Early Care for individuals triaged as immediate or who cant care for themselves

Important: Keep yourself safe and dont do anything that will cause you injury or may injure someone youre trying to help. If youre not certain about how to help, find a healthcare professional in your Mutual.
Skills learned in this class: how to sit a person up to give fluids and food, how to turn a person safely from side to side to get a blanket under and over him or her, how to do basic leg exercises to prevent blood clots from forming in the legs Whats safe? Look at a building from all sides by doing a lap around volunteers should go in pairs
Light damage Broken windows, fallen or Try to care for person inside cracked plaster, minor or remove to designated area damage to interior contents Moderate damage Visible signs of damage, Evacuate person to a safe decorative work damaged or area while minimizing the fallen, many visible cracks in number of rescuers inside plaster, major damage to the building interior contents Heavy damage Partial or total collapse, Do not enter a building with tilting, obvious structural heavy damage under any instability, heavy smoke or circumstances fire, hazardous materials inside, rising or moving water Source: Community Emergency Response Team Participant Manual. June, 2003- page 512/5-13. Get File of Life from persons apartment if it is safe to do so and attach with duct tape or with a safety pin to the persons clothing If person sheltered in own apartment, recruit neighbors to use gloves, brooms, etc, to clean up glass and debris in apartment and to move heavy items away from the bed, couch, or chair where the injured person will be placed If person sheltered outside in a tent, in a patio, or outside, obtain if safe to do so a mattress, blankets, pillows, etc. from the persons apartment 2. Helping With Basic Needs First Aid

 Safety

Give First Aid if needed, e.g., stopping bleeding, splinting, etc.

Move person away from safety hazards. Assign one person to stay with a person with dementia. (For more dementia suggestions, see Helping with Specific Health Problems

Water and food Give sips of water and other fluids and food every few hours if person is able to safely swallow Dont give fluids or food to a person who is unconscious, confused, choking, coughing, drooling, or has facial drooping, or who tells you he or she has trouble swallowing in these instances, contact a health care professional If person can swallow safely, move him or her to a straight up sitting position to prevent him/her from inhaling fluids or foods into the lungs

Warmth Use blankets, large towels, etc., from persons own apartment or from Mutual emergency supplies Be sure to put blankets both underneath and on top of person

Pain Control Check for allergies. Ask if the person wants someone to get over-the-counter analgesics (e.g., Tylenol, Advil) from his/her own apartment. Use persons own supply of prescription pain medication with caution. Check to see how long since the last dose, how much is taken, and what the persons response to the medication is. Apply cold packs to help decrease pain; use frozen vegetable packets from freezers as cold packs

Mobility Have neighbors move person to a sitting position for 10-15 minutes while person is awake move into different positions if possible when lying down Encourage the person to breathe deeply several times an hour Do leg exercises (moving feet toward the head and down toward the floor and flexing knee joints if possible every hour.

Elimination If possible, have neighbors help person walk to a toilet. If person unable to move, recruit neighbors to help with toileting/cleaning using adult diapers, wipes, and gloves if available. The goal is to keep the skin as clean and dry as possible to prevent skin breakdown and infection. Alternatives to adult diapers are newspapers, quilts, bed sheets, dishtowels, hand towels, or absorbent paper towels. Use food cans or jars as urinals for males. Have volunteers use bed sheets to provide privacy when taking care of elimination needs

Skills Practice Sitting a person up to drink fluids have 2 people on each side of the person bring the person to a sitting position on the count of 3 put the back of a chair or have a third person sit with his/her back facing the back of the injured person. Give fluids if safe to do so and encourage the person to take several deep breaths. Turning a person to a side-lying position with a blanket underneath and on top Turning to the left side - Roll up a blanket or comforter and place it as far underneath as possible on the left side of the person to be turned. Move the persons left upper extremity to the left side (as if the person was raising his/her hand) while supporting both the hand and elbow. Supporting the hip and knee, turn the persons right leg to the left. Pull the person to the left, reach underneath to feel for the blanket. Pull the blanket through and use the blanket to put on top of the person. Reverse directions if turning the person to the right side. Leg exercises support the persons ankle and gently move the foot toward the floor several times. Repeat on the opposite side.

Helping with Specific Health Care Problems

Note: These suggestions do not address all situations that may occur Problem Cuts and abrasions Stopping bleeding in people who take blood thinning medications Suggestions for management First Aid If the person takes any type of blood thinner, it may take longer than usual stop bleeding. With a clean cloth, apply direct pressure to the wound. Raise the extremity higher than the heart to decrease blood flow. You may need to apply pressure directly to the wound longer than usual. Get someone to help you keep pressure on if you get tired. Dont take the cloth off to see if bleeding has stopped. If blood soaks through the cloth, dont remove it just add more cloth on top and tie with a band of gauze or cloth. If bleeding continues, try to find a health care professional. Use paper mask to protect from debris. Monitor vital signs and calm person down. Reinforce pursed-lip breathing. Allow the person to assume a comfortable position, usually sitting up. If individual uses oxygen, do not turn oxygen to a high liter flow (may cause person to stop breathing) Immobilize any associated fracture, provide comfort measures (i.e., having an individual sit with the injured person, give overthe-counter analgesics to lessen pain. Get face to fact on the persons level to he/she can see you but dont get too close. Smile and speak calmly, but dont touch the person. Listen to the person and dont argue. Try to find someone who knows the person; dont leave the person with dementia alone. Take an agitated person for a walk if its safe or sing familiar songs to decrease agitation. Make sure the person gets water and food. Get someone to help the person to

Acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) Crush injuries Dementia

Hypothermia

Fractures arm or leg

Dehydration Acute panic attack Angina/Heart Attack

Hip or pelvic fractures

Dependent on essential medications and/or technology Burns (thermal)

the bathroom and in the bathroom. Find out if the person has pain do you hurt? or point to where it hurts. Look for facial expressions that might indicate the person is in pain. Keep those at risk well covered and warm. Remove any wet clothing. Apply cover using additional dry clothing and wrapping in blankets. Insulate from cold surfaces such as the ground and cement floors. Hydrate with warm, non caffeinated, non-alcoholic liquids in a conscious person not at risk of aspiration. Apply warm packs (if available), covered to prevent heat injury, to center body parts, e.g., chest/axilla, abdomen/groin, head/neck. Use buddy warming, i.e., having a person who is warm lying next to the person with hypothermia. Dont try to straighten the arm or leg. Take off rings and jewelry immediately and put in persons pocket. Splint the arm below and above the fracture with a regular splint or a magazine tied together with strips of gauze or clothing. Pad the inside of the splint with a small towel. If fingers or toes are broken, tape them together carefully with duct tape or stips of cloth. Elevate the arm or leg on a pillow to decrease swelling; use cold packs if available. If bone is sticking out, rinse the wound with clean water, cover with a clean cloth, and apply a splint. Be sure to label open wound with date and time. Have someone help the person get water and food and help with toileting. Provide water to rehydrate Try to calm person down, assign a calmer to be with the agitated person. Persons with pre-existing mental illness need to have medication replacement promptly Place the person in a sitting position with head and chest elevated 45 degrees. It the person has sublingual (or spray) nitroglycerine prescribed and has symptoms similar to past episodes of angina, assist with giving the medication at the persons request. If the heart attack symptoms are new and the person isnt allergic to aspirin or have a bleeding problem, or recent major surgery, have the person chew to 1 tablet of adult aspirin (325 mg.) whole or crushed in water. Do not have the person swallow a whole tablet with a glass of water. Provide a calm environment and have someone stay with the person. Assign a volunteer to be responsible for making sure the person has access to water and food; train volunteers to help with toileting needs. Provide comfort measures (i.e., having an individual sit with the injured person, give over-the-counter analgesics to lessen pain. Wash any superficial wounds with soap and water to prevent infection. Wait for medical supply and/or pharmacy access and/or hospital transport Use First Aid for less serious burns. Cool the burned area with large amounts of cool water. Cover the burned area with dry sterile dressings to exclude air. For small burns with open blisters that do not require medical attention care for an area as

Animal bites

an open wound, wash with soap and water. Apply antibiotic ointment. Provide comfort measures (i.e., having an individual sit with the burned person, give over-the-counter analgesics to lessen pain, and await hospital transport for more serious burns Wash bite with soap and water and cover with bandage. Identify and secure animal.

8/2012 Health Disaster Resource Committee Reviewed by: Leisure World Health Care Center (2011), Orange County Fire Authority Battalion Chief David Steffen, California Institute of Technology, CSULB nursing students Resources: Chauma V. Disaster First Aid: What To Do When 911 Cant Come (2009); Veemena TG. Ready RN: Handbook for Disaster Nursing and Emergency Preparedness (2nd ed. ) (2009) Volunteers who assist in the Leisure World Emergency Preparedness Program are not trained to substitute for paramedics, firefighters, police, etc. Please rely on governmental first-responders to provide medical, fire fighting, and police services in the event of an emergency legal opinion published in November, 2011 in the Golden Rain News.