Silver Medallion Life Support

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Silver Medallion Life Support

• Module
• Choose plan strategies to manage emergencies

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Overview

• The award, Silver Medallion - Life Support
  consists of a number of units which form the
  basis of two key awards (Advanced Resuscitation
  Senior First Aid).
• Additionally an extra module is provided which
  focuses on choosing planning strategies to
  manage emergencies (SLSA Training Manual, 1999)

Overview Slide 1
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Overview

• The course is based on the module Choose plan
  strategies to manage emergencies

Choose plan strategies to manage emergencies
SILVER MEDALLION LIFE SUPPORT
Senior First Aid
ARC
Overview Slide 2
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Overview

• Program consists of a number of sessions. The
  objective being for participants to be able to
• Make decisions about emergency situations
• Make decisions about rescue situations
• Identify possible strategies for dealing with
  rescues and emergencies
• Selecting strategies
• Identify solve potential problems of putting
  plans into practice
• Carry out planned actions
• Review modify planned strategies actions

Overview Slide 3
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Overview

• Recognition of previous skills attained (eg ARC,
  SFA)
• Focus is on higher understanding of emergency
  operations, planning management, not ARC and
  First Aid skills.
• Focus is on understanding planning management
  issues relating to emergencies

Overview Slide 4
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Session 1
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Priority Management

• What are the Priorities in an Emergency?

• In all emergency situations, the rescuer must
• assess the situation quickly
• ensure safety for the rescuer, victim
  bystanders
• remain with the victim call for help
• commence appropriate treatment following Basic
  Life Support Flow Chart
• Where there is more than one victim, the care of
  an unconscious victim has priority.
• The rescuer should not be distracted by victims
  who are calling out, their needs are less urgent
  as they are able to breathe (Australian
  Resuscitation Council)

Session 1 Slide 1
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Priority Management

• What is Priority Management?
• Priority Management is the ability to identify,
  code allocate resources (personnel/equipment)
  as required in accordance with triage principles.

Session 1 Slide 2
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Priority Management

• What is Triage?
• Triage is the classification sorting of
  casualties for the purpose of management
  evacuation, according to the degree of urgency.
• The aim is to ensure that the most good is done
  for the largest number of people.

Session 1 Slide 3
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Priority Management

• Mass Casualties.
• Bus, boating or industrial accident.
• Removal of casualties from site.
• Extremely important if there is a risk
• of further injury from explosion,
• collapse etc.

Session 1 Slide 3
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Priority Management

• Degree of Urgency.
• Casualties think that their injuries are more
  serious than others. You may have to decide
  which casualties to evacuate or treat first.
• An Important Triage Principle.
• Absent breathing, no pulse and major blood loss
  take precedence. These symptoms are the most
  manageable for you as a First Aider.

Session 1 Slide 3
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Priority Management

• Grouping Casualties.
• Casualties with trivial injuries can leave the
  site unaided after registering their names.
• Casualties with sprains, bruises and abrasions
  can leave the site after registering their names
  and seek treatment from their own doctor.
• Casualties who require early transport to
  hospital. These can be further divided into
  groups.

Session 1 Slide 3
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Priority Management

• Priority 1 - Urgent Transport to Hospital.
• Breathing difficulties, e.g. flail chest,
  pneumothorax or obstructed airway.
• Severe bleeding, abdominal injury with signs of
  shock, open fractures or burns to 30 of body
  surface.
• Head injuries and altered conscious state.
• Multiple injuries.

Session 1 Slide 3
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Priority Management

• Priority 2 Require Surgery within Hours.
• Unconscious with clear airway.
• Abdominal injuries, no signs of shock.
• Large wounds with controlled bleeding.
• Burns to 10 - 30 of body.
• Dislocation of major joints.

Session 1 Slide 3
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Priority Management

• Priority 3 Require Surgery when Possible.
• Closed fracture.
• Facial injuries without airway obstruction.
• Eye injury.
• Minor wounds.
• Burns to less than 10 of body.
• Spinal injury.

Session 1 Slide 3
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Priority Management

• Priority 4 Casualties who are clinically dead
  or are going to die before reaching hospital.
• The Triage officer must be realistic in
  selecting casualties for evacuation. Do not
  jeopardise the survival of casualties with a
  chance of survival by using resources for the
  untreatable. These casualties are the last to be
  evacuated.

Session 1 Slide 3
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Priority Management

• On Site Treatment
• Casualties in Categories 1 and 2 should receive
  treatment on site before evacuation if resources
  permit.

Session 1 Slide 3
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Priority Management

• Reverse Triage
• The principles are the same but priority is
  given to evacuating those who can be treated
  rapidly with a good chance of a permanent cure.
• In a disaster situation the least seriously
  injured would be evacuated first.

Session 1 Slide 3
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Priority Management

• Is a Patient beyond help?
• Look for the following
• No natural heart action after 45 to 60 minutes.
• Inability of helpers to continue providing basic
  life support.
• Obvious fatal injuries.

Session 1 Slide 3
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Priority Management

• Is a Patient beyond help?
• If the patient has been dead for some time the
  signs are
• No breathing or heartbeat (beware of
  hypothermia).
• Body same temperature as the environment.
• Skin pale grey, darker to blue on the lower
  surface.
• Pupils widely dilated with no response to light.
• Eye surface glazed and dry.

Session 1 Slide 3
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Session 2
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Identifying Strategies

• Scene
• Two patients, both appear to be unconscious,
  laying in an open area, 25 metres apart.
• One is laying on their back, the other is laying
  face down.
• There are no signs of danger in the area and you
  are central to both.
• Activity
• Identify person at most risk explain why.
• Identify strategies/options to deal with
  situation.

Session 2 Slide 1
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Identifying Strategies

• Person most at risk
• person on back due to airway management
  principles (eg possibility of blocking airway
  with tongue)
• Strategies/Options
• call for assistance, put 1st patient on side,
  check ABC, check 2nd patient determine greater
  need.
• Asses both then drag one closer to the other.
• Run
• The first point is the most viable.

Session 2 Slide 2
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Session 3
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Prioritising Selecting Strategies

• Worksheet Session 3, Briefing
• Individually read the exercise and complete part
  A B.
• Once completed form groups (preferably 3 - 4
  people) and determine a Group priority order and
  reasons why.
• Once Part A B have been completed as a group do
  Part C, provide strategies or options to deal
  with this situation
• Present findings to other groups.

Session 3 Slide 1
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Prioritising Selecting Strategies

• Part A B
• Lack of information results in different
  interpretations/priorities
• Lack of information results in different
  assumptions.
• Part C
• Options are hard to validate without more
  information
• Need to be flexible, adaptive responsive

Session 3 Slide 2
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Session 4
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Problem SolvingPlanning/Management

• Briefing - Problem Solving/Planning/Management
• Individually identify areas to be addressed, Part
  A.
• Group discussion on areas.
• Working in groups detail all items that need to
  be considered for specific activity/event, Part
  B.
• Detail possible solutions
• Determine feasibility for each
• Prepare a brief plan/overview on how your group
  would organise for this event prior to an on the
  day, Part C.
• Present to other groups

Session 4 Slide 1
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Session 5
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Scenarios - Casualty Simulation

• Briefing Outline
• Teams will have approx. 5 minutes each to discuss
  how they propose to manage the activity.
• Perform scenario - focus will be on priority
  management triage principles, NOT on specific
  treatment of patients.
• Complete sufficient scenarios to ensure that all
  have played a significant role in priority
  management, including reviews.

Session 5 Slide 1
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Session 6
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Summary/ Review

• The ability to understand planning management
  issues is critical to individuals who will need
  to choose plan strategies to manage
  emergencies.
• Focus is on being able to identify problems,
  solutions priority.
• Maintaining direction is critical as is the need
  to adapt, modify cope with changing factors.
• The need to think make decisions is critical as
  is ensuring that appropriate information has been
  sourced to assist in these judgements.

Session 6 Slide 1
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THANK YOU