A general impression is a quick sense of what has occurred, or is occurring, when you first observe an emergency scene. This impression can help guide you in your approach.
If injured, how was the person injured? Injuries occur from physical force against the body. The manner in which that force creates an injury is called the Mechanism of Injury. Mechanisms that transfer significant force are best assumed to result in serious injury until proven otherwise.
Does the person appear to be unresponsive? A person who is not moving and appears to have collapsed can be in a life-threatening condition known as sudden cardiac arrest. Your immediate assessment and care can be his or her only chance for survival.
Deciding to Help:
Most critical decision you will make is whether to get involved when a medical emergency has occurred. It is normal to feel hesitant because you are unsure of your ability to help. You might hesitate because you feel like you are alone in helping. You are only the first link in a progressive chain of emergency care. Your involvement lasts only until relieved by another first aid provider or responding EMS providers—in most cases,a very short period of time.
You might hesitate for fear of making things worse. Your basic first aid training provides you with sound knowledge and skills designed only to help – and not harm –those in need. You might also hesitate because you think you don’t have a lot of medical knowledge. Extensive medical knowledge is not necessary. First aid skills are based on common sense and simple, effective procedures that can be easily learned and safely applied.
Finally, you might hesitate because others have already stopped to help. It never hurts to see if additional assistance is needed. Other bystanders may not have any first aid training or may be hesitant to provide care.
Emergency scenes are often unsafe. Your personal safety is always the highest priority, even before the safety of an ill or injured person.Putting yourself in danger to help someone can make the situation worse.
Always pause for a moment before approaching an emergency and look for obvious hazards. Consider the possibility of hidden dangers. If the scene is unsafe, do not approach. If the location you are already in becomes unsafe, get out!
Electricity — Consider any potential electrocution extremely dangerous. Follow These precautions around any wire, person, or vehicle that is possibly energized:
• Do not approach within 8 feet.• Notify the local utility and have trained personnel sent to the scene.
• Never attempt to handle unless properly trained and equipped.• Turn off power only if safe to do so.
Water — To help someone struggling to stay afloat in water, “reach, throw, row, or go” in
Priority order: • From a stable surface, reach to a drowning person by extending an arm,stick, or pole.
• Throw something that will float, such as a personal floatation device (PFD),wood, or foam cooler.
• If a small boat is available, row or paddle it carefully to the person.
• Attempting to swim or go to rescue a person in water is extremely dangerous.
Do not try it unless you are trained and equipped to do so.
Traffic — When responding to an emergency in a roadway, take the following steps:
• Park a safe distance away and turn on vehicle hazard lights.
• Stay away from active traffic lanes; cross a roadway only if you must and with extreme care. Get others off the roadway.
• Beware of traffic behind you. Have someone safely try to flag oncoming traffic to slow down.
Chemicals — Reduce your risk of exposure to hazardous chemicals and toxic substances with a few key strategies:
• Inform yourself; know the names, toxicity, and other hazards of the chemicals you come into contact with. Use the Material Safety Data Sheet (MSDS) for each to learn more.
• Use engineering controls such as substitution of a less hazardous substance, isolating the chemicals with an enclosure, and ventilation to draw contaminated air away.
• Use personal protective equipment (PPE) such as gloves,face shields, and aprons to put barriers between you and the chemicals.
SETUP is an acronym that can help you remember the important points of making sure it is safe to provide care:
• Stop — Pause to identify hazards
• Environment — Consider your surroundings
• Traffic — Be careful along roadways
• Unknown Hazards — Consider things that are not apparent
• Personal Safety — Use protective barriers
Primary Assessment --
Responsive Person Just as with an unresponsive person, the primary assessment for someone who is responsive is to assess for and immediately treat life-threatening problems, including bleeding and shock.
If it is safe for you to approach, do so. Introduce yourself. Let the person know you are first aid trained and there to help. Check for confusion or disorientation.
Assess for any difficulty in breathing.Scan the body for serious bleeding. If found, control it immediately.Check the face for tissue color. Tissue color depends on the amount of blood circulating below the skin.
• Normal tissue color is light pink.
• Paleness can indicate blood loss or shock
.• A bluish color can indicate a lack of oxygen.
When checking a dark-skinned person for tissue color, assess the palms of the hands, fingernails, or inside the lip. Assess skin temperature by touching the forehead with your bare wrist.
• Normal skin feels warm and dry.
• Cool, wet skin can be an indication of shock. Quickly activate EMS and provide any primary care when a life-threatening medical condition is found or suspected.
When a primary assessment indicates no life-threatening problems, complete a secondary assessment to gather additional information.
Quickly try to determine the person’s chief complaint. Ask what happened. If he or she cannot answer, ask bystanders. The person may have a medical alert bracelet or necklace identifying a medical condition that could be related to the current problem.
The mechanism or forces that caused an injury may help predict the presence of a hidden injury. Clues in the environment, such as the temperature, or the presence of medications or containers, may help identify the cause of the chief complaint.
Physically assess the person. Briefly assess the body from head to toe.
Look and feel for signs of illness and injury.
The DOTS acronym helps to remind you what to look for:
• Open injuries
If needed, remove or cut away clothing to get a better look at an affected body part. Compare one side of the body to the other. If at any time you suspect spinal injury, immediately provide spinal motion restriction by manually stabilizing the head.
Ask questions. Use the acronym SAMPLE to help you remember what to ask about.
• Symptoms — Things the person is feeling, such as pain, nausea, dizziness, or anything related to the situation.
• Allergies — Things the person may be allergic to.
• Medications — Medications the person has been prescribed oris taking.
• Past medical history — Medical problems that may be related to what is going on.
• Last oral intake — When the person last ate or drank.
• Events leading up to problem — What the person was doing just prior to the problem.
If you find or begin to suspect a life-threatening problem is occurring while performing a secondary assessment, stop, quickly activate EMS, and provide the primary care.
Emergencies are dynamic events that can change at any time.
Reassessment is the ongoing observation of an ill or injured person to monitor his or her condition and the effectiveness of first aid.
• Make sure the situation remains safe for you to be there.• Watch for changes in a person’s level of responsiveness.
• Ensure the airway is open and clear and that the person is breathing normally.
• Reassess to ensure external bleeding is controlled.
• Look for changes in the person’s tissue color or skin temperature
.• Check at regular intervals until another provider or EMS personnel take over.
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