Simple & Easy – Emergency Preparedness
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LDS Emergency Resources – First Aid Actions pt2

LDS - First Aid Actions

Now I’m gonna do something that you should never do as an instructor: and that is, never hand out, whenever you’re teaching a class, never hand out handouts in the middle of your lecture. Reason is, everybody will read that and stop listening to you. Well, in this one, I’m gonna give this to you because I want to follow along with me, as we go through what we’re gonna cover this evening on emergency medical.

This is taken directly from the medical unit station of our state’s emergency preparedness plan that I created 18 months ago – I think it was January of ’07 that I put it together. And I was coming to this class, trying to figure part of the real thing of what I could teach in 20 minutes that’s gonna be of some value and that could help you on emergency preparedness and emergency first aid. And I thought that this would probably be one of the best brief explanations I could give for emergency first aid.

First of all, one of the things we need to realize in emergency first aid is, and we’ve talked about this before is nobody’s going to help you. You’re on your own to take care of yourself or others. So, this presupposes that EMT’s were not coming. The reason I say that is because, in most major traumas, if there was an emergency, you have a tragic skating accident and you have to prep yourself, you hold your finger until the EMTs get there. Or when one of your friends is hurt or you’re in a car accident – you just kind of maintain the person’s existence until EMTs get there – there’s no need for the rest of any of this.

But if they’re not coming, then we need to take care of ourselves and others. One of the first things we have to do is sort out the wounded. That sorting out is called triage – the French word that means “to sort”. And that’s what you’re going to do – is sort through the people who you’ve come in contact with. You sort them into groups and it might seem kind of cold and calculated to you, but we sort them because we want to provide the greatest amount of good to the greatest amount of people.

In our inner-relationships with other people, one of the things we teach them is CPR, providing CPR for somebody. In an emergency disaster, we don’t perform CPR on people. The reason is, CPR is only a method to provide a window of opportunity to survive until they get advanced life support. If advanced life support is not coming, you can spend all of your time on somebody who’s ostensibly dead, when other people around are going to remain alive if you help them. So we try not to spend any time on the dead – we try to spend the time on the living. I know that kind of seems cold and calculated, but it’s one of the best ways to use limited resources.

So during triage, you basically have 3 kinds of people. You want to evaluate if they have an open airway, you might have heard in CPR classes the ABCs are airway, breathing and circulation – we want to see if the person has an open airway. If they have an open airway, we want to see if they’re breathing. If they’re not breathing, you have no heartbeat – that’s why they call it CPR (Cardiopulmonary Resuscitation) – you have no heartbeat, you’re not breathing. There’s a term for that – the term is dead. If you open their airway, they’re not breathing, they have no heartbeat, and therefore they’re dead. We move on to people that we can help. We’re talking about opening their airways, excessive bleeding and spinal injuries – we want to take care of them as much as possible.

So we need to sort these people out in the best way we can. We want to sort them into people who need our immediate help. Those we can and should help, they’ll be first, okay? Then we sort those out into others who are immediate, delayed or dead. Then we can separate those people out and give out our resources the best way that we can.

There is basically a 6 step procedure that we can follow through the situation of how to get through this, obviously traumatic experience. The first thing we want to do is to take a size-up the situation: we want to see what the thing is, how to handle it. Think about a fire department – when they roll out to a fire, the firemen don’t go off the truck and go rolling in. The first thing they do is stand back and take a situation awareness.

Then you can conduct a voice triage. It’s simply by saying “Everybody that can hear the sound of my voice and can walk to me, come to me!” Everybody that is standing and walking up to you is already on the delayed. All that are left are the people who need immediate or the dead. So anybody who’s left standing – the walking wounded – they don’t need help, most of them, they don’t need help immediately. And so, just by doing that voice triage, we can separate a lot of them.

Then we need to conduct a sweep of the area and do a systematic sweep of the area that is involved. Your house, your neighbor’s house, something like that. You need to be able to go on, stand outside “Can you hear me Bob?” You can have them come to you, then you can sweep that area safely and get everybody else out and then there’s just a matter of fashion.

Then you need to give some kind of tag to each victim – either immediate, delayed or dead. In a lot of cases, having a lipstick and just writing right on the person’s foot a latter: I for immediate help, D for delayed or anything on their forehead if they’re dead. Then you need to go back and treat the immediate people first – those should get your resources first. Then, if possible, you want to document all that you’ve done and make some order out of the chaos.

So how do you size up a situation? Step one: you want to stop, look and listen. You want to take in and gather as much information as you possibly can. The things we want people to do when they’re in an emergency situation, we want them to be the first responders not the second victim. So, you make things worse by being there – everyone else is okay and then you got smashed. That would be terrible, so we want you to take a second to figure out – stop, take a deep breath – we don’t want that big red ass of yours running into a burning building, that would be a bad idea. We want you to think about it, then put your plan in action.

We want you to put an action plan into effect. The paralysis of the analysis has probably been more damaging, people go “What should I? What can I…?” We want you to come up with a plan knowing that no plan is perfect and her plan is not her plan and it’s not my plan. And you go in with your plan. No plan is perfect- you drew the very best you can. Secondly, we want you to do a voice triage. As soon as you walk in there and ask everybody who can to come to the sound of your voice. That separates a lot of people right there. Everybody who can stand and walk out, you just tell them – walk outside. “I’m hurt!” “I know, but you can walk, so walk outside”.

Then the people who are left are the people who will probably need your help the most. It’s really important to keep those people who are ambulatory, to keep them in one area. Cause what are they going to do? Wander off. It’s going to take a lot of your effort and energy to go get them and bring them back to help them. If you have somebody who is walking wounded but is not terribly wounded, you can help them, have them help him by saying “Everybody come out here and keep them by you – I’ll be back to help you.”

And you can also have them give you information like “Who else was in the house?” “Oh, my Bob and Helen and kitty”. “We’ll go after Bob and Helen – kitty’s on his own”.

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