Health Introduction to Safety and First Aid Introduction to Safety and First Aid Essential Questions: What are the top ten unintentional causes of death in the US? Can you list ways to stay safe? What are ways to protect yourself when giving first aid? What phone numbers should be on a emergency phone list? What are the steps for and how do you perform CPR, Rescue Breathing, and Abdominal Thrusts? What are ways to handle a variety of basic First Aid situations? To view the standards for this unit, please download the handout from the sidebar. I personally feel that the term "car accidents" is often misused. The word "accident" implies that the mishap could not have been prevented despite whatever measures could have been taken. What do you think about this...aren't most "accidents" caused by something such as driving too fast, inexperience with driving, not paying attention when driving, using a cell phone (texting/talking) when driving, being under the influence of alcohol and/or drugs while driving, etc? I believe a more appropriate term to use instead of "accidents" is "unintentional injury." Many times when emergency help is needed, it is not given in time, not given correctly, or simply not given at all due to lack of knowledge concerning correct procedure. Upon completion of this unit, you will have the knowledge to assess when a person needs the Heimlich Maneuver, Rescue Breathing, or Cardiopulmonary Resuscitation and how to perform these procedures depending on the age/size of the victim. There are several video clips from the American Red Cross linked through the unit. These will help you gain a better understanding of certain emergency lifesaving techniques. formation. Some Important Vocabulary Accident- an unexpected event that causes injury Violence- using physical force to injure someone or cause damage Gang- a group of people who often use violence Weapon- an object or device that can be used o hurt someone First Aid- emergency medical care for someone who has been hurt or who is sick Fracture- a broken or cracked bone Dislocation- an injury in which a bone has been forced out of its normal position in a joint Shock- the body's response to reduce blood flow Abdominal Thrusts- actions that apply pressure to a choking person's stomach to force an object out of the throat Cardiopulmonary Resuscitation (CPR)- a technique used to save a victim who isn't breathing and doesn't have a heartbeat Rescue Breathing- an emergency technique in which a rescuer gives air to someone who is not breathing Primary Care Provider- a healthcare professional who handles general care Specialist- a healthcare professional who has received training in a specific medical field Health Insurance- a policy you buy that covers certain costs in the case of illness or injury image from www.plu.edu Emergency Phone List Assignment Click Here for the Emergency Phone List Assignment. Your instructor will inform you on how to submit this assignment. Automobile Safety Did you know the number one cause of death for people aged 15-24 is automobile accidents? There are many reasons for why this is so: Inexperience with driving in itself Driving too fast Not paying attention to the road Inexperience with alcohol and/or drugs and then driving under the influence Not heeding to precautions necessary for certain driving conditions Not wearing seatbelts What others can you think of? Many people of all ages fail to realize the seriousness of getting behind the wheel. Have you ever thought how two thin yellow lines painted on the road are the only things keeping you and another car from colliding? Have you ever thought about just how thin the metal is that separates you and another car during a collision? Have you ever thought about what actually happens when a person not wearing their seatbelt hits the front windshield? I could go on and on about the frightening realities of being on the road (whether as a driver or a passenger). So, what can be done about such high death rates among young people from car accidents? Please check out the Teenage and Adult Driver Responsibility Act - and review all of the information on the TADRA. Abdominal Thrusts (for Choking Victims) Adults most commonly choke on meats and children most commonly choke on anything small and round (especially nuts, grapes, hot dogs, small round toy pieces, etc.) After reading the steps for each procedure below, watch the video clips to see these steps put into use. Conscious Choking Child/Adult Victim: Step 1: CHECK scene, then CHECK person. Step 2: Have someone CALL 9-1-1. Step 3: Obtain consent (If it is a child obtain consent from a parent/guardian if possible). Step 4: Lean the person forward and give 5 back blows with the heel of your hand. Step 5: Give 5 quick, upward abdominal thrusts. Give chest thrusts to a choking person who is pregnant or too big for you to reach around. You can give abdominal thrusts to yourself just as you do another person or lean over and press your abdomen against any firm object (example: back of a chair). For a child you may have to kneel behind them to administer back blows and abdominal thrusts. Step 6: Continue back blows and abdominal thrusts until object is forced out, person can breathe or cough forcefully, and/or person becomes unconscious. How To Save A Choking Victim Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "How To Save A Choking Victim" video by clicking here. The video is approximately 17 minutes long. Unconscious Choking Victim FIRST..... How do you know a person is unconscious due to choking? Whenever you find an unconscious person, always check a person's ABCs: A: Airway- open their airway by tilting the forehead back and lifting up on the chin B: Breathing- look, listen and feel for signs of breathing, if not breathing give the victim two rescue breaths, if these initial two breaths do not enter the lungs, re-tilt the victim's head and re-attempt two more breaths C: Circulation If these re-attempted breaths still do not go in, then you can definitively say that this victim is choking. Unconscious Choking Adult Victim CHECK, CALL, CARE Step 1: Tilt head farther back. Try 2 rescue breaths again. Step 2: If chest does not rise - Give 30 chest compressions (2 hands).s Step 3: Look for an object. Step 4: Remove object if one is seen. Step 5: Try 2 rescue breaths. Now What? If breaths do not go in - Continue Steps 2-5; If breaths go in - Check for signs of life and give care accordingly. Performing The Heimlich Maneuver On A Victim Who Has Collapsed Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "Performing The Heimlich Maneuver On A Victim Who Has Collapsed" video by clicking here. The video is approximately 3 minutes long. After learning the information in CPR topic, you will realize that performing Abdominal Thrusts on an unconscious adult is basically CPR + a hooked finger sweep...or conversely, CPR is unconscious Abdominal Thrusts minus the hooked finger sweep. Unconscious Choking Child Victim CHECK, CALL, CARE Step 1: Re-tilt child's head. Try 2 rescue breaths again. Step 2: If chest does not rise - Give 30 chest compressions (one hand). Step 3: Look for an object. Step 4: Remove object if one is seen. Step 5: Try 2 rescue breaths. Now What? If breaths do not go in - Continue Steps 2-5; If breaths go in - Check for signs of life including a pulse and give care accordingly. The Modified Heimlich Maneuver For Infants And Small Children Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "The Modified Heimlich Maneuver For Infants And Small Children" video by clicking here. The video is approximately 3 minutes long. Choking Infant Victim Conscious Choking Infant: Step 1: CHECK scene, then CHECK infant. Step 2: Have someone CALL 9-1-1. Step 3: Obtain consent from parent or guardian, if present. Step 4: Give 5 back blows Step 5: Give 5 chest thrusts (2 fingers). * Hold head and neck securely when giving back blows and chest thrusts. Step 6: Continue back blows and chest thrusts until - object is forced out, infant can breathe or cough forcefully, and/or infant becomes unconscious. Unconscious Choking Infant: CHECK, CALL, CARE Step 1: Re-tilt infant's head. Try 2 rescue breaths again. Step 2: If chest does not rise - Give 30 chest compressions (2 fingers). Step 3: Look for an object. Step 4: Remove object if one is seen. Step 5: Try 2 rescue breaths. Now What? If breaths do not go in - Continue Steps 2-5; If breaths go in - Check for signs of life including a pulse and give care accordingly. Abdominal Thrusts Practice Use the activities below to review the steps for each situation. Conscious Choking Child/Adult Victim: Unconscious Choking Adult Victim Unconscious Choking Child Victim Conscious Choking Infant Victim Unconscious Choking Infant Victim SO, when you should you call EMS in all of this? After giving one minute of rescue breathing...you have reset the clock on the amount of time that your victim has been w/o oxygen (with regards to extent of brain damage, if any). Rescue Breathing (Artificial Respiration) Rescue breathing is also called "artificial respiration." This is necessary when a victim is NOT breathing BUT DOES have a pulse. 1. FIRST: Do the "head tilt/chin lift" method (this moves the tongue away from the throat and also moves the epiglottis away from the trachea), then pinch the nose. 2. SECOND: Take a breath and make a complete seal over the person (adult or child's) mouth. For an infant you must seal your mouth over their nose and mouth when giving a breath. Then, blow in to make the chest clearly rise. Each rescue breath should last about one second. 3. THIRD: After 2 minutes, recheck signs of life and pulse for no more than 10 seconds. If there is a pulse but no breathing, continue rescue breathing. If there is no pulse, give CPR or use an Automated External Defibrillator (AED) (adult/child only). ADULT RESCUE BREATHING Give one breath every 5 seconds First Response: C.A.R.E. CPR Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "First Response: C.A.R.E. CPR" video by clicking here. The video is approximately 47 minutes long. INFANT & CHILD RESCUE BREATHING Give one breath every 3 seconds. Differences Between Adult and Infant/Child Rescue Breathing: 1. Distance with head tilt-chin lift. When lifting the chin and tilting the head back before giving rescue breaths, you will not need to tilt an infant's head back very much at all, a child's a little, and an adult's a good bit more. o You will be able to tell if you have tilted the victim's head back far enough because your rescue breaths will enter the victim's lungs. (If your breaths don't go in the victim's lungs, you have either not tilted their head back enough or the victim is choking on something and needs the Heimlich Maneuver). 2. Forcefulness of breaths. With an infant, you must only "puff" your breaths into it, with a child it's about a half-force breath, and with an adult your rescue breaths should be somewhat forceful. o You will be able to tell if your breaths are forceful enough because you will see the victim's chest rise out of the corner of your eye, if you are breathing too hard, you will get some resistance when breathing and you should decrease the forcefulness. 3. Where you breathe into the victim (mouth or mouth and nose). When giving adult or child rescue breathing, only breathe into the victim's mouth and pinch close the nose. When giving infant rescue breathing give your breaths into the infant's mouth and nose. SO, when you should you call EMS in all of this? After giving one minute of rescue breathing...you have reset the clock on the amount of time that your victim has been w/o oxygen (with regards to extent of brain damage, if any). Cardiopulmonary Resuscitation (CPR) Heart Disease Uncontrollable Risk Factors for Heart Disease: Race, age, gender, & heredity Controllable Risk Factors for Heart Disease: Smoking, diet, activity level, alcohol consumption, stress management & others related to a person's lifestyle. Signs/Symptoms of a Heart Attack: Persistent chest pain/discomfort (under the sternum, shoulder, arm, neck, jaw). Beware of such pain that is accompanied by other signs/symptoms that lasts 10 minutes or longer. Angina pectoris: chest pain, comes from heart not getting enough oxygen. Breathing difficulty: noisily, short of breath, faster than normal. Skin appearance is pale, ashen, bluish, moist, abnormal sweating. Misc. signs/symptoms = nausea, vomiting... Cardiovascular Disease, Heart Attack And Stroke Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "Cardiovascular Disease, Heart Attack And Stroke" video by clicking here. The video is approximately 5 minutes long. Care for a Heart Attack: Recognize the signs/symptoms Call EMS/911 Have the victim rest, stop activity Comfort the victim If the person has medication, get it for them (e.g., nitroglycerin) BE PREPARED TO GIVE CPR IF NECESSARY! Common Causes of Cardiac Arrest: Cardiovascular disease Drowning Suffocation Certain drugs Severe injuries to the chest Severe blood loss Electrocution Strokes & other types of brain damage EVEN UNDER THE BEST CONDITIONS, CPR ONLY GENERATES APPROXIMATELY 1/3 OF NORMAL BLOOD FLOW TO THE BRAIN. Performing CPR Adult CPR: 8 years and older Victim should be on a firm, flat surface with his/her head at the same level as the heart Hand position: between the nipples Position your body in an area next to the victim that makes it easy for you to go between doing compressions and breaths Put your hands in the correct position, straighten your arms and lock your elbows so that your shoulders are directly over your hands Release the pressure on the chest after each compression without removing your hands 30 compressions per 2 breaths 5 cycles every 2 minutes Compression Depth = 1 ½ to 2 inches Continue cycles of 30 compressions and 2 breaths until an AED is attached, the patient moves, the scene becomes unsafe, or until another CPR or EMS responder takes over your care. AFTER 2 MINUTES: 1. Recheck for a pulse (carotid pulse). 2. If you're alone and haven't called EMS/911 yet, do so now. Adult CPR Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "Adult CPR" video by clicking here. The video is approximately 10 minutes long. Child CPR: 1 to 8 Years Old You must maintain an open airway with one hand on the forehead and do chest compression between the nipples with the other hand. DON'T USE BOTH HANDS! Be sure to remove your compression hand when lowering yourself to give the one breath. Continue cycles of 30 compressions per 2 breaths 5 every 2 minutes. Compression Depth = 1/3 to 1/2 the depth of the chest. AFTER 2 MINUTES: 1. Recheck for a pulse (carotid pulse). 2. Call EMS/911 if not already done. Child CPR Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "Child CPR" video by clicking here. The video is approximately 5 minutes long. Infant CPR: Birth to 1 Year Old Chest compressions should be done just below the nipple line, use ONLY two fingers: your ring finger and your middle finger Be sure to release compression pressure between compressions and also when giving breaths Continue cycles of 30 compressions per 2 breath 5 every 2 minutes. Compression Depth = 1/3 to 1/2 the depth of the chest. AFTER ONE MINUTE: 1. Recheck for a pulse (brachial pulse). 2. Call EMS/911 if not already done. Infant CPR Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "Infant CPR" video by clicking here. The video is approximately 3 minutes long. SO, when you should you call EMS in all of this? After giving one minute of rescue breathing...you have reset the clock on the amount of time that your victim has been w/o oxygen (with regards to extent of brain damage, if any). First Aid and Safety Option Assignment Click Here for the First Aid and Safety Option Assignment. Your instructor will inform you on how to submit this assignment. Burns Burns are classified by degree of damage to the skin and underlying tissue. Any burns involving the airway are life-threatening. Some signs of possible burns include wheezing and/or coughing as the patient breathes particles of soot in the saliva, sooty or smoky smell on breath, and visible burns of the mucous membranes in the mouth and/or nose. Watch the presentation below to learn about burns. Infant CPR Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "Infant CPR" video by clicking here. The video is approximately 3 minutes long. External Bleeding Any severe, uncontrolled bleeding (external or internal) can rapidly lead to life-threatening shock, so it is vital to administer care ASAP. There are 3 types of external bleeding: 1. Capillary 2. Venous 3. Arterial Care for External Bleeding Apply pressure directly to the wound. Elevate the injury above the level of the heart. External bleeding sometimes requires the use of pressure points to resolve the bleeding. Pressure points are places where an artery is close to a bone and the surface of the skin. By applying pressure to these locations, you can stem the flow of blood. Our bodies' pressure points are as follows: Some Types of Open Wounds Clean abrasion (figure on the left -below) wounds with running water or sterile gauze. Never remove an impaled object from a puncture (middle figure - below) wound. Stabilize in place and seek medical assistance. Apply direct pressure to stop the flow of blood from a wound created by an incision (figure on the right - below). If after 15 minutes you've been unable to slow the bleeding, call EMS (911). How To Treat Bleeding Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "How To Treat Bleeding" video by clicking here. The video is approximately 4 minutes long. Nose Bleeds A nosebleed can be scary to get or see, but try to stay calm. Most nosebleeds look much worse than they really are. Almost all nosebleeds can be treated at home. If you get a nosebleed, sit down and lean slightly forward (see figure to the right). Keeping your head above your heart will make your nose bleed less. Lean forward so the blood will drain out of your nose instead of down the back of your throat. If you lean back, you may swallow the blood. This can cause nausea, vomiting and diarrhea. Use your thumb and index finger to squeeze together the soft portion of your nose (see figure to the left). This area is located between the end of your nose and the hard, bony ridge that forms the bridge of your nose. Keep holding your nose until the bleeding stops. Don't let go for at least 5 minutes. If it's still bleeding, hold it again for 10 minutes straight and seek medical assistance. You can also place a cold compress or an ice pack across the bridge of your nose to prevent swelling. images from Gwinnet County Fire Department @ http://www.gwinnettcounty.com/cgi-bin/gwincty/egov/ep/gcbrowse.do?channelId=536881926&pageTypeId=536880236 Muscle and Bone Injuries For Muscles & Bone Injuries Use The "RICE" Method: REST ICE COMPRESSION ELEVATION Watch the presentation below to learn about muscle and bone injuries. First Response: Head and Spinal Injuries and Muscle, Bone, and Joint Injuries Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "First Response: Head and Spinal Injuries and Muscle, Bone, and Joint Injuries" video by clicking here. The video is approximately 24 minutes long. Heat and Cold Emergencies Heat Emergencies Heat exhaustion is very common in warm weather. If left untreated, it will progress to heat stroke. Heat stroke is lifethreatening. If the victim is not treated immediately, severe brain damage or death may occur. It's critical to know the difference between heart exhaustion and heat stroke. The progression of heat related emergencies is as follows: heat cramps, heat exhaustion, heat stroke. Heat Exhaustion Heat exhaustion is a condition caused by too much water loss through sweating on a hot day. Signs of heat exhaustion are as follows: Moist, clammy, and pale skin Normal or subnormal temperature Weak, dizzy, or faint No appetite, nausea Headache The best way to treat heat exhaustion is to stop exercising, go inside (cool area), loosen clothing, and drink some water or sports drink (rich in electrolytes). If symptoms do not improve, call for help. Heat Stroke Heat stroke is an injury that happens when the body cannot control its temperature. A person with heat stroke can't sweat (how our bodies cool us down). Signs of a heat stroke are as follows: Skin is dry and hot to the touch Very high body temperature (fever) Strong and rapid pulse Confused mental status Collapse and have convulsions Coma or near coma Someone suffering from heatstroke should be taken to the hospital immediately (or call EMS). Heatstroke can be life-threatening. Do not offer or force fluids by mouth for victims with heat stroke. Loosen clothes, remove heat source, and cool the body with wet clothes until help arrives or you reach help. Heat Related Emergencies Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "Heat Relateed Emergencies" video by clicking here. The video is approximately 3 minutes long. Cold Emergencies Cold emergencies do not just occur exclusively in arctic regions. Being exposed to the elements, such as cold weather and/or frigid water for a long period of time, can develop into hypothermia and/or frostbite. Hypothermia Hypothermia is defined as a serious condition in which the body temperature falls below normal. Five Stages of Hypothermia: 1. Shivering (body's response to generate heat) stops below a body temperature of 90 degrees 2. Apathy and decreased muscle function 3. Decreased level of consciousness: glassy stare, possible frozen extremities 4. Decrease vital signs: slow pulse, slow respirations 5. Death Victim's should be kept warm (remove wet clothes and wrap the victim in dry blankets). Call the EMS (911). Frostbite Frostbite is defined as damage to skin and other tissues caused by extreme cold. Frostbite usually affects fingers, toes, ears, and/or nose. Frostbitten skin is pale, stiff, and numb. If someone is suffering from frostbite, call EMS (911) immediately. While you wait for the EMS to arrive, put the affected area in lukewarm water. Cold Related Emergencies Video: In order to view this video on the Discovery Education website, you must set up an account using the password received from your teacher. Please watch the "Cold Related Emergencies" video by clicking here. The video is approximately 3 minutes long. Shock Shock kills everyone. Every death is a result of some type of shock. Shock progresses as time passes. Once it has begun you cannot stop shock; however, you may minimize the damage with proper treatment. Never wait for the symptoms of shock to develop; by the time they are obvious it may be too late. Treat any illness or injury immediately if you believe that shock may occur! Signs and Symptoms of Shock shallow, irregular, labored, rapid, or gasping breathing dull, ashen or chalk-like-skin- As time passes, the skin will appear bluish cold, clammy skin profuse sweating general weakness weak, rapid pulse nausea and vomiting closed or partially-closed eyelids lusterless eyes, dilated pupils extreme thirst anxiety dizziness or confused mental status Treatment for Shock: Check, Call, Care Check the scene for safety. Activate EMS immediately Maintain patient Airway, Breathing, and Circulation, and stop serious bleeding. Place victim in position of comfort. Get the blood where it is needed: If the face is red, raise the head; If the face is pale, raise the tail (feet). Keep victim still and calm. Give no fluids by mouth. Reassure the victim. Monitor level of consciousness and pulse. THE LONGER SHOCK GOES UNCHECKED, THE WORSE THE VICTIM OUTCOME! Assignment: What Would You Do? Click Here for the What Would You Do? Assignment. Your instructor will inform you on how to submit this assignment. Seven Ways to Protect Yourself 1. Think before you act. Think about what could result from or consequence of your actions; avoid doing anything that might hurt you or another person. 2. Pay attention. Be aware of your surroundings and of potential accidents (dangers). 3. Know your limits. Stay within your limits. 4. Practice refusal skills. Don't be afraid to say no to something that (may cause injury) is not safe. 5. Use safety equipment. Safety equipment can keep you from getting hurt or may save your life. Use the right safety equipment for your activity. 6. Change risky behavior. Change a habit that puts you or someone else at risk. 7. Change risky situations. Fix things that might cause an accident and/or tell someone who can fix it. Responding To An Emergency Follow the 3 steps below when responding to an emergency: CHECK, CALL, CARE 1. Check: Check out the situation. First, make sure it is safe for you. Whatever hurt the victim, might hurt you. If you are in danger, leave the area. If you are safe, check the victim for injuries. Try and find out how the victim got hurt. Check for medical alert jewelry, which lets you know about the victim's health. 2. Call: Responding to an emergency often means making a phone call for help. It's important to stay calm when you call an emergency number. If you panic, the emergency operator may not be able to understand you. You will need to give the operator a lot of information. The emergency operator uses this information to make sure you get the help you need. They will also tell you what you can do for the victim until help arrives. What you need to do: Stay Calm Make sure you're safe Answer all the operator's questions as best you can Follow the operator's instructions Stay on the line until the operator tells you to hang up What you need to say: Your name Where you are The type of emergency The condition of the victim(s) if someone is hurt The medical history of the victim if known What you have done to help the victim 3. Care: How quickly a victim gets help may determine his or her fate. If you have training, you should give the victim first aid right way. First aid is emergency medical care for someone who has been hurt or who is sick. Knowing first aid and acting quickly can help you save a victim's life. Giving first aid can be risky. You may be exposed to blood, saliva, and other body fluids. These fluids may contain bacteria and viruses that can make you sick. You can protect yourself by using protective equipment, such as breathing masks, sterile gloves, etc. Make sure to protect yourself when giving care. Safety Assignment Click Here for the Safety Assignment. Your instructor will inform you on how to submit this assignment. Cyber Bullying What is cyber bullying, exactly? "Cyber bullying" is when a child, preteen or teen is tormented, threatened, harassed, humiliated, embarrassed or otherwise targeted by another child, preteen or teen using the Internet, interactive and digital technologies or mobile phones. It has to have a minor on both sides, or at least have been instigated by a minor against another minor. Once adults become involved, it is plain and simple cyber-harassment or cyber stalking. Adult cyber-harassment or cyber stalking is NEVER called cyber bullying. When adults are trying to lure children into offline meetings, that is called sexual exploitation or luring by a sexual predator. But sometimes when a minor starts a cyber bullying campaign, it also involves sexual predators who are intrigued by the sexual harassment or drawn by ads posted by the cyber bullies offering up the victim for sex. The methods used are limited only by the child's imagination and access to technology. And the cyber bully one moment may become the victim the next. The kids often change roles, going from victim to bully and back again. Children have killed each other and committed suicide after having been involved in a cyber bullying incident. Cyber bullying is usually not a one-time communication, unless it involves a death threat or a credible threat of serious bodily harm. Kids usually know it when they see it, while parents may be more worried about the lewd language used by the kids than the hurtful effect of rude and embarrassing posts. Cyber bullying may rise to the level of a misdemeanor cyber harassment charge, or if the child is young enough, may result in the charge of juvenile delinquency. Most of the time the cyber bullying does not go that far, although parents often try and pursue criminal charges. It typically can result in a child losing their ISP or IM accounts as a terms of service violation. And in some cases, if hacking or password and identity theft are involved, it can be a serious criminal matter under state and federal law.