Disease-Causing Agents Viruses Hepatitis, measles, mumps, chicken pox, meningitis, rubella, influenza, warts, cols, herpes, HIV, genital warts, small pox, avian flu Bacteria Tetanus, meningitis, scarlet fever, strep throat, tuberculosis, gonorrhea, syphilis, chlamydia, toxic shock syndrome, Legionnaires disease, diphtheria, food poisoning, Lyme disease, anthrax Fungi Athlete’s foot, ring worm, histoplasmosis Protozoa Malaria, dysentery, cyclospora, giardiasis Rickettsia Typhus, Rocky Mountain spotted fever Parasitic Worms Abdominal pain, anemia Prions Mad cow disease Yeasts candidiasis Bacteria • Can be treated with antibiotics Famous People Affected/ Died From Syphilis • • • • • • Napoleon Bonaparte Al Capone Paul Gauguin Henry VIII Ivan the Terrible Friedrich Nietzsche • Vincent Van Gogh • Franz Schubert • Adolf Hitler Viruses • Few medications can fight viruses • The body’s immune system is number one protection against infection • Influenza • Chickenpox / shingles • Ebola Viruses Continued • Herpes • Hepatitis • HIV/AIDS Herpes • A highly contagious STD that is caused by two forms of herpes simplexes • Simplex 1-fever blisters/ cold sores in the mouth or lips • Simplex 2-blister-like lesions in the genital areas Hepatitis B • Is a liver infection • Can be severe or fatal • Can be in the body for up to 6 months before symptoms appear. • Sign and symptoms: flu-like, jaundice, fatigue, joint pain, nausea, loss of appetite • There is currently a vaccine (3 doses) must be made available to all employees who have occupational exposure, including LG’s Hepatitis C • Liver disease • Most common chronic bloodborne infection in the US • Signs & symptoms: similar to hbv, jaundice, dark urine, abdominal pain, loss of appetite, nausea • There is no vaccination and no treatment after exposure • It is the leading cause of liver transplants HIV • This virus causes AIDS • Attacks white blood cells, thus destroying the immune system • Signs & symptoms: many • No cure or vaccination Fact About AIDS • The disease: • Caused by HIV- Human Immunodeficiency Virus • Infections that strike people whose immune systems are weakened by HIV are called opportunistic infections. • When a person has a significant drop in white blood cells they are diagnosed as having AIDS • AIDS- Acquired Immune Deficiency Syndrome Famous People Affected/ Died From HIV/AIDS • • • • • • • • • • Arthur Ashe Rock Hudson Liberache Freddy Mercury Anthony Perkins Robert Reed Eazy-E Greg Louganis Perry Ellis Magic Johnson How is the Disease Transmitted? • The virus enters three basic ways: • Through direct contact with the blood stream (blood, semen, vaginal fluids, breast milk) • Through the mucous membrane linings (eyes, mouth, throat, rectum, vagina) • Mother to unborn baby How Pathogens Spread (pp 87-88) • 4 conditions must be met for a pathogen to spread: – A pathogen present – A sufficient quantity of the pathogen is present to cause disease – A person is susceptible to the pathogen – The pathogen passes through the correct entry site (eyes, mouth or other mucous membranes, non-intact skin or skin pierced by needlesticks, human bites, cuts, etc.) Direct contact • Occurs when infected blood or body fluids from one person’s enters another person’s body • Kissing • Touching • Sex • Blood splashing in the eye or from directly touching the body fluids. Indirect contact • Occurs when a person touches an object that contains the blood or body fluid • Coming in contact with something that has been touched by droplets of an infected person • Picking up blood-soaked bandages • Sneeze • Cough Hennessey Facts: ~Sneezes can travel at a speed of 100 miles per hour and the wet spray can radiate five feet. ~Donna Griffiths from Worcestershire, England sneezed for 978 days, sneezing once every minute at the beginning. This is the longest sneezing episode on record. Prevention • Your behavior can put you at risk for being infected with HIV, HBV/HCV • Sharing needles • Unprotected sex Universal/Standard Precautions • These precautions require that ALL human blood and substances be treated as if known to be infectious. • Make sure immunizations are up to date • Avoid touching body fluids • Wear disposable gloves & dispose of properly • Wash hands before and after care • Clean areas that come in contact with body fluids (water/bleach solution) Precautions continued (p.90) • Use a pocket mask when giving mouth-tomouth resuscitation • Don’t eat, drink, or touch your mouth, nose, or eyes when giving care • Be prepared by having first aid kit handy & stocked with protective equipment & supplies • Personal protective equipment: breathing barriers, nonlatex disposable gloves, gowns, masks, shields and protective eyewear. Pocket Masks Removing Latex Gloves Skill Assessment…Glove Removal (pp. 90-91 Fig.6-7) General Procedures for Injury or Sudden Illness on Land • 1. Size up the scene – Is scene safe? – Look for dangers (down power lines, traffic, explosions, violence, etc) – Put on protective equipment – What happened? – # of victims – Additional help needed? (fire, police, EMS) General Procedures cont… • 2. Perform Initial Assessment – Is done to identify lifethreatening conditions – Is done to identify lifethreatening conditions – Is done to identify lifethreatening conditions How to perform initial assessment: pp.94-95 • CHECK the victim for consciousness & obtain CONSENT if victim is conscious – Tap on shoulder, ask…are you ok? Pinch an infants toe – IF NO RESPONSE…Summon EMS • CHECK for signs of life (movement and breathing) – Look, listen, & feel • CHECK for a pulse – Carotid artery in neck (adult/child) – Brachial artery inside arm/bicep (infant) • CHECK severe bleeding General Procedures cont… • Summon EMS (read “call first or care first” pg. 94…see list of when to summon EMS p.95) – 9-1-1 – Give conditions • Perform Secondary Assessment – Identifies additional conditions – May become life threatening if not cared for Obtaining Consent p.95 • Before providing care to a conscious victim, obtain his/her consent. If a minor get consent from parent/guardian. • LG Tip: document any refusal of care. If a witness is available, have witness listen to, and document in writing any refusal of care. Demonstrate & Practice Performing Initial Assessment Pages 95-96 Emergency Moves on Land • Move an injured victim on land only if– The scene is unsafe – To reach another victim who may a have a more serious injury or illness – To provide proper care Demonstrate & Practice Emergency Moves (pp. 98-100) • • • • Clothes Drag Two-person seat carry Walking assist Pack-strap carry Review Questions • How can you best protect yourself from possible blood borne pathogens? • Use protective equipment, such as disposable gloves and breathing barrier • The steps you follow in an emergency are performed in the following order• Size up scene, perform an initial assessment, summon EMS, perform a secondary assessment Review Questions continued… • A woman collapses in front of you as she is entering the aquatic facility. You size up the scene and then check the victim for consciousness. She does not respond. What should you do next? • Summon EMS • You come upon a scene where a patron seems to be hurt. Why should you size up the scene before approaching the victim? • To determine if the scene is safe Review Questions continued… • To determine if a victim is breathing--• Look for movement and look, listen and feel for breathing for no more that 10 seconds • A person has been injured and is conscious. You should--• Obtain consent, check the victim for lifethreatening conditions and speak with the victim to find out what happened.