Friday, February 15, 2013

Lesson Fourteen: Rescue?

Lesson Fourteen: Only A Fool Fights In A Burning House -- Rescue?

As previously discussed, the beginning of first aid isn't the ABCs (Airway, Breathing, Circulation) it's Safety.

Your next consideration still isn't the ABCs.
It's Rescue? And note the question mark.

Outside of professionals, this concern is rarely ever addressed by most responder training. If you're going to help, don't zoom in with tunnel vision, and ignore a ton of pertinent information before you get into things. A minute from now may be too late. Take the time to survey the scene beforehand.

A lot of my earliest training had my victims obligingly laid out on the carpeted floor at the local Red Cross. Unfortunately, real victims are seldom so accommodating. They have accidents on freeways with traffic trying to drive around and through. They fall into wells, off cliffs, down slopes, and into small spaces.

What's important for you are several rules to consult before making a rescue decision.

1. Has anybody called 9-1-1?
Triple check that this is "yes." Period. Dispatchers far prefer three calls for the same incident to no calls. So do you. If you send/assign someone to make the call, have them report back to you. i.e You don’t say “Call 9-1-1.” You say “Call 9-1-1, tell them I have X, with Y, and I need Z, and come back and tell me what they say!” You want the confirmation, you may need the extra help, and they may have information from the dispatcher that you need to know.

2. How many patients are there, and how serious is their situation?
Locate all your victims. Try and imagine that feeling of accomplishment after you pull some woman out of a burning car, only to find out as it goes up in smoke that her baby was asleep in the back seat. Enough said.

3. Can I safely treat this patient where they are?
For instance, it's possible to do CPR through a jagged windshield. Not fun, but do-able. If the victim is pinned, you're out of options. Make sure the car isn't burning.

Basically, can you perform whatever amount of care necessary where the person is, or do immediate concerns necessitate moving/removing them to a batter spot? If they're conscious, breathing, and trapped, summoning more/better/stronger help would be far smarter than trying to rescue them.

4. Can I get to them safely in order to move them?
If they're at the bottom of a well, or floundering in the surf, your options are obviously limited. If you're not in the military, the Coast Guard, or public safety, there isn't going to be any honor guard and town parade when you stupidly hurl yourself into some situation, and increase the victim toll by one: yourself. Dumb is not heroic, and dead is forever.

5. If I can get to them, will I be able to move with them?
What resources are available? Do you have rope, a backboard, a litter, a ladder, or what? Do you have anyone who can help you do what you need to do to remove your victim(s)? Getting down to the bottom of a well to do CPR, or what have you, just puts two of you down there waiting for someone to come find you.

6. Can the victim extricate themselves, or assist you in any way?
Obviously not if they're unconscious. Otherwise, take whatever help they can give.

7. What other hazards might I be missing?
Stop. Look. Think. Repeat.

Maybe the reason that guy's passed out is because he's in a confined space with a toxic gas. Rushing in to help makes you Victim #2. Are there any electrical wires, leaking chemicals, smoke, flames, wild leopards, gang bangers with guns, or zombies on crack that you might be overlooking in your dash to get to someone?

8. How far is far enough?
Getting off the middle of the road might be good. Or down from a high place, up from a low one, or out from a small one. Away from a burning one is good too, especially if something else might be exploding later on. Know what you're planning to do before you jump into doing it.

Your goal is to limit victims, keeping yourself outside that subset. First aid can be challenging. But often times the most thinking (and the most help) you can provide in an emergency is the brainwork you do before you start laying hands on anyone to help. You need the strength of character and the focus on what you’re about to ignore bystanders’ whining and even heart-wrenching screams from the victim to take a few considered seconds to assess your course of action.

Keep do-gooders away from the sparking wires. Get the driver to move that driveable car out of the middle of the highway, and off to the side of the road. Or perhaps into a blocking position upstream from more serious victims. Call 9-1-1 for some professionals, and gather some help for immediate actions. Get what you need to do your rescue before you're already in the middle of things. Throw a rope to someone in the water, or through ice, down a hole, or over a slope. Chock wheels or tie off cars to solid anchors, so you don't end up climbing in to help someone and have the whole thing slide down a slope or off a ledge. Maybe put out a small fire with an extinguisher while you can do so, rather than try to carry four people trapped inside to safety, singlehandedly. Don't let anybody throw down flares when there's gasoline on the road. Realize that if a person or their car got buried in one avalanche of snow, rocks, or whatever, there might be a second one. And on and on.

Every situation is unique. But no matter how simple it looks, take a minute for yourself and gain a good situational awareness of where you are, what's going on, and catalog mentally as many possible complications of your location and situation as you can before you rush in.

Or else you might not be rushing out, ever.

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