CHAPTER 24 Rescuing and Moving Victims
Lesson Objectives 1. Describe how to rescue or care for a victim in each of the following emergencies: Fire scene Hazardous materials incident Vehicle crash Potential drowning situation Broken ice 24-2
Lesson Objectives continued 2. Describe how to prioritize the care for multiple victims with different types of injuries. 3. Explain when it may be necessary to move a victim. 24-3
Lesson Objectives continued 4. Demonstrate the following emergency moves: Shoulder drag Clothes drag Ankle drag Blanket drag Walking assist Packstrap carry Cradle carry Piggyback carry 2-handed seat carry Hammock carry with multiple rescuers 24-4
Rescuing a Victim Be sure scene is safe. If not safe, stay away and call for help. Do only what you have been trained to do. 24-5
Fire Smoke or fumes can overcome anyone entering scene. Invisible gases pose a threat. Do not enter area of smoke or flames to search for victims. 24-6
Fire continued 1. Remove everyone from area. Close doors behind you. 2. Call 9-1-1 or set off alarms. 3. Use fire extinguisher only if fire is small. 4. Do not go into area of flames and smoke to rescue others. 24-7
Fire continued If trapped inside: 24-8
Hazardous Materials Treat any unknown substance as hazard until proven otherwise. Avoid spilled liquid or powders and possible fumes. Leave cleanup to hazmat professionals. 24-9
Hazardous Materials continued 1. Stay out of area and keep bystanders away. 2. Outside, stay uphill and upwind of area to avoid possible fumes. 3. Call 9-1-1. 4. Approach victim only if safe. 5. Get victim to emergency shower or rinse with a hose. 24-10
Vehicle Crashes Risks of passing traffic, fire, vehicle instability If safe to reach vehicle, do not remove victim unless fire or other threat likely. 24-11
Vehicle Crashes continued 1. Stop a safe distance past crash, and turn on vehicle s hazard lights. 2. Call 9-1-1. 3. Set up warning triangles. 4. Approach only if scene is safe. 5. If vehicle still running, turn off ignition. 6. Do not try to remove victim unless imminent threat. 7. Assume unresponsive victim has spinal injury. 8. Provide care as needed. 24-12
Drowning Results in over 3,900 deaths a year Near-drowning can result in brain damage and permanent disabilities. First or second leading cause of injury-related death for children in age groups of 1-14 years Children younger than 1 often drown in bathtubs, buckets or toilets. 24-13
Common Risk Factors for Drowning Lack of swimming ability Lack of barriers Lack of close supervision Location Failure to wear life jackets Alcohol use 24-14
Preventing Drowning Among Children Never leave children alone near water. Do not let children dive in shallow, murky or unknown water. Keep children away from big waves, undertows, boats. Use personal flotation device or life jackets on boats and around water. In public areas, let children swim only when lifeguards present. 24-15
Preventing Drowning Among Children continued Make sure rescue floats or other devices present at pools. Children should learn water safety and how to swim from qualified instructor. Even children who can swim are not drown-proof. Do not let older siblings or baby-sitters supervise children around water. 24-16
Preventing Drowning Among Children continued When supervising children around water: Avoid all distractions. Childproof home pools: Appropriate fencing Gates Floating pool alarms 24-17
Preventing Drowning Among Children continued 24-18
Preventing Drowning of Adults Never drink or use drugs around water. Wear personal flotation device (PFD) when boating. Dive into water only over 9 feet deep and when water is clear and no obstructions present. Do not swim alone. Consider swimming ability. Swimming in cold water can lead to hypothermia may lead to drowning. 24-19
Preventing Drowning of Adults continued Be prepared for emergency: Keep CPR skills up. Keep telephone handy when supervising others. 24-20
Recognizing a Drowning Situation Swimmer may become tired. Hypothermia may set in and weaken swimmer. Victim may call for help or may keep head above water but not progress to safety. 24-21
Recognizing a Drowning Situation continued Responsive victim: Cannot swim, float or tread water effectively Struggling just to keep head out of water to breathe Victim does not call for help. Victim s face just above surface or bobbing in and out Arms flailing 24-22
Recognizing a Drowning Situation continued Unresponsive victim: No longer breathing May be floating face-down at surface May be underwater 24-23
Safe Water Rescue Rescue technique depends on specific situation and equipment available. Do not jump immediately into water to save victim: May be unsafe May be appropriate to swim to victim if no other means Reach-throw-go priority 24-24
Reach Rescue Use rescue pole at pool: Hook victim s body and pull to edge. Use anything available to reach victim. Can reach with own body: Hold onto something with arms. Extend legs to victim. May need to wade short distance to reach victim. 24-25
Throw Rescue Look for anything that floats to throw: Life ring Rescue tube Life jacket Throw bag Buoyant seat cushion Water jug Empty cooler 24-26
Throw Rescue continued If possible, attach rope to throwable device. Victim may be able to float with device and kick to shore. Device may keep victim afloat while you find something to reach with. 24-27
Go Rescue Do not attempt except with small child or unresponsive victim. Look for other ways to go to victim: Surfboard Kayak Other watercraft Wear life jacket. 24-28
Go Rescue continued Keep object between you and victim. Stabilize head and neck before removing victim from water if suspected spinal injury. 24-29
Walking Assist Use if responsive victim at standing depth. 24-30
Beach Drag Use for unresponsive victim in shallow water with gradual shoreline. 24-31
If Stranded in Cold Water Minimize heat loss. If alone use heat escape lessening position (HELP). 24-32
If Stranded in Cold Water continued Two or more people should use huddle position. 24-33
Ice Rescue Very dangerous Call 9-1-1. If safe and necessary, use reach-throw-go priorities. 24-34
Multiple Victims Decide who needs care and who can wait. Triage systems classify victims into four categories: 1 st priority (critical) 2 nd priority (serious) 3 rd priority (stable) 4 th priority (obviously dead) 24-35
1 st Priority Critical Victims with life-threatening injuries who cannot wait for help: Airway or breathing problems Severe bleeding Shock Severe burn 24-36
2 nd Priority Serious Victims with injuries that need care soon but may be able to wait: Burns Broken bones Other injuries that are not severely bleeding 24-37
3 rd Priority Stable Victims who can wait for some time: Minor injuries Victims who can walk 24-38
4 th Priority Victims who cannot be saved No signs of life 24-40
Triage Process Ask who can walk, and ask them to move to one side (3 rd priority). Assess remaining victims in less than 1 minute: Check for responsiveness, normal breathing, severe bleeding. Do not start care for anyone until you have checked all. If victim s condition changes, may have to change priority. 24-40
First Aid: Multiple Victims 1. Call 9-1-1 immediately. Tell dispatch multiple victims. 2. Ask victims who can walk to move aside. 3. Check victims for life-threatening problems to identify 1 st priority. 4. Start providing BLS to 1 st priority victims. Move to 2 nd priority only after you have cared for 1 st priority. 5. When help arrives, tell EMS about victims present. Offer to help care for victims. 24-41
Moving Victims Moving injured victim likely to cause further injury In most cases, wait for professional help, May have to move victim to protect from danger at scene. May have to move victim to flat surface to provide CPR. May have to move victim to reach another victim with lifethreatening condition. 24-42
How Best to Move a Victim Several factors to determine best method to move victim: How quickly must victim be moved? Does victim s condition affect move? Are others present who can help? Is any equipment needed? Do you have necessary physical strength? 24-43
Use Good Body Mechanics: Lifting Do not lift more than what you can lift without straining. Lift with legs, not your back. Keep feet shoulder-width apart. One foot in front of other. Keep back straight and crouch down. Lift by straightening legs. 24-44
First Aid: Moving Victims Consider moving victim only if: Fire or explosion likely Poisonous fumes may be present. Structure may collapse. Victim needs to be moved into position for life-saving care. Victim is in way of another seriously injured victim. 24-45
First Aid: Moving Victims continued Try to move victim only if you are physically able and can do it safely. Get help from others at scene. Support head and neck of unresponsive victim or one with suspected spinal injury. Use good body mechanics. 24-46
First Aid: Moving Victims If Alone Unresponsive victim with suspected spinal injury: Shoulder drag (short distance) Clothes drag (short distance) Blanket drag (longer distance) 24-47
First Aid: Moving Victims If Alone continued Unresponsive victim without suspected spinal injury: Ankle drag (short distance over smooth surface) effective for small rescuer with large victim 24-50
First Aid: Moving Victims If Alone continued Responsive victim who can walk with help: One-person walking assist 24-49
First Aid: Moving Victims If Alone continued Unresponsive victim who cannot safely be dragged: Packstrap carry 24-50
First Aid: Moving Victims If Alone continued Lighter victim or child: Cradle carry (responsive or unresponsive victims) Piggyback carry (responsive victim) 24-51
First Aid: Moving Victims With Help Responsive victim: Two-person walking assist Two-handed seat carry 24-52
First Aid: Moving Victims With Help continued Unresponsive victim: Use 3-6 rescuers with hammock carry 24-53
CHAPTER 24 Learning Checkpoint
Chapter Opening Scenario You are called to the equipment room where an employee has been found unresponsive. He is lying on the floor beneath a rack of electrical equipment that he apparently was working on. Thinking he may have been electrocuted, you first make sure the power to this equipment is turned off, and then you check him and determine he is not breathing normally. Because he is lying on his side beneath overhanging equipment, however, you cannot give him chest compressions. Given the risk of a spinal injury, you know normally that you should not move him. What do you do? 24-57
CHAPTER 24 Critical Thinking Challenge Questions
Scenario 1 You are in a shopping mall when you hear an explosion inside a nearby store. Windows have been broken, and you hear a scream inside. When it seems safe to approach, you look inside to see if anyone needs help. Several people have minor injuries, but 3 victims obviously have more serious injuries. A man lies on the floor, apparently unresponsive, with a large puddle of blood beneath his torso. A woman is sitting on the floor clutching her bleeding leg, in which there is a large shard of glass. A 10-year-old child lies on the floor farther away, apparently unresponsive but with no visible injuries. What are the first 2 actions you should take? 24-59
Scenario 1 continued When you quickly check the 3 victims, you find the man is not breathing and has lost a very large amount of blood from gaping wounds in his abdomen and chest. Blood is slowly oozing from the woman s leg wound, but she remains responsive. The child is not breathing, but has no visible wounds or bleeding. What do you do now? 24-69
CHAPTER 24 Discussion and Questions