Acting in an Emergency Shelley Westwood, RN, BSN Adapted from Ed Reesor, RN
I can: Explain how pathogens are transmitted from one person to the next. Describe standard precautions (SP) and how they can prevent disease transmission when giving first aid Describe step by step action to take whenever you recognize an emergency Learning Target
Emergencies vary in: Acting in an Emergency
Emergencies vary in: Nature of illness/injury Acting in an Emergency
Emergencies vary in: Nature of illness/injury Severity of illness/injury Acting in an Emergency
Emergencies vary in: Nature of illness/injury Severity of illness/injury Presence of other injuries of factors affecting victim s wellbeing Acting in an Emergency
Emergencies vary in: Nature of illness/injury Severity of illness/injury Presence of other injuries of factors affecting victim s wellbeing Scene of the emergency Acting in an Emergency
Emergencies vary in: Nature of illness/injury Severity of illness/injury Presence of other injuries of factors affecting victim s wellbeing Scene of the emergency The victim Acting in an Emergency
Key concepts applicable to all emergencies: Acting in an Emergency
Key concepts applicable to all emergencies: Take steps to prevent disease transmission Acting in an Emergency
Key concepts applicable to all emergencies: Take steps to prevent disease transmission Respond to all emergencies safely and efficiently Acting in an Emergency
Key concepts applicable to all emergencies: Take steps to prevent disease transmission Respond to all emergencies safely and efficiently Always check the scene for safety before entering Acting in an Emergency
Key concepts applicable to all emergencies: Take steps to prevent disease transmission Respond to all emergencies safely and efficiently Always check the scene for safety before entering Take care of yourself after an emergency Acting in an Emergency
Standard Precautions Standard precautions rules are developed by the CDC and FDA. Occupations Safety and Health Administration (OSHA) passed regulations in 1991 requiring all health care facility employers to abide by SP Acting in an Emergency
Standard Precautions The minimal amount of precautions used when providing patient/victim care Used to break the chain of infection and prevent spread of bloodborne infections Acting in an Emergency
Starts with someone with an infection (infectious agent and reservoir) Chain of infection
Starts with someone with an infection (infectious agent and reservoir) The infectious pathogen leaves the infected person s body (portal of exit) Chain of infection
Starts with someone with an infection (infectious agent and reservoir) The infectious pathogen leaves the infected person s body (portal of exit) The infectious pathogen reaches another person by direct or indirect contact and enters his/her body (means of transmission and portal of entry) Chain of infection
Starts with someone with an infection (infectious agent and reservoir) The infectious pathogen leaves the infected person s body (portal of exit) The infectious pathogen reaches another person by direct or indirect contact and enters his/her body (means of transmission and portal of entry) The second person develops the infection (susceptible host) Chain of infection
1. All body fluids should be considered potentially infectious 2. All patients should be considered potential sources of infection 3. Wash hands before and after any patient 4. If any surface comes in contact with blood or body fluids, wash immediately and thoroughly Standard Precautions
5. Wash hands after removal of gloves 6. Wear gloves whenever contact with blood or body fluids is possible 7. Change gloves after contact with each patient 8. Gloves should not be reused Standard Precautions
9. Gowns should be worn during any procedure with risk of splashing of blood or body fluids immediately. 10. Masks and protective eyewear to be worn during procedures that may produce blood or body fluids 11. Extreme care should be taken while handling sharp objects. (Do not bend, break or recap needles. Dispose of them in puncture-resistant containers.) Standard Precautions
12. Spills or splashes of blood or body fluids should be wiped up immediately. Wear gloves, and use a disinfectant solution. 13. Mouthpieces or resuscitation devices should be used to avoid the need for mouth-to-mouth resuscitation. 14. Know the requirements for disposal of waste materials and dispose of wastes in the proper container. 15. Report any cut, injury, needle stick, or splashing of blood or body fluids immediately. Any preexisting cuts or scrapes need to be covered prior to giving care Standard Precautions
Standard Precautions include: A. Treat all victims as if their body fluids were infected B. Always wear gloves if blood may be present C. Do not touch your mouth, nose or eyes when giving first aid D. All of the above Learning checkpoint
Standard Precautions include: D. All of the above Learning checkpoint
Which of the following situations could lead to contracting an infectious disease: A. Touching a bloody bandage in a trash can B Shaking hands with a person with HIV C Receiving Hepatitis B vaccine D. Not wearing gloves and giving first aid if you have a cut on your finger E. Being near a person with Hepatitis C who is coughing F. Contact with an unresponsive person Learning checkpoint
Which of the following situations could lead to contracting an infectious disease: A. Touching a bloody bandage in a trash can D. Not wearing gloves and giving first aid if you have a cut on your finger Learning checkpoint
Items may remain infectious for some time Disposal and disinfection of supplies and equipment
Items may remain infectious for some time Never reuse disposable equipment or supplies Disposal and disinfection of supplies and equipment
Items may remain infectious for some time Never reuse disposable equipment or supplies Disinfect equipment and surfaces with a 10% bleach solution Disposal and disinfection of supplies and equipment
Items may remain infectious for some time Never reuse disposable equipment or supplies Disinfect equipment and surfaces with a 10% bleach solution Double-bag waste Disposal and disinfection of supplies and equipment
Recognize the emergency Principles in all Emergencies
Recognize the emergency Check the scene Principles in all Emergencies
Recognize the emergency Check the scene Check the victim Principles in all Emergencies
Recognize the emergency Check the scene Check the victim Call 9-1-1 Principles in all Emergencies
Recognize the emergency Check the scene Check the victim Call 9-1-1 Give first aid Principles in all Emergencies
Recognize the emergency Check the scene Check the victim Call 9-1-1 Give first aid Have the victim seek medical attention (when appropriate) Principles in all Emergencies
Recognize the emergency quickly Recognize the emergency
Recognize the emergency quickly If CPR will be required, need to start compressions within 10 seconds of recognition of cardiac arrest Recognize the emergency
Check the scene for safety Check the scene
Check the scene for safety Check for multiple victims Check the scene
Check the scene for safety Check for multiple victims Look for clues about what happened and what first aid may be needed Check the scene
Check scene for safety Check for multiple victims Look for clues about what happened and what first aid may be needed Look for bystanders to help Check the scene
Check first for life-threatening conditions: Check the victim
Check first for life-threatening conditions: Unresponsiveness Check the victim
Check first for life-threatening conditions: Unresponsiveness Not breathing normally or severe bleeding Check the victim
Check first for life-threatening conditions: Unresponsiveness Not breathing normally Severe bleeding Do not move victim unless necessary Check the victim
Call 9-1-1 when appropriate Call 9-1-1
Call 9-1-1 when appropriate For any life-threatening injury or illness Call 9-1-1
Call 9-1-1 when appropriate For any life-threatening injury or illness Call immediately for most unresponsive victims Call 9-1-1
Call 9-1-1 when appropriate For any life-threatening injury or illness Call immediately for most unresponsive victims Check responsive victims before calling Call 9-1-1
Give basic life support (BLS) for life-threatening conditions Give First Aid
Give basic life support (BLS) for life-threatening conditions Do not administer medications, but in some cases help a victims with his or her own medications Give First Aid
Help victim seek medical attention (when appropriate) Help victim seek medical attention
Help victim seek medical attention (when appropriate) Often the injury or sudden illness is not an emergency and 9-1-1 is not called Help victim seek medical attention
Help victim seek medical attention (when appropriate) Often the injury or sudden illness is not an emergency and 9-1-1 is not called Victims with many injuries still need to see a health care provider Help victim seek medical attention
Arriving EMS professionals take over the care of the victim After an Emergency
Arriving EMS professionals take over the care of the victim Fully describe to emergency responders what you observed and what care you gave After an Emergency
Arriving EMS professionals take over the care of the victim Fully describe to emergency responders what you observed and what care you gave After giving first aid, wash your hands and clean the area After an Emergency
Talk to others: family members, co-workers, local emergency responders or your health care provider Coping with a traumatic event
Talk to others: family members, co-workers, local emergency responders or your health care provider Remind yourself that your reaction is normal Coping with a traumatic event
Talk to others: family members, co-workers, local emergency responders or your health care provider Remind yourself that your reaction is normal Do not be afraid or reluctant to seek help from your school s student health center Coping with a traumatic event
True or false: If you see someone injured in an emergency, the first thing you should do is get to the victim quickly and check his/her condition. Learning checkpoint
False---first check scene for safety before entering Learning checkpoint
Handwashing
Skills steps: Handwashing
Skills steps: Remove any jewelry Handwashing
Skills steps: Remove any jewelry Use paper towel to turn on water; adjust temp to warm Handwashing
Skills steps: Remove any jewelry Use paper towel to turn on water; adjust temp to warm Wet hand to 3-4 inches above the wrists and lather with soap; keep hands below elbow during the procedure Handwashing
Skills steps: Remove any jewelry Use paper towel to turn on water; adjust temp to warm Wet hand to 3-4 inches above the wrists and lather with soap; keep hands below elbow during the procedure Wash all areas of hands, wrists and lower arms; scrub between fingers and scrub fingernails on palmar surface. Work up good lather for at least 15 seconds. Handwashing
Skills steps: Remove any jewelry Use paper towel to turn on water; adjust temp to warm Wet hand to 3-4 inches above the wrists and lather with soap; keep hands below elbow during the procedure Wash all areas of hands and wrists; scrub between fingers and scrub fingernails on palmar surface. Work up good lather for at least 15 seconds. Clean well under fingernails by rubbing fingers against palms. Use nail file or orange stick to clean under fingernails. Handwashing
Skills steps: Remove any jewelry Use paper towel to turn on water; adjust temp to warm Wet hand to 3-4 inches above the wrists and lather with soap; keep hands below elbow during the procedure Wash all areas of hands and wrists; scrub between fingers and scrub fingernails on palmar surface. Work up good lather for at least 15 seconds. Clean well under fingernails by rubbing fingers against palms. Use nail file or orange stick to clean under fingernails. Rinse well and pat dry each hand with paper towel. Turn faucet off with a dry paper towel and then use paper towel to open bathroom door. Handwashing
PPE creates a barrier between the worker and infectious material Personal Protective Equipment (PPE)
PPE creates a barrier between the worker and infectious material Examples of those most commonly used for First Aid: Gloves Barrier devices pocket face mask or face shield for CPR Personal Protective Equipment (PPE)
PPE creates a barrier between the worker and infectious material Examples of those most commonly used for First Aid: Gloves Barrier devices pocket face mask or face shield for CPR Other types of PPE: Masks Gowns Shoe covers Hair covers Eye protection Personal Protective Equipment (PPE)
Skills steps for donning (putting on) gloves: Gloves
Skills steps for donning (putting on) gloves: Pull glove onto 1 hand Gloves
Skills steps for donning (putting on) gloves: Pull glove onto 1 hand Make sure the fit is snug Gloves
Skills steps for donning (putting on) gloves: Pull glove onto 1 hand Make sure the fit is snug Pull glove onto 2 nd hand Gloves
Skills steps for removing contaminated gloves: Gloves
Skills steps for removing contaminated gloves: With one hand, grasp your other glove at the wrist and pull it away from your hand Gloves
Skills steps for removing contaminated gloves: With one hand, grasp your other glove at the wrist and pull it away from your hand Pull the glove the rest of the way off Gloves
Skills steps for removing contaminated gloves: With one hand, grasp your other glove at the wrist and pull it away from your hand Pull the glove the rest of the way off Holding the removed glove balled up in the palm of your gloved hand, insert two fingers under the cuff of the remaining glove Gloves
Skills steps for removing contaminated gloves: With one hand, grasp your other glove at the wrist and pull it away from your hand Pull the glove the rest of the way off Holding the removed glove balled up in the palm of your gloved hand, insert two fingers under the cuff of the remaining glove Remove the glove by stretching it up and away from the hand and turning it inside out as you pull it off Gloves
Skills steps for removing contaminated gloves: With one hand, grasp your other glove at the wrist and pull it away from your hand Pull the glove the rest of the way off Holding the removed glove balled up in the palm of your gloved hand, insert two fingers under the cuff of the remaining glove Remove the glove by stretching it up and away from the hand and turning it inside out as you pull it off Dispose of gloves in biohazard container and wash your hands Gloves