Lesson 36: Reaching and Moving
Victims in the Water
Introduction
 Water provides people with some of the most enjoyable
recreational activities, but water can be dangerous.
 Drowning is death by suffocation in water.
 Drownings may occur during swimming, boating, hunting,
fishing or while taking a bath.
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The Risk of Drowning
 Children younger than age 5 and young adults ages 15 to 24
have the highest rates of drowning.
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Preventing Aquatic Emergencies
 The best thing anyone can do to stay safe in, on and around
the water is to learn to swim.
 The American Red Cross has swimming courses for people of
any age and swimming ability. To enroll in a swimming
course, contact a local Red Cross chapter.
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Preventing Aquatic Emergencies
(continued)
 Follow these guidelines whenever you are swimming in any
body of water (pools, lakes, ponds, quarries, canals, rivers or
oceans):
 Always swim with a buddy; never swim alone.
 Read and obey all rules and posted signs.
 Swim in areas supervised by a lifeguard.
 Children or inexperienced swimmers should take extra
precautions, such as wearing a U.S. Coast Guardapproved life jacket when around the water.
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Preventing Aquatic Emergencies
(continued)
 Watch out for the “dangerous too’s”:
 Too tired
 Too cold
 Too far away from safety
 Too much sun
 Too much strenuous activity
 Be knowledgeable of the water environment and the
potential hazards.
 Know how to prevent, recognize and respond to
emergencies.
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Preventing Aquatic Emergencies
(continued)
 Use a feet-first entry when entering the water.
 Enter head-first only when the area is clearly marked for
diving and has no obstruction.
 Do not mix alcohol with swimming, diving or boating.
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Recognizing an Emergency
 An emergency can happen to anyone in, on or around
the water.
 The key to recognizing an emergency is staying alert
and knowing the signals that indicate an emergency is
happening.
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Recognizing an Emergency
(continued)
 There are two kinds of water emergency situations:
 A swimmer in distress
 A drowning victim
 A distressed swimmer may be too tired to get to the shore or
the side of the pool but is able to stay afloat and breathe and
may be calling for help.
 An active drowning victim is vertical in the water but unable
to move forward or tread water. The victim is struggling to
keep his or her head above water to breathe.
 A passive drowning victim is not moving and will be floating
face-down on the bottom or near the surface of the water.
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Recognizing an Emergency
(continued)
 Once you know there is an emergency, you must decide to act
and decide how to act.
 Follow the emergency action steps: CHECK—CALL—CARE.
 Make sure the scene is safe—do not go rushing into a dangerous
situation where you too may become a victim.
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Recognizing an Emergency
(continued)
 Always check first to see whether a lifeguard or other
trained professional is present.
 If you must assist someone who is having trouble in the
water, you must have the appropriate equipment.
 Send someone else to call 9-1-1 or the local emergency
number.
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Out-of-Water Assists
 You can help a person in trouble in the water by using
reaching assists or throwing assists.
 Out-of-water assists are safer for you.
 Start the rescue by talking to the victim.
 Let the victim know help is coming.
 Tell the victim what you want him or her to do to help with
the rescue.
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Reaching Assists
 If the victim is close enough, you can use a reaching assist
to help him or her out of the water.
 If available, use any object that will extend your reach,
such as a pole, an oar or paddle, a tree branch, a shirt, a
belt or a towel.
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Reaching Assists
(continued)
 If there is equipment available—
1. Brace yourself on a pool deck, pier surface or shoreline.
2. Extend the object to the victim.
3. When the victim grasps the object, slowly and carefully
pull him or her to safety. Keep your body low and lean
back to avoid being pulled into the water.
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Reaching Assists
(continued)
 If you have no equipment available to perform a reaching
assist, you should—
1. Reach with one arm and grasp the victim.
2. Pull the victim to safety.
3. Brace yourself on the pool deck or pier surface.
 If you are already in the water—
1. Hold onto the pool ladder, overflow trough, piling or
some other secure object with one hand.
2. Extend your free hand or one of your legs to the victim.
Do not let go of the secure object and do not swim out
into the water.
3. Pull the victim to safety.
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Throwing Assists
 You can rescue a conscious victim out of reach by using a throwing
assist. Use anything that will provide the victim support.
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Throwing Assists
(continued)
 A floating object with a line attached can be used to throw to
the victim and pull him or her to safety.
 To perform a throwing assist, follow these guidelines:
1. Get into a stride position.
2. Step on your end of the line with your forward foot.
3. Shout to get the victim’s attention.
4. Bend your knees and throw the object to the victim.
5. When the victim has grasped the object or the line, slowly
pull him or her to safety.
6. If the object does not reach the victim, quickly pull the
line back in and throw again.
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Wading Assist with Equipment
 To perform a wading assist, follow these steps:
1. Take a buoyant device with you.
2. Wade into the water and extend the object to the victim.
3. When the victim has grasped the object, tell him or her to
hold onto the object tightly for support and pull him or her
to safety.
 A victim who has been lying motionless and face-down in the
water for several seconds is probably unconscious.
1. If the water is not over one’s chest, wade into the water
carefully with some kind of flotation equipment and turn
the person face-up.
2. Bring him or her to the side of the pool or shoreline.
3. Remove the victim from the water.
4. Give care if needed.
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Wading Assist with Equipment
(continued)
 If a victim is discovered on or near the bottom of the pool in
deep water, call for trained help immediately.
 If in shallow water less than chest deep and a head, neck or
back injury is not suspected—
1. Reach down and grasp the victim.
2. Pull the victim to the surface.
3. Turn the victim face-up and bring him or her to safety.
4. Remove the victim from the water.
5. Give care if needed.
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Walking Assist
 If the victim is in shallow water where he or she can stand,
he or she may be able to walk out of the water with some
support.
 To perform a walking assist, follow these guidelines:
1. Place one of the victim’s arms around your neck and
over your shoulder.
2. Grasp the wrist of the arm that is over your shoulder
and wrap your free arm around the victim’s back or
waist.
3. Maintain a firm grasp and help the victim walk out of
the water.
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Beach Drag
 You may use the beach drag with a victim in shallow water
on a sloping shore or beach. This method works well with a
heavy or unconscious victim.
 To perform the beach drag—
1. Stand behind the victim and grasp him or her under the
armpits. Support the victim’s head with your forearms.
2. While walking backward slowly, drag the victim toward
the shore.
3. Remove the victim completely from the water or at least
get the victim’s head and shoulders out of the water.
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Head, Neck, or Back Injury Management
in the Water
 Most injuries to the head, neck or back occur in shallow water.
 These injuries may result from diving into shallow water, diving
into above-ground pools and unsupervised diving from starting
blocks.
 Injuries can also result from head-first entry into the surf at a
beach, off a pier at a lake, from a cliff into a water-filled quarry
or from falling while surfing or boogie boarding.
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Recognizing a Head, Neck or Back Injury
 Usually a head, neck or back injury is caused by hitting the
bottom or an object in the water.
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Recognizing a Head, Neck or Back Injury
(continued)
 Your major concern is to—
 Keep the victim’s face out of the water to let him or her
breathe.
 Prevent the victim’s head and back from moving further.
 Move the victim to safety.
 Always check first whether a lifeguard or other trained
professional is present.
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General Guidelines for Care
 Follow these guidelines for a victim with a suspected head,
neck or back injury in shallow water:
1. Be sure someone has called 9-1-1 or the local emergency
number.
2. Minimize movement of the victim’s head, neck and
back.
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•
Try to keep the victim’s head in line with the body.
•
This technique is called manual stabilization.
•
Do this without pulling the head.
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General Guidelines for Care
(continued)
3. Position the victim face-up at the surface of the water.
4. Check for consciousness and breathing once you have
stabilized the victim’s head, neck and back using the
manual stabilization technique.
•
A victim who can talk or is gasping for air is conscious
and breathing.
5. Support the victim with his or her head, neck and back
immobilized until help arrives.
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Specific Immobilization Techniques
 The following sections describe two methods for stabilizing the
victim’s head, neck and back in the water.
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Specific Immobilization Techniques
(continued)
 Two methods for immobilizing a head, neck or back injury
are the hip shoulder support or the head splint technique.
 To perform the hip and shoulder support—
1. Approach the victim from the side and lower yourself to
chest depth.
2. Slide one arm under the victim’s shoulders and the
other arm under the hip bones. Support the victim
horizontally, keeping the face clear of the water.
3. Do not lift the victim, but support him or her in the
water until help arrives.
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Specific Immobilization Techniques
(continued)
 To perform the head splint technique—
1. Approach the victim from the side.
2. Gently move the victim’s arms up alongside the head by
grasping the victim’s arms midway between the shoulder
and elbow.
•
Grasp the victim’s right arm with your right hand.
•
Grasp the victim’s left arm with your left hand.
3. Squeeze the victim’s arms against his or her head. This
helps to keep the head in line with the body.
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Specific Immobilization Techniques
(continued)
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4.
With your body at about shoulder depth in the water,
glide the victim slowly forward.
5.
Continue moving slowly and rotate the victim toward
you until he or she is face-up.
6.
Position the victim’s head in the crook of your arm
with the head in line with the rest of the body.
7.
Maintain this position in the water until help arrives.
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Helping Someone Who Has Fallen Through Ice
 If a person falls through ice, never go out onto the ice yourself to
attempt a rescue.
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Helping Someone Who Has Fallen Through Ice
(continued)
 Follow these guidelines:
1. Send someone to call 9-1-1 or the local emergency number
immediately.
2. From a secure place on land, try a reaching or throwing
assist.
3. If it is possible to do so safely, pull the victim to shore. If it is
not, talk to the victim and make sure he or she is secure as
possible with the object until help arrives.
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Closing
 Many drownings can be prevented by following simple
precautions when in, on or around water.
 Use the basic methods of reaching, throwing or wading to
reach or assist a victim in the water without endangering
yourself. Always remember to stay safe.
 If there is any chance that you cannot safely and easily help
the victim in trouble, call for professional assistance.
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Closing
(continued)
 Further training in water safety and lifeguarding is available
through local Red Cross chapters.
 Questions?
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Lesson 37: People with
Special Needs
Introduction
 In an emergency, be aware of the special needs and considerations
of—
 Children.
 Older adults.
 People with disabilities.
 People who do not speak the same language you speak.
 Knowing about these needs and considerations will help you give
appropriate care.
 Being able to communicate with and reassure people with special
needs is essential for you to care for them effectively.
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Infants and Children
 Infants and children have unique needs and require
special care.
 Assessing a conscious infant’s or child’s condition can
be difficult.
 At certain ages, infants and children do not readily
accept strangers.
 Infants and very young children cannot tell you what is
wrong.
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Communicating with an Ill or Injured Child
 You need to reduce the child’s anxiety and panic and gain the
child’s trust and cooperation if possible.
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Communicating with an Ill or Injured Child
(continued)
 A child has certain fears. These include—
 The unknown.
 Being ill or injured.
 Being touched by strangers.
 Being separated from parents or a guardian.
 To interact with an ill or injured infant or child is very important.
 Move in slowly.
 Keep a calm voice.
 Smile at the child.
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Communicating with an Ill or Injured Child
(continued)
 Ask the child’s name.
 Talk slowly and distinctly.
 Explain to the child and parents or guardian what you
are going to do.
 Reassure the child.
 Children act differently depending on their age.
 Infants (birth to 1 year)
 Infants less than 6 months old are relatively easy to
approach.
 Older infants often exhibit “stranger anxiety.”
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Communicating with an Ill or Injured Child
(continued)
 Toddlers (1 to 2 years)
 Toddlers may not cooperate.
 They need reassurance.
 A toddler may also respond to praise or be comforted.
 Preschoolers (3, 4 and 5 years)
 Children in this age group are usually easy to check.
 Allow them to inspect items such as bandages.
 They need reassurance that you are going to help and
will not leave them.
 Demonstrate on a stuffed animal or doll what you are
going to do to them.
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Communicating with an Ill or Injured Child
(continued)
 School-age children (6 to 12 years)
 School-age children are usually cooperative.
 Do not let the child’s general chronological age
influence you to expect an injured or ill child to
behave in a way consistent with that age.
 Be especially careful not to talk down to these
children.
 Let them know if you are going to do anything that
may be painful.
 Make every effort to respect their modesty.
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Communicating with an Ill or Injured Child
(continued)
 Adolescents (13 to 18 years)
 Adolescents consider themselves more adult than child.
 They respond better when you direct your questions
about what happened to them.
 They are modest and respond better to responders of
the same gender.
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Interacting with Parents and Guardians
 To interact with an ill or injured child and his or her
parents—
 Calm the family and the child will often calm down as
well.
 Get consent to care for the child.
 Behave as calmly as possible.
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Observing an Infant or Child
 Look for signals that indicate changes:
 Level of consciousness
 Trouble breathing
 Apparent injuries and conditions
 You can check a conscious child while the parent or guardian
is holding him or her.
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Observing an Infant or Child
(continued)
 Use a toe-to-head check.
 Ask a young child to point to any place that hurts. An older
child can tell you the location of painful areas.
 If you need to hold an infant, always support the head when
you pick him or her up.
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Special Problems
 Certain problems are unique to children, such as specific
kinds of injury and illness.
 Injury
 Illness
 Poisoning
 Child abuse
 Sudden Infant Death Syndrome (SIDS)
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Injury
 Injury is the number one cause of death for children in the
United States.
 Many of these deaths are the result of motor vehicle crashes.
 Severe bleeding must be controlled as quickly as possible.
 The head is the most often injured part of the child’s body.
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Illness
 Certain signals in an infant or child can indicate specific illnesses.
Often these illnesses are not life threatening, but some can be.
 A high fever in a child often indicates some form of infection.
 Your initial care for a child with a high fever is to—
 Gently cool the child.
 Remove excessive clothing or blankets.
 Sponge the child with lukewarm water.
 Call a physician at once.
 Not give the child aspirin.
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Poisoning
 Poisoning is the fifth-largest cause of unintentional death in the
United States for people ages 1 to 24.
 For the youngest of these victims, mainly children under 5 years
of age, poisoning often occurs from ingesting household products
or medications.
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Child Abuse
 Child abuse is the physical, psychological or sexual assault of
a child, resulting in injury and emotional trauma.
 Child abuse involves an injury or pattern of injuries that
happen to a child and are not the result of a mishap.
 Signals of child abuse include—
 An injury that does not fit the description of what caused
the injury.
 Obvious or suspected fractures in a child younger than 2
years of age or any unexplained fractures.
 Bruises and burns in unusual shapes.
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Child Abuse
(continued)
 Injuries in various stages of healing, especially bruises and
burns.
 Unexplained lacerations and burns, especially to the
mouth, lips and eyes.
 Injuries to the genitalia; pain when the child sits down.
 More injuries than are typical for a child of that age.
 The child’s unwillingness to talk about the situation.
 If you suspect abuse, explain your concerns to responding
police officers or EMS personnel if possible.
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Child Abuse
(continued)
 If you think you have reasonable cause to believe that abuse
has occurred, report your suspicions to a community or state
agency, such as the Department of Social Services, the
Department of Child and Family Services or Child Protective
Services.
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Sudden Infant Death Syndrome (SIDS)
 SIDS is a disorder that causes seemingly healthy infants to
stop breathing while they sleep.
 SIDS is a leading cause of death among children ages 1 month
to 1 year.
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Sudden Infant Death Syndrome (SIDS)
(continued)
 Care for the child as you would other cardiac arrest victims.
Perform CPR and have someone call 9–1–1 or the local
emergency number.
 An incident involving a severely injured or ill infant or child or
one who has died can be emotionally upsetting.
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Older Adults
 Older adults, or the elderly, are generally considered those
people over 65 years of age.
 Normal aging brings about change. Body functions decline as
we age.
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The Aging Process
 Aging brings about the following changes and decline in
function:
 Lungs are less efficient.
 The amount of blood pumped by the heart decreases.
 Heart rate slows down.
 Blood vessels harden.
 Hearing and vision usually decline.
 Reflexes become slower and arthritis may affect joints.
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Checking an Older Adult
 Checking an older adult may be difficult.
 When checking an older adult’s condition—
 Learn the victim’s name.
 Be respectful.
 Position yourself at the victim’s eye level.
 Assess the cause of any confusion the victim is experiencing.
 Confusion may be a result of impaired vision or hearing
loss. Find the victim’s glasses or other aids.
 Speak slowly and clearly and look at the person’s face while
you talk.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
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Checking an Older Adult
(continued)
 Find out if the victim is using medications or has known
medical conditions.
 Recognize that the victim may minimize signals of an injury
for fear of losing his or her independence.
503
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Special Situations
 Physical and mental changes can occur as a result of aging.
Because of these changes, many older adults are susceptible
to certain problems, such as—
 Falls.
 Head injuries.
 Confusion.
 Heat and cold emergencies.
504
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
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People with Disabilities
 The absence or loss of motor, sensory or mental function is
called a disability.
 Impairment is damage or reduction in quality, quantity, value
or strength of the function.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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People with Disabilities
(continued)
 General guidelines for approaching an ill or injured person whom
you believe is in some way disabled include—
 Speaking to the person before touching him or her.
 Asking if or how you can help.
 Asking the person and any available family or friends for
information about his or her condition.
 Not removing any physical aids or supports.
 Looking for medical alert identification.
 Keeping an animal guide with the person.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Hearing Loss
 The biggest obstacle you must overcome when caring for
a person who has a partial or total loss of hearing is
communication.
 You may be able to communicate with a person with
hearing loss through—
 Sign language.
 Looking straight at the person while you speak.
 The person with hearing loss reading lips (this is
called “speech reading”).
 Gestures and written messages.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Vision Loss
 Vision loss is a partial or total loss of sight.
 When caring for a person with vision loss:
 Help to reassure him or her.
 Stand beside the person, if he or she can walk.
 Do not speak loudly or in overly simple terms.
 If the victim has a guide dog, try to keep the dog
with the person.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Motor Impairment
 A person with motor impairment is unable to move normally.
 Determining which problems are pre-existing and which are
the result of immediate injury or illness can be difficult.
 Care for all problems you detect as if they are new.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
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Mental Impairment
 Mental, or cognitive, function includes the brain’s capacity to
reason and to process information.
 When caring for a person with mental impairment—
 Approach the person the same way you would anyone
else in that age group.
 Listen carefully to what the person says.
 Explain who you are and what you are going to do.
 If a parent or guardian is present, ask that person to help
you care for the victim.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
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Language Barriers
 Getting consent to give care can be difficult with an individual
who speaks in a language other than one in which you are fluent.
 Find out if any bystanders speak the victim’s language and can
help translate.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Language Barriers
(continued)
 Communicate nonverbally; use gestures and facial expressions.
 When you call 9-1-1 or the local emergency number, explain that
you are having trouble communicating with the victim and say
what nationality you believe the victim is or what language he or
she is speaking.
512
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Special Situations
 There are some situations in which you should not become
involved, such as a crime scene or a hostile victim.
 Do not enter the scene of a suicide.
 In the case of an unarmed suicidal person—
 Do not argue with him or her.
 Call 9-1-1 or the local emergency number and the
police.
 If the scene is safe, listen to him or her and try to keep
the person talking until EMS personnel arrive.
513
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Special Situations
(continued)
 Do not enter the scene of a physical assault or sexual assault
or any scene if there is a weapon.
 Call 9-1-1 or the local emergency number.
 Stay a safe distance away.
 If the victim is hostile—
 Remove yourself from the potential dangerous situation.
 Call 9-1-1 or the local emergency number.
 Try to be sympathetic and calm with hostile family
members.
 Explain what you are trying to do.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
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Closing
 Situations involving people with special needs require your
awareness and understanding.
 If a situation is in any way unsafe, do not approach the
victim. If you have already approached, withdraw to a safe
place until EMS personnel arrive.
 Questions?
515
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Lesson 38: Childbirth
Introduction
 Childbirth is a natural process. Thousands of children all over
the world are born each day, without complications, in areas
where no medical care is available.
 By following a few simple steps, you can effectively assist in the
birth process.
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Pregnancy
 Pregnancy begins when an egg (ovum) is fertilized by a sperm,
forming an embryo.
 The embryo implants itself within the mother’s uterus.
 The embryo is surrounded by the amniotic sac.
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Pregnancy
(continued)
 After about 8 weeks, the embryo is called a fetus.
 The embryo receives nutrients from the mother through a
specialized organ called the placenta, which is attached to the
lining of the uterus.
 The placenta is attached to the fetus by a flexible structure
called the umbilical cord.
 The fetus will continue to develop for approximately 40 weeks,
at which time the birth process begins.
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Birth Process
 The birth process begins with the onset of labor. Labor is the
final phase of pregnancy.
 Labor begins with the rhythmic contraction of the uterus and
the dilation of the cervix.
 Dilation allows the baby to travel from the uterus through
the birth canal.
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Labor
 Labor has three distinct stages. The length and intensity of each
stage vary:
 Stage One—preparation
 Stage Two—delivery of the newborn
 Stage Three—delivery of the placenta
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Copyright © 2006 by The American National Red Cross
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Assessing Labor
 If you must care for a pregnant woman, you will want to
determine whether she is in labor.
 Is she is in labor, you should determine in what stage of labor
she may be and whether she expects any complications.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Assessing Labor
(continued)
 Ask the following questions:
 Has 9-1-1 or the local emergency number been called?
 Is this her first pregnancy?
 Does she expect any complications?
 Is there a bloody discharge?
 Has the amniotic sac ruptured (or water broken)?
 What are the contractions like? Are they close together?
Are they strong?
 Does she have an urge to bear down or push?
 Is the newborn’s head visible?
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
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Preparing the Mother
 You can help the expectant mother cope with the discomfort
and pain of labor.
 Suggest that the mother try specific physical activities that
she can do to relax, such as regulating breathing by—
 Deep breathing—inhaling slowly and deeply through the
nose and out through the mouth.
 Focusing her attention on an object in the room while
regulating her breathing.
 Stay calm, firm and confident, offering encouragement.
524
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Assisting with Delivery
 Assisting with delivery of the newborn is often a simple process.
 Begin by positioning the mother.
 Establish a clean environment.
 Protect yourself.
 As crowning begins, place a hand on the top of the newborn’s
head and apply light pressure.
 Ask the mother to change her breathing pattern.
525
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Assisting with Delivery
(continued)
 After the head emerges, lower the head and guide one
shoulder out at a time.
 Do not pull the newborn.
 Use a clean towel to catch the newborn.
 Place the newborn on its side, between the mother and you.
 Note the time the newborn was born.
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Caring for the Newborn
 You have two priorities at this point.
 Your first priority is to see that the newborn’s airway is open
and clear.
 Clear the nasal passages and mouth thoroughly.
 If the baby does not spontaneously breathe or cry, flick the
soles of his or her feet to stimulate crying.
 If the baby does not begin to breathe on his or her own,
begin rescue breathing. If the baby does not have signs of
life, begin CPR.
527
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Caring for the Newborn
(continued)
 Your second priority for the newborn is to maintain normal
body temperature.
 Dry and wrap the baby in a clean, warm towel or blanket.
 Continue to monitor breathing, circulation and skin color.
 Place the wrapped baby on the mother’s abdomen.
528
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Caring for the Mother
 Help the mother to begin nursing the newborn if possible.
This will stimulate the uterus to contract and help slow
bleeding.
 As the uterus contracts, it will expel the placenta, usually
within 30 minutes.
 As the placenta emerges, place it in a towel or container for
transport with the mother and baby to the hospital.
 It is not necessary to separate the placenta from the newborn.
529
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Caring for the Mother
(continued)
 Gently clean the mother using gauze pads or clean towels.
 Place a sanitary pad or a towel over the vagina. Do not insert
anything in the vagina.
 Gently massage the lower portion of the abdomen.
 Keep the mother positioned on her back. Keep her from getting
chilled or overheated and continue to monitor her condition.
530
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
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Scenario
A car pulls into your driveway. The driver jumps out screaming for
help for his wife, who is in the back seat. The woman is 35 years
old and full term in her pregnancy. Her contractions are less than 2
minutes apart. She says that the baby is coming and she feels the
need to push. Her husband tells you this will be their fourth child.
How do you respond?
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Complications During Pregnancy
 Complications during pregnancy are rare; however, they do
occur.
 One such complication is miscarriage, or spontaneous abortion.
 Concern yourself with recognizing signals that suggest a serious
complication during pregnancy.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Complications During Pregnancy
(continued)
 Two important signals you should be concerned about are
vaginal bleeding and abdominal pain.
 An expectant mother showing these signals needs to receive
advanced medical care quickly. While waiting for EMS
personnel—
 Place a pad or other absorbent material between the
mother’s legs.
 Take steps to minimize shock:
 Help the expectant mother into the most comfortable
position.
 Keep the expectant mother from becoming chilled or
overheated.
533
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Complications During Childbirth
 Complications during childbirth require the help of more
advanced medical care.
 More common complications include—
 Persistent bleeding.
 Prolapsed umbilical cord.
 Breech birth.
 Multiple births.
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Closing
 Childbirth should occur in a controlled environment under
the guidance of health-care professionals trained in labor and
delivery.
 Unexpected deliveries may occur outside of a controlled
environment and may require your assistance.
 To assess the mother’s condition before delivery and to assist
in the delivery, be familiar with the three stages of labor and
understand the birth process.
 By knowing how to prepare the expectant mother for
delivery, assist in the delivery and give proper care for the
mother and newborn, you can help bring a new child into the
world.
535
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Closing
(continued)
 Questions?
536
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Lesson 39: Delayed-Help
Situations I
Introduction
 Situations in which emergency medical care is delayed for 30
minutes or more are called delayed-help situations.
 Areas in which delayed-help situations occur include—
 Rural areas.
 Wilderness environments.
 In delayed-help situations, use the emergency action steps,
CHECK—CALL—CARE, as your basic plan of action.
However, how you check the scene and the victim, call for help
and care for the victim may change.
538
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Types of Delayed-Help Environments
 There are three types of environments that can create a
delayed-help situation:
 Rural areas
 Wilderness areas
 Disaster situations
539
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Rural Areas
 Include country and farm areas.
 Response times are often delayed because of long distances
and adverse conditions.
540
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Rural Areas
(continued)
 Emergencies that usually occur involve—
 Equipment.
 Animals.
 Electricity.
 Falls.
 Fires.
 Overturned vehicles.
 Chemicals or pesticides.
 Agricultural machinery mishaps.
541
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Wilderness
 A wilderness is an area that is not settled, is uncultivated and
has been left in its natural condition.
 A phone and emergency personnel may be miles away.
 If an emergency occurs, give care for the victim and consider
how you are going to get help.
 You may need to send someone to get help or go yourself.
 If you decide to go for help, you will have to shelter the victim
from the elements.
542
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Disaster Situations
 Disasters, such as hurricanes, earthquakes or mass trauma
(explosions, acts of terror) are likely create delayed-help
situations.
 Certain activities such as boating may create delayed-help
situations.
543
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Taking Action in a Delayed-Help Situation
 In a delayed-help environment, you may have to modify the
emergency action steps: CHECK—CALL—CARE.
 The CHECK step may need to be more detailed.
 The information you gather will be important to developing
a plan for getting help and caring for the victim.
544
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Taking Action in a Delayed-Help Situation
(continued)
 The CALL step may be delayed for a few minutes or a few
hours, or in some situations, you may decide it is better to
take the victim to help.
 The CARE step in a delayed-help environment includes giving
care and periodically rechecking the victim’s condition until
help arrives.
545
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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CHECK
 The CHECK step of the emergency action steps includes
checking the scene, checking the victim and checking for
resources.
546
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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CHECK the Scene
 Check the entire scene and try to get a general idea of what
happened.
 Look for hazards or impending problems.
547
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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CHECK the Victim
 After determining that the scene is safe, approach the victim
carefully and check for life-threatening conditions. Care for
the conditions you find.
548
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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CHECK the Victim
(continued)
 If the victim has fallen or you do not know how the injury
occurred, assume that there is a head, neck or back injury.
 Check the victim for any other problems that are non-lifethreatening.
 Perform a head-to-toe check of the victim.
 If possible, write down the information you gather.
549
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Copyright © 2006 by The American National Red Cross
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CHECK for Resources
 Check the scene for resources.
 Check the surrounding environment.
 Note conditions that would make it difficult for you to get help.
 Consider whether you may have to move the victim.
550
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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CALL
 The CALL step of the emergency action steps is divided into
two phases—
 Making a plan for getting help.
 Executing the plan.
551
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Making a Plan and Getting Help
 In a delayed-help situation, you have four options for getting
help:
 Stay where you are and call, radio or signal for help.
 Send someone to go get help or leave the victim alone to
go get help.
 Transport the victim to help.
 Care for the victim where you are.
552
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Making a Plan and Getting Help
(continued)
 To help you decide on the best approach to getting help and
giving care for the victim, ask yourself these questions:
 Is advanced medical care needed?
 Is there a way to call from the scene for help?
 If phone or radio communication is not possible, is there
a way to signal for help?
 If there is no way to call for help, is it possible to go get
help?
 Is there a way to transport the victim to help?
 Is it possible to give care where you are until the victim
can travel?
 Is it safe to wait for help where you are?
553
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Making a Plan and Getting Help
(continued)
 You may discover that there is no “best” plan, but there may
be a way to reduce the risks to both you and the victim.
 Once you have a plan, you need to execute it.
554
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Calling for Help
 Make sure you have gathered information that describes all
important aspects:
 Victim’s condition
 Your location
 Any other basic information that EMS or rescue personnel
may need
555
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Calling for Help
(continued)
 Make sure that you give rescuers specific information about
where you are.
 Identifying prominent landmarks and marking your area can
help rescuers find your location.
 Consider that some landmarks may not be visible at night.
 Be aware of hazards that may arise, such as fires from using
flares.
556
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Improvised Distress Signals
 If you have no way to call for help and it is dangerous or
impractical to use flares or send someone for help, you may have
to improvise.
557
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Improvised Distress Signals
(continued)

Two of the most widely used distress signals are—
 Signals in threes.
 Ground-to-air signals.
 In addition, smoke, mirrors, flare guns and whistles can
create visual or auditory signals to attract responders.
558
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Sending for Help
 When you send someone to get help, he or she should have
certain written information including—
 The victim’s condition and medical information.
 A map indicating the victim’s location.
 A list of other members in the group.
 Available resources.
 A description of weather, terrain and access routes if
known.
559
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Sending for Help
(continued)
 Another consideration in going for help is to make sure you
can lead rescuers back to the victim.
 Use compass readings and maps or charts when possible.
 Always mark your way so that you can find your route
back.
 Make sure that you leave enough people to care for the
victim while waiting for help.
 Before sending anyone for help, consider whether actions
that must be taken at the scene require everyone’s help.
560
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Leaving a Victim Alone
 In some situations, if you are the only one present, it may be best
to leave the victim and go get help.
561
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Leaving a Victim Alone
(continued)
 Before leaving a victim, follow these steps:
 Write down the route, the time you are leaving and
when you expect to be back.
 Provide for the victim’s needs while you are gone.
 Make certain that the victim has adequate clothing
and shelter.
 Recheck any splints or bandages and adjust them if
necessary.
 If the victim is unconscious or unable to move, place
him or her in the recovery position.
 Before leaving a conscious victim, make sure he or she
understands you are going for help and let him or her
know when you expect to return.
562
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Transporting the Victim to Help
 Consider transporting a victim if a vehicle or other means of
transportation is available.
 Factors to consider when deciding to move the victim
include—
 The extent of the victim’s injuries.
 The distance to be traveled.
 Available help.
 Do not move or transport a victim with a possible head, neck
or back injury unless the scene is not safe or a potential for
danger exists.
563
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Transporting the Victim to Help
(continued)
 If you decide to transport a victim to help, plan the route
you will follow.
 To minimize pain and injury during the move, immobilize
any possible bone or joint injuries.
 Select a place in the vehicle for the victim that will be as
comfortable as possible.
 Transport at a safe speed.
 Monitor the victim’s condition.
564
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Closing
 Delayed-help situations may occur in areas where people may
be able to call 9-1-1 or the local emergency number but may
have to wait a long time before EMS personnel arrive or in
areas where medical help is unavailable because of distance,
travel conditions and communication difficulties.
 In a delayed-help environment, you may have to modify the
emergency action steps: CHECK—CALL—CARE.
 Getting help may involve calling for help, sending for help,
leaving the victim alone and going for help, transporting the
victim to help or allowing the victim to recover sufficiently so
that he or she can walk to help.
 Questions?
565
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Lesson 40: Delayed-Help
Situations II
Introduction
 In delayed-help situations, use the emergency action steps:
CHECK—CALL—CARE.
 If you are in a delayed-help environment or find yourself in a
situation where a phone is not immediately accessible, it is
important that you know how to give care.
567
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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CARE
 In a delayed-help situation, you may need to care for the
victim for a long time.
 It is important that you remain calm and develop and follow
a plan of action.
 Provide support and reassurance to the victim until EMS
personnel arrive and take over.
568
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Monitoring the Victim
 After completing your initial check of the victim and
giving initial care, continue to monitor the victim’s
condition while waiting for help.
 Watch for changes in skin appearance, temperature and
level of consciousness.
 Recheck any splints or bandages and adjust them if they
are too tight.
 Keep a written record each time you recheck the victim.
 Note any changes you find and the time the changes occur,
as well as any care you give.
569
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Fractures and Dislocations
 You should not move a victim with a possible fracture unless
it is absolutely necessary.
 If you must move or transport the victim, splint the injured
body part.
570
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Fractures and Dislocations
(continued)
 Do not attempt to move a person or have the person
move without first splinting the injured part.
 Be sure to loosen the splint and recheck the limb every
15 minutes.
571
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Bleeding
 Most external bleeding can be stopped simply by—
 Applying direct pressure.
 Applying a pressure bandage.
572
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Bleeding
(continued)
 A tourniquet is a wide band of cloth or other material placed
just above a wound to stop all blood flow to the area below
it.
 Using a tourniquet is very dangerous. Applying a tourniquet
means risking a limb in order to save a life and is a measure
of last resort.
573
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Burns
 General steps for caring for a burn in a delayed-help
environment are the same as in other settings:
 Stop the burning by removing the victim from the
source of the burn.
 Cool the burned area to stop the burning.
 Cover the burned area.
 Prevent infection.
 Minimize shock.
574
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Sudden Illness
 When caring for a victim of sudden illness, follow the same
procedures as if you were not in a delayed-help situation.
 For a victim recovering from an episode of low blood
sugar—
 Have the victim rest after eating or drinking something
sweet.
 If he or she shows no signs of improvement within
5 minutes, you need to give the victim water.
 Transport him or her to a medical facility.
 Never give an unconscious victim anything to eat or
drink.
575
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Sudden Illness
(continued)
 To care for someone who has experienced a seizure—
 Do no further harm and complete a detailed check for
injuries after the seizure is over.
 Maintain the victim’s body temperature and help to
prevent shock.
576
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Shock
 In a delayed-help situation, it is likely you will have to give
care to minimize shock.
577
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Shock
(continued)
 If you or someone you are with is susceptible to a severe form
of anaphylaxis or anaphylactic shock as a result of a bite or
sting—
 Be sure someone knows the location of necessary
medication.
 Quickly transport a person who shows signals of
anaphylactic shock.
 If medical care is more than 2 hours away, give preventive
care for shock.
 Give a conscious victim frequent small amounts of cool
water or clear juices.
578
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Shock
(continued)
 Do not give fluids if—
 The victim is unconscious.
 The victim is having seizures.
 The victim has a serious head or abdominal injury.
 Vomiting is frequent and sustained.
 If you give fluids and the victim starts to vomit, wait before
giving the victim any more to drink.
 Remember to keep the victim from becoming chilled or
overheated.
579
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Head, Neck and Back Injuries
 If you suspect a head, neck or back injury, prevent further
injury by providing manual stabilization.
 If you are alone and need to free yourself from maintaining
manual stabilization of the victim’s head and neck, place two
heavy objects wrapped in clothing next to each side of the head
to hold it in line.
 It is important to help the victim maintain normal body
temperature.
580
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Difficult Decisions
 One of the most stressful and emotionally draining situations
you can be faced with is dealing with a life-threatening
condition when medical care is not easily obtainable.
581
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Difficult Decisions
(continued)
 You may be faced with the difficult question of how long
to continue resuscitation efforts.
582
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
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Difficult Decisions
(continued)
 CPR can limit brain damage in case the heart starts and may
even improve the chance that the heart will start. In such a
case, CPR should be continued until—
 The heart starts beating.
 You are relieved by another trained responder.
 EMS personnel arrive and take over.
 The situation becomes unsafe.
583
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Protection from the Weather
 Protecting the victim from environmental conditions such
as heat, cold, wind, rain, sleet or snow is critical.
 A shelter may need to be constructed for the victim using
whatever materials you have on hand.
584
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Protecting the Victim
 Keep the victim from getting chilled or overheated. Provide
some type of insulation to protect the victim.
 If the ground is dry, use cloth items, such as towels,
blankets, clothing or sleeping bags.
 In cold weather, lying on the ground draws heat away from
the body and increases the chances of hypothermia.
 If the ground is too hot, the heat from the ground will travel
to the body and raise the victim’s temperature.
585
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Protecting the Victim
(continued)
 If the ground is wet, put a waterproof tarp, raincoat or poncho
between the insulating material and the ground.
 If the victim is exposed to hot sun, rain, snow or chilling wind,
provide an appropriate shelter.
586
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Constructing a Shelter
 If you are caring for the victim for an extended period of time or
if you must leave the victim while you go for help, you may have
to construct a shelter.
587
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Constructing a Shelter
(continued)
 There are four common types of shelters:
 Natural shelters
 Artificial shelters
 Snow shelters
 Tents and bivouac bags
 A car can also be an effective shelter.
588
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Preparing for Emergencies
 People who live or work in a delayed-help environment
or plan to be in one should develop a plan for how to
respond to emergencies that may arise.
589
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Types of Preparation
 There are three general types of preparation that can help
you in a delayed-help environment:
 Knowledge
 Skills
 Equipment
590
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Ensuring Adequate Preparation
 Your preparation needs will vary with the activities you
plan, the weather and the special needs or skills you
and your companions have.
591
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Ensuring Adequate Preparation
(continued)
 Planning for emergencies is an important part of preparation
for any trip or activity. These include—
 The level of first aid training among group members.
 The distance you will be away from medical help.
 The duration of the trip or activity.
 The level of risk associated with activity or environment.
 Group-related factors, such as pre existing medical or
physical conditions.
 Any special equipment or supply requirements.
 The size of the group.
592
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Ensuring Adequate Preparation
(continued)
 Get additional training that will help prepare you for your
specific activity.
 Find out about local weather conditions.
 Find out about local emergency resources in the area.
 Plan your route and write it down. Leave it with someone who is
not going to accompany you.
593
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Closing
 Emergencies do not always happen in locations where it is
quick and easy for you to call 9-1-1 or the local emergency
number.
 As with all emergencies, use the emergency action steps:
CHECK—CALL—CARE, as your basic plan of action.
594
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Closing
(continued)
 Generally, the care you give the victim in a delayed-help
situation is no different from what you do in other situations.
You may, however, have to spend more time caring for the
victim.
 If you are planning to venture into a delayed-help environment
or if you live or work in one, you should think about how you
can reduce the risk of emergencies.
 Questions?
595
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Lesson 41: A Safer and
Healthier Life
Introduction
 Injuries and illness have a significant impact on our
society.
 The cost in lost wages, medical expenses, insurance,
property damage and other indirect costs is staggering—
many billions of dollars a year.
 Illness and injury are not simply unpleasant facts of life to
be shrugged off as inevitable.
 Often, illness and injury can be prevented by taking safety
precautions and choosing a lifestyle that promotes optimal
health.
597
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Injury
 Each year in the United States, an estimated 1 in 12 people
require medical treatment for an injury.
 An estimated 150,000 people die from the injuries they receive.
 Injury is the leading cause of death for people ages 1 to 39 years
old.
598
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Factors Affecting Risk of Injury
 A number of factors affect risk or injury:
 Age
 Gender
 Geographic location
 Economic status
 Alcohol use and abuse
599
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Reducing Your Risk of Injury
 Strategies to prevent injuries include the following:
 Encourage people at risk to change their behavior.
 Require people at risk to change their behavior, such as
with laws requiring people to wear safety belts.
 Provide products that offer automatic protection, such as
air bags, designed to reduce the risk of injuries.
600
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Reducing Your Risk of Injury
(continued)
 Taking the following steps reduces your risk of injury:
 Know your risk.
 Take measures that make a difference. Change behaviors
that increase your risk of injury and the risk of others.
 Think safety.
 Learn and use first aid skills.
601
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Vehicle Safety
 Wear a safety belt.
 Infants and children should always ride in approved safety
seats.
 Do not leave objects loose in your vehicle.
 Do not drink and drive.
602
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Fire Safety
 Cooking is the leading cause of home fires in the United States.
 Fires are also caused by heating equipment, appliances, electrical
wiring and careless smoking.
 Install a smoke detector on every floor of your home.
 Fire escape plans should include the following considerations:
 Escape routes from each room
 The location of a meeting place upon exiting the building
 A designated person who will call the fire department and
from which phone
603
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Safety at Home
 About 8 million disabling injuries occur in homes each
year in the United States.
 Three leading causes of accidental death include the
following:
 Falls
 Poisoning
 Fire
604
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Safety at Home
(continued)
 Taking the following steps will help make your home a safer
place:
 Post emergency numbers.
 Make sure that stairways and hallways are well lit.
 Equip stairways with handrails, and use nonslip tread or
securely fastened rugs on stair steps.
 Secure rugs to the floor with double-sided tape.
 If moisture accumulates in damp spots, correct the cause
of the problem. Clean up spills promptly.
 Keep medicines and poisons locked up and out of the
reach of children.
605
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Safety at Home
(continued)
 Keep medicines in their original containers, with safety caps.
 Keep heating and cooling systems and appliances in good
working order.
 Read and follow manufacturer’s instructions for electrical
tools, appliances and toys.
 Turn off the oven and other appliances when they are not in
use.
 Make sure that your home has at least one working, easily
accessible fire extinguisher and that everyone knows how to
use it.
 Keep any firearms so that they are not accessible to
unauthorized persons.
606
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Safety at Home
(continued)
 Have an emergency fire escape plan and practice it.
 Try crawling around your home to see it as an infant or
young child sees it.
 Turn pot handles toward the back of the stove.
 Ensure that the cords for lamps and other items are not
placed where someone can trip over them.
607
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Safety at Work
 Most people spend approximately one-third of their day at work.
 To improve safety at work, you should be aware of the following:
 Fire evacuation procedures
 How to activate your emergency response team and how to
call 9-1-1 or the local emergency number
 The location of the nearest fire extinguisher and first aid kit
 If you work in an environment where hazards exist—
 Wear recommended safety equipment and follow safety
procedures.
 Inspect equipment and ladders.
 Check for worn or loose parts.
608
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Safety at Play
 Safety in a recreational setting may be enhanced through the
following suggestions:
 When cycling, wear an approved helmet.
 Keep off roads that are busy or have no shoulder.
 Wear reflective clothing and make sure you have a headand taillight and reflectors on your bicycle wheels if you
cycle at night.
 Make sure your bicycle and your child’s bicycle are in
good condition and the brakes and headlights work.
609
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Safety at Play
(continued)
 Wear protective goggles when appropriate.
 Wear appropriate footwear.
 Learn how to swim or always wear a Coast Guard
approved flotation device when in, on and around the
water.
 Take lessons to learn the skill when beginning an
unfamiliar sport and make sure your equipment is in
good condition.
610
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Reducing Your Risk of Illness
 Making good choices about your lifestyle can affect your health
and general well-being.
 Informed choices can reduce or eliminate your chances of
cancer, stroke, cardiovascular disease, pneumonia, diabetes,
HIV infection and liver disease.
611
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Nutrition
 Nutrition is the science that deals with the food you eat and
how your body uses it.
 Studies indicate that poor diet is a contributing factor to
many diseases.
612
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Food Labels
 Food labels describing the product’s nutritional value are
required by law.
 Food is made up of six classes of nutrients:
 Carbohydrates
 Fats
 Proteins
 Vitamins
 Minerals
 Water
613
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Food Labels
(continued)
 Food labels include the following information:
 Calories
 Calories from fat
 Total fat
 Saturated fat
 Trans fat
 Cholesterol
 Sodium
614
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Food Labels
(continued)
 Total carbohydrates
 Dietary fiber
 Sugars
 Protein
 Vitamins and minerals
615
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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A Healthy Diet
MyPyramid: symbolizes physical exercise, moderation,
personalization, proportionality and variety.

Parts pf the pyramid include:
- Grains
- Milk
- Vegetables
- Meat and beans
- Fruits
Milk, Yogurt & Cheese Group
2-3 Servings
Discretionary calories - Physical Activities
Vegetable Group
2-5 Servings
616
Fats, oils and sweets
USE SPARINGLY
Meat, Poultry, Fish, Dry Beans, Eggs &
Nuts Group
2-3 Servings
Fruit Group
2-4 Servings
Bread, Cereal, Rice & Pasta
Group
6-11 Servings
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Weight
 Obesity is defined as a condition characterized by excess
body fat.
 Obesity contributes to certain diseases, such as heart
disease, high blood pressure and gallbladder disease.
 Weight loss and weight gain depend on the balance of
caloric intake and energy output.
 A planned weight loss or weight gain should always be
combined with regular exercise.
617
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
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Fitness
 Fitness involves cardiorespiratory endurance, muscular
strength, muscular endurance and flexibility.
618
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Exercise
 Be sure to warm up to prepare the body before vigorous
exercise and cool down afterward.
 When possible, add exercise or activities that strengthen the
muscles to your fitness routine.
 You should exercise for a minimum of 30 minutes a day, at least
three times a week.
 The benefits of exercise include weight loss, more disease
resistance, stress reduction and increased energy.
619
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Cardiorespiratory Endurance
 Cardiorespiratory endurance—the foundation of total fitness—
is the ability to take in, deliver and extract oxygen for physical
work.
 Cardiorespiratory endurance is best accomplished through
aerobic exercise.
 To achieve cardiorespiratory endurance, you must exercise your
heart and lungs.
 To do this, you should exercise at least three to five times a
week for a minimum of 30 to 45 minutes at your
appropriate target heart rate range.
620
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Stress
 Stress is a physiological or psychological response to real or
imagined influences that alter an existing state of physical,
mental or emotional balance.
 The reaction to stress can take on various forms, such as—
 Muscle tension.
• Anger.
 Dizziness.
• Excitement.
 Increased heart rate.
• Energy
 Acute Anxiety.
• Joy.
 Sleeplessness.
621
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Stress
(continued)
 A stressor is an event or condition that triggers the stress
response.
 Positive, or “good,” stress is productive.
 “Bad” stress (distress) can result in negative responses.
 Any stressful situation has an effect on the body.
622
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Stress
(continued)
 You need to be aware of the physical and mental signals of
stress.
 Some of the physical indicators of negative stress include—
 Severe headaches.
 Sweating.
 Lower back pain.
 Weakness.
 Sleep disturbance.
 Shortness of breath.
623
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
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Managing Stress
 Stress management is a person’s planned attempt to cope or
deal with stress.
 Managing potentially harmful stress may require using a
variety of techniques, including using time effectively, exercise
and evaluating the activities that are important for you and
establishing achievable goals.
 Relaxation techniques can be helpful in reducing or avoiding
the negatives of dealing with stress.
624
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Smoking
 Every year, more than 342,000 Americans die of lung disease.
 Smoking costs the United States over $150 billion each year in
health-care costs.
 Cigarettes contain at least 69 distinct cancer-causing chemicals.
 Consider that smokers are at risk for—
 Lung cancer.
 Emphysema and chronic bronchitis.
 Heart attack and sudden cardiac arrest.
 Cancer of the esophagus, pancreas, bladder and larynx.
 Increased incidence of still births and low-birth-weight
babies.
625
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Alcohol
 Alcohol is the most popular drug in Western society.
 In addition to the hazardous relationship between
drinking alcohol and driving, consuming alcohol in large
amounts has other unhealthy effects on the body.
 A blood alcohol concentration (BAC) of 0.05 percent or
higher impairs judgment and reflexes and makes activities
such as driving unsafe.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Alcohol
(continued)
 Whether hosting a party or participating in one, you can act
responsibly by keeping alcohol consumption under control by
following these guidelines:
 Drink slowly.
 As a host, make nonalcoholic beverages available to your
guests.
 Do not drink before a party.
 Avoid drinking when angry or depressed.
 Eat plenty of food before and while drinking.
 Avoid salty foods.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Alcohol
(continued)
 Do not play or promote drinking games.
 When mixing drinks, measure out the amount of alcohol.
 As a host, do not have an open bar or serve someone who
has had too much to drink and avoid serving salty foods.
 Stop serving and drinking alcohol 1 hour before the party
is over.
 Do not drink and drive.
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AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Closing
 You can help prevent injury and disease by taking safety
precautions and making lifestyle choices that promote health.
 To reduce your risk of injury, it is important to take safety
precautions in vehicles, at work, at play and in your home.
 To reduce your risk of illness, make healthy choices about your
lifestyle.
 Eating a healthy diet, exercising regularly, avoiding harmful
substances and managing stress all contribute to a person’s
health and well-being.
 Questions?
629
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Lesson 42: Putting It All Together III/
Course Review
The Plan of Action
 Did the group’s plan follow the emergency action steps:
CHECK—CALL—CARE?
 Did the plan involve bystanders appropriately?
 Did the plan demonstrate proper care?
631
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Scenario 1
Unknown Unconscious Victim
It is a perfect day for a cookout! You could not have asked for better
weather. A friend has arrived early to help you prepare for the
hungry crowd that will soon descend. Just when everything seems to
be falling in place, you are distracted by a faint, distant call for help.
It sounds like your neighbor’s grandson. You and your friend run
toward the voice. As you arrive in your neighbor’s front yard, you
see your neighbor, an older woman, lying on the ground. She had
been gardening. She appears to be unconscious and to have vomited.
A container of pesticides is nearby.
632
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Scenario 1
Unknown Unconscious Victim

633
You would like to help. How do you respond?
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Scenario 2
Sudden Illness with Chest Pain
The game you and your dad have waited for all season is about to
begin. The outcome will determine who will play for this year’s
national championship. As you both begin to settle in front of the
TV for the next couple of hours, you notice that your dad is acting
strangely. He does not appear to feel well. When you question him,
he denies that anything is wrong. After 20 minutes or so, you notice
that your dad is not paying attention to the game. He seems to be
feeling worse. He is pale, sweating and appears to be having
trouble breathing. He insists that it is only indigestion.
634
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Scenario 2
Sudden Illness with Chest Pain

635
You would like to help. How do you respond?
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Scenario 3
Injury
As you ride along the bike trail, you are tired but relaxed. You
must have ridden at least 10 miles. Then, as you round a sharp
curve, you abruptly swerve to avoid a young woman sprawled
in the middle of the path. She appears to have been roller
blading and fallen. She is in obvious pain and is cradling her
bent arm close to her chest. You stop your bike.
636
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Scenario 3
Injury

637
You would like to help. How do you respond?
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.
Closing
 Questions?
638
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION
Copyright © 2006 by The American National Red Cross
All rights reserved.