Welcome to the Community Emergency Response Training Refresher video series. Today, we are going to practice the steps in victim assessment. Remember airway, bleeding, and shock control are the critical steps in accessing, evaluating, and addressing victim’s needs. But before we do any activity, let’s talk safety.
Before considering any CERT response, three issues must be determined. Am I working in a buddy system, do I have the appropriate equipment, and have I conducted size-up? No CERT response should occur, unless all responders have considered these issues. Safety is critical in every CERT response. Never respond alone, always respond using a buddy system. Evaluate your equipment. No CERT response should ever be attempted unless all responders are wearing safety equipment. Good footwear, which have thick soles and if possible a protective toe cap. A safety vest, with highly visible reflective tape. Protect your hands, no CERT respond should occur unless both pairs of gloves are being worn. Surgical gloves, to protect the responder and heavy work gloves to protect the surgical gloves. Wear a dust mask to prevent debris and body fluids from entering your body that may come from the victim. A helmet, be sure to adjust this helmet so that it sets high on your head, so you may take the most advantage of the suspension system that the helmet offers. Wear eyewear to prevent dust, debris, and body fluids that may come from the victim from then entering in your eyes. A whistle, to signal to others that you are needing their attention. Additional items to consider adding to your response kit, a secondary flashlight, a note pad and ink pin, duct tape and water proof marker, a crescent wrench for turning off the gas, and protective knee pads. And finally, but most importantly do not forget to turn on your CERT brain. As you learned in class, an end of every CERT responds, the conductor must conduct size up. Size up includes asking, what is the situation? Have you identified all risks that may occur to the responder? Where could this situation go? Is the situation headed in a good or stable direction? Or is the situation headed in an unstable or unsafe direction? Next, What do I as a responder need to do to stop this situation and to return it to a more stable or safe environment? And finally, Can I and my buddy safely respond without adding to any of the problem? Remember your primary objective, you as the responder wish to be a part of the solution not a part of the problem. This is your choice. Be safe.
In our video today we will watch as a rescuer takes his team through victim search and rescue and applies appropriate technique for head to toe assessment. Further leading shock control. With every response, team leader should always be sure every team member is wearing their equipment properly and that they understand their objective. Now you see our team leader preparing to check a door to see if they spot a possible fire inside the room. Leader is using the back of his hand to check the top, middle, and back of his hand, finally to check the door handle. Next our rescuer will find the door hinge this will become important as they use that as and indicator where to place their back when opening the door. Checking the base of the door and the frame for the presence of fire or smoke. Next our leader places his team in a safe location putting his back where he has found the door hinge our rescuer will indicate to his team that he is preparing to open the door. Placing his foot our rescuer will open the door, pushing the door open count to three to assure any smoke or heat inside that room has a chance to escape. Once the doorway is open our rescuer announces that a CERT team is on scene and allows any other victim in the room an opportunity to leave. Once finding the victim our team leader assigns duties to the team members, has he prepares to do head to toe assessment. Our team leader reaches out and touches our victim; remember that ensuring our safety promotes victim safety. Upon finding no response our team lead then prepares to check for airway obstruction, placing a cheek over the victims mouth and a hand over the victims stomach our rescuer determines if our victim is breathing. Finding that our victim is breathing, our rescuer then asks for assistance from a fellow rescuer to begin the process of head to toe assessment. Our rescuer then determines if there are injuries to the head beginning with the top of the head and then fills around the remainder of the victim’s head. In this process our rescuer also determines if there may be a possible spinal cord injury. Be sure to look into the eyes, nose, and mouth to determine if there may be a presence of blood. Always, maintain control of our victims head at all times, unless our victim is talking with us, so we can determine there is no possible spinal cord injury. Next our rescuer begins to check our victim. Notice how they are using their hands in a very flat manner, this always our rescuer to cover as much of the victim and efficient manner as possible. Wrapping their hands around the victims arm always the rescuer to determine if there is an injury on the bottom of the arm without actually lifting the victims arm and looking under the victims arm. Continue that assessment all the way out to the end of the fingers. Then the rescuer applies a blanch test and a capillary refill test to determine if circulation is good out to the extremity. Remember good extremity circulation indicates good internal circulation. Next, our rescuer turns to the rib cage then the rescuer begins again using his hand in a flat manner cover as much of the victim as possible over a timely and efficient manner. Remember, time is not always on our side. Effiency is the name of the game. Pulling out those gloves allows the rescuer to determine if their possible injury on the back of the victim. Our rescuer has seen a bleeding injury to the leg of our victim he will utilize compression bandages to control that bleeding. Here you see a rescuer laying out that bandage, folding the point in and then one additional time keeps that bandage flat and as much of that bandage as usable as possible. You want that bandage about four inches wide, then place it on the victim. Placing a piece of gauze immediately over the injury, then the bandage. Remember that you will want to tie your bandage so that the knot is on top of the wound. Pulling and applying pressure to the bandage will make sure that is working as effiently as possible. Using a bowknot allowing any adjustment to the bandages that may be necessary. A rescuer continues to asses our victim and has completed her assessment of the chest and is moving to the hip, upper thigh, and eventually the lower leg and eventually to the foot of the victim and all the way to the toes. Again, effient use of the hands is critical so that you do not miss any component or injury of the body that might be inured. Unless, absolutely necessary always leave shoes on the victim. Our rescuer has begun search on the other side of the victim, he began that search at the toes again in a very effienct manner working in a circular motion around our victim. Maintaining our victim body temperature is crucial. In order to promote good circulation to our victims brain we will elevate the injured limbs above the level of the heart. Here we use a piece of debris from the sight as a way of accomplishing that task. Rescuers might want to take notes of what they are finding on the victim and their response to the injuries on that victim. These notes may be helpful for future assessment and medical treatment among the victim. Don’t forget the back, you can see our rescuers using the shovel technique as a method to asses injury on the back. Before moving to one section of the back to another our rescuer will check their gloves to make sure there is no sign of blood. Blood on gloves indicates injuries on places that cannot be seen. Remember all areas of the body must be assessed utilization of a blanch test on both sides of the body assures the determination of good internal circulation. Finally, a triage tag is prepared, remember date, time, and triage level. Also utilize an identifier that can be written on the triage tag stays on the same victim. In this situation our rescuer used the word written on our victim an identifier. Again, maintain body temperature is so critical to the victim recovery. Here we see our rescuers using good victim roll techniques, maintaining the safety of our victim, as we place a blanket under the victim to prepare to move him to the triage area. Note our rescuer at the head is maintaining excellent control of the head as our victim is being rolled. Our rescuers are utilizing excellent technique of rolling the blanket to use as a stretcher, by making a rope out of the stretcher. Standing tall using good techniques our victim is then removed the room. Victims should be removed from the room feet first to minimize any potential further damage to the victim’s head. Remember rescuer safety promotes victim safety.