Bechtel Environmental, Safety, and Health (BESH) Emergency Response: Assessing the Scene and the Victim(s) Bechtel First Response Training Session 2

Bechtel Environmental, Safety, and Health (BESH)

Emergency Response:Assessing the Scene and the Victim(s)

Bechtel First Response TrainingSession 2

Slide 2Bechtel Environmental, Safety, and Health (BESH)

Safety is Our ValueSafety is Our Value

“We measure safety performance by the number

of incidents. But let’s be clear…

it’s really not about incident rates…it’s about people.

People who have faces, names, families, hopes, and dreams.”

-Riley BechtelAugust 15, 2001


Assessing the Scene and Victim(s)Assessing the Scene and Victim(s)Enabling Learning ObjectivesEnabling Learning Objectives

Defining proper emergency response

Prioritizing safety Securing the scene Calling for help Prioritizing care Indications for moving

victims Methods of safely

repositioning, moving and rescuing victims


Proper Emergency ResponseProper Emergency Response

prevents the present situation from getting worse protects workers from further danger and injury provides first aid to the injured worker(s) protects material and equipment from further damage isolates and secures the area to ensure that nothing is

disturbed


Prioritize Your Own SafetyPrioritize Your Own Safety

Priority for safety is in the order of:

self, site, patient A responder who becomes one of

the injured is not aiding the problem but contributing to it

Personal protective equipment (PPE) must be available and worn

– protective gloves, eye and ear protection; maintain your badge on your person at all times

All responders must be familiar with where the first response equipment is located and how to use it

Additional equipment should be added only for a specific reason and by authorization of the Safety & Health Department


Secure the Scene Before Administering Secure the Scene Before Administering AidAid

Evaluate the scene for number of injured and nature of the event

Assess the safety of the scene, including the potential for toxic vapors or gases in the air, and other risks such as electrical or fire hazards

Prioritize care when there are several injured

Check victims for medical alert tags Perform a logical head-to-toe check

for injuries Move the victim only if absolutely

necessary to prevent further injury from a hazard at the scene

If possible, leave material where it is found

Secure area until the investigation is completed


Taking ChargeTaking Charge

Immediately assess seriousness of situation and size up the scene for:– scene safety, – body substance isolation determination, – mechanism of injury/nature of illness determination, – number of patients, and – resources needed

Priority should be personal injury followed by property damage. Questions to answer immediately:– Can the present situation get worse? – Is anybody injured? – How can damage be minimized?

Eliminate and contain hazards


Making a Mayday CallMaking a Mayday Call

State your name, location, and nature of the emergency

Registered Nurse will counsel and transport to scene, activate EMS

Provide initial first aid as soon as possible

Continuously monitor the victim(s) Safety will meet and escort EMS

directly to the incident scene Ensure clear access for EMS Identify witnesses and immediately

make a list of those directly involved in incident, including injured persons. Tell witnesses that their help will be needed later.

Incidents attract onlookers. Direct them away from scene.


Victim AssessmentVictim Assessment

Perform a logical head-to-toe check for injuries

Assess each victim for

– responsiveness,

– Airway patency (blockage),

– Breathing,

– Circulation, and

– medical alert necklace or bracelet

Take a victim’s history at the scene, including determining the mechanism of injury


American Heart Association CPR Guidelines American Heart Association CPR Guidelines 20102010

1. Assess the victim

2. Call for help

3. Being Chest Compressions Push hard and push fast Perform compressions at the

rate of 100 CPM If trained in CPR, after 30

compressions, open the airway and give 2 breaths

If not trained or if you do not feel comfortable, continue compressions without interruption until other help arrives


Triage PrinciplesTriage Principles

Nurse will assume command of the scene and will triage the injured when she/he arrives on the scene – EMS will assume command of the

scene when they arrive Triage is a system for sorting

casualties into priority for treatment by subsequent teams, enables limited resources to be deployed efficiently

Treating a less critically ill patient could deny life-saving interventions to others who may die as a result

Non-medical person has no authority to tag an injured person as deceased – Dead bodies should be left where

they are (uncovered)


Emergency RescueEmergency Rescue

Moving a victim from a dangerous location to a place of safety

Procedure:– Avoid unnecessary

disturbances– Ensure open airway– Control bleeding– Check for injury– Immobilize injured parts

before moving– Transport


Indications for moving VictimsIndications for moving Victims

Victims who are in immediate danger should be moved away from the danger at once by whatever means possible. Indications: Fire, danger of explosion Danger of asphyxia due to

lack of O2 or gas Serious traffic hazard Risk of drowning Exposure to cold/heat Possibility of injury from

collapsing walls or building Electrical injury or potential

injury Pinning by machinery


Moving VictimsMoving Victims

Victims who are NOT in immediate danger should be moved only after they have been stabilized

Position to prevent aggravating injuries or to prevent additional injuries

Be prepared to assist other rescuers with lifting and moving victims


Positioning VictimsPositioning Victims

Reposition the head to open the airway

Stabilize patient in position found until all assessments are complete, bleeding is controlled, and injuries are splinted

Roll unresponsive people onto their left side into the recovery position

Patient who is nauseated or vomiting should be allowed to remain in a position of comfort

Non-trauma patients can be positioned as found


Methods of TransferMethods of Transfer

Pulling the Victim Lifting the Victim Supporting the Victim Two Man Carry Blanket Lift Three Man Hammock

Carry


Moving the InjuredMoving the Injured

Keep patient’s head in line with the body

Pull patient in the direction of the long axis of the body to provide as much protection to the spine as possible

Greatest danger when moving a patient quickly is the possibility of aggravating a spinal injury or compromising the patient’s airway

1st protect yourself 2nd protect the airway 3rd protect the breathing 4th protect the circulation 5th protect the spine 6th protect the rest of the body


Three Man Hammock CarryThree Man Hammock Carry


Backboard

Backboard is used as a method of preventing an injured neck/back from getting worse and as a way to move an injured person that is suspected of having a neck/back injury without making the injury worse.

Nurse will use symptoms, mechanism of injury (e.g. how far did they fall) and medical knowledge to decide if a backboard is necessary


Stokes Basket

Normal position: horizontal or feet down Start with splinting/wound management Padding beneath patient in a Stokes basket

Under knees, between legs, along sides, around head Not under neck

Never leave patient unattended, always have plan if need to tip patient Strap patient in tight, don’t depend on seat belts On-going care: pedal pulse/vitals

Ask patient if they feel numbness/tingling/hot spots (indicates straps too tight or loose)

Rescuer at the head is in charge Feet first, rescuer at patient’s head looks forward


Assessing the Scene Review QuestionsAssessing the Scene Review Questions

1. If you encounter another person in immediate danger, what is the first priority? SELF

2. Name three situations that require emergency move of a victim.– Fire, danger of explosion– Danger of asphyxia due to lack of O2 or gas– Serious traffic hazard– Risk of drowning– Exposure to cold/heat– Possibility of injury from collapsing walls or

building– Electrical injury or potential injury– Pinning by machinery

3. What is the sequence followed when performing an initial assessment?

1. Perform a logical head-to-toe check for injuries

2. Assess responsiveness3. Airway patency (blockage)4. Breathing5. Circulation6. medical alert necklace or bracelet


We value yourWe value your Safety Safety and and HealthHealth

Questions?Questions?Speak with your Project Nurse or

Safety Professional


Learn More about Learn More about Assessing Scene Assessing Scene SafetySafety

American Heart Association (AHA.org)

Centers for Disease Control (CDC.gov)

National Institute for Occupational Safety & Health (NIOSH.org)

National Safety Council (NSC.org)

Occupational Safety & Health Administration (OSHA.gov)

U.S. Department of Health and Human Services (HHS.gov)

U.S Department of Homeland Security (DHS.gov)

Documents

Bechtel Environmental, Safety, and Health (BESH) Emergency Response: Assessing the Scene and the Victim(s) Bechtel First Response Training Session 2