Life Threatening Situations

How to Position Injured People

To help them breathe:

• When a person is conscious and breathing, but having trouble talking, let them sit or lie however they feel best. If they are struggling to do so, help them.

• The body will automatically go to the best position when someone is alert.

• Don’t force them to lie down or sit up, especially if they’re trying to reposition themselves.

Steps to follow:

1. Is the person breathing?

• NO: Do you know CPR?

• YES: Open the airway & begin CPR if necessary.

• NO: Seek help immediately.

• YES: Move the injured person into the recovery position.

Recovery Position:

A way to place the body on its side to keep the airway open and prevent choking.

• Body: Laid on the side.

• Bottom arm: Reached outward.

• Top arm: Rest forearm on the bicep of the bottom arm.

• Head: Rest on hand.

• Legs: Bent slightly.

• Chin: Raised forward.

• Mouth: Pointed downward.

Minimize movement of head & neck.

Steps to Control Bleeding:

1. Find the source of bleeding.

2. If you have something to put between the blood and your hand, use it to keep things as sanitary as possible (e.g., gloves, cloth, plastic bag).

3. Firmly apply steady pressure directly on the source. PUSH HARD, even if it’s painful to the injured.

4. Keep pressure until EMS arrives.

When to Use a Tourniquet:

Another way to apply firm, steady pressure when:

• The injury is to an arm or leg.

• Bleeding is so severe it can’t be controlled otherwise.

How to Use a Tourniquet:

1. Place as high as possible on the injured limb, closest to the torso (can be on bare skin or over clothing).

2. Pull the strap through the buckle.

3. Twist the rod tightly until bleeding stops/slows significantly.

4. Secure the rod.

5. If bleeding doesn’t stop, place a second tourniquet.

5. Leave in place until EMS takes over care.

Stop the dying/bleeding with pressure, and then apply the tourniquet to control further bleeding.

Tripod Position

• Purpose: Allows lungs and ribcage to expand fully for better breathing.

• When sitting (chair/bench):

• Legs shoulder-width apart.

• Hands/elbows on knees.

• Lean slightly forward.

• When standing:

• Legs shoulder-width apart.

• Hands on knees.

• Arms straight.

• Lean forward with a flat back.

Until Help Arrives - Key Actions

1. Call for help (e.g., 911).

2. Protect the injured person from harm.

3. Stop bleeding.

4. Position the injured so they can breathe.

5. Provide comfort.

Impact of Training Program

• Completion Stats: Since the program’s launch, 302,000 people have completed training.

• Effectiveness:

• 98% of participants said they feel more likely to help because of what they learned.

• Trauma Statistics:

• Trauma is the leading cause of death for Americans under 46 years old.

• 35% of pre-hospital trauma deaths are due to blood loss.

Mass Casualty Incidents

• Definition: Incidents resulting in injuries that exceed the normal response capacity of hospitals.

• Examples: Large-scale disasters, car crashes, and weather incidents.

Clarification on “Accident”

• The term “accident” suggests unavoidability.

• Many “car accidents” are preventable; “car crashes” is a more accurate term as they often involve driver error.

Life-Threatening Situations

• Working with People with Functional/Access Needs:

• Examples: wheelchair users, individuals with medical equipment, service animals.

• Ask how you can help; don’t assume.

• Keep caregivers or family together with the person.

• Confusion, difficulty hearing, or loss of memory may result from injuries.

• Prepare at Home:

1. Make a plan.

2. Keep supplies at home, work, and in vehicles.

3. Sign up for emergency alerts.

4. Practice the plan regularly.

• Emergency Aid Kit Essentials:

• Emergency trauma dressings (6 inches).

• Rolled gauze.

• Effective tourniquet with instructions.

• Trauma scissors (shears).

• Gloves.

• Emergency blanket.

• Bag/container for all equipment.

Providing Comfort to the Injured

• Always Start By Asking:

• “Can I help?”

• Share your name and ask what they need.

• What to Tell Them:

• What is currently known (avoid speculating).

• What is being done to assist them.

• What will happen next.

• Other Tips:

• Keep them warm to prevent hypothermia.

• Offer a hand to hold or shoulder to lean on.

• Maintain eye contact; be patient and understanding.

Keeping an Injured Person Warm

• Even if it feels warm, injured people may lose body heat rapidly.

• Warmth helps:

1. Improve blood clotting.

2. Reduce stress and lower shock risk.

3. Provide comfort.

Working with Children

• Sit or crouch at eye level.

• Use simple words and explain calmly.

• Shield the child as much as possible from the scene.

• Be aware that younger children may not fully understand the situation.

Types of Incidents

1. Common:

• Vehicle crashes, injuries at home (e.g., car/motorcycle/bicycle accidents, home repairs, pedestrian injuries).

2. Rare:

• Man-made or local weather incidents (e.g., tornados, active shooters).

3. Very Rare:

• Large-scale disasters (e.g., terrorism, bombings, large-scale transportation incidents).

Steps:

1. Call 911 to activate the chain of survival.

2. Move the injured away from danger to keep them safe.

3. Keep them alive until medical responders arrive:

• Apply pressure to stop bleeding.

• Help them to breathe by allowing them to sit up, lean forward, or place them in the recovery position if unconscious.

4. Talk to the injured to provide comfort.

• If in immediate danger, get them out of harm’s way before calling 911.

EMS Response Time:

• Typically 6–9 minutes, but life can be lost before responders arrive.

Good Samaritan Laws:

• Protect those who help from liability until professional help arrives.

• All 50 states and D.C. provide protection for reasonable actions to help.

• EMTs/paramedics are held to higher standards due to training.

• Laws differ by location—check your area.

Chain of Survival:

How emergency medical systems flow to keep people with life-threatening situations (LTS) alive.

• Components include:

1. You

2. Non-medical first responders

3. Emergency medicine

4. Surgeons

Impact of Stress:

In an LTS, you may experience physical and psychological effects such as:

1. Distortion of Time Assessment Loop:

• Denial

• Deliberation

• Action

2. Distortion of Senses:

• Sight (tunnel vision)

• Sound

3. Adrenaline (Fight/Flight Response):

• Temperature changes

• Shaky hands

• Loss of other functions

4. Nausea

• These are normal reactions to stress, and most people will experience them.

Calling 911:

• 911 operators are trained to:

• Assess the situation.

• Take appropriate actions.

• Help ensure safety.

Steps When Calling 911:

1. Take a deep breath.

2. Let the operator guide you.

3. Follow their specific instructions.

Types of Questions Operators Ask:

• Specific location (floor, room, landmarks).

• Severity of injuries to send appropriate help.

• Safety concerns (dangers or ongoing threats).

Stay Safe:

• Use your 5 senses (see, hear, smell) to assess the area.

• Ask yourself:

• Do you feel safe here?

• Yes: Stay and provide care.

• No: Move to a safe location and call for help.

Stop the Bleeding:

• Humans have about 5-6 liters of blood in their body.

• Losing 500 cc (half a liter) causes physiological problems.

• Losing half the blood volume can cause death, no matter the hospital care.

Key Points:

• Bleeding is irreversible if untreated.

• Body can lose fatal blood amounts in minutes.

• Apply pressure to stop bleeding.

• Major blood vessels are deep under the skin near bones—protect these areas.