Chapter 1 of the textbook has 11 topic summaries (in boxes outlined in red) that are important to know. Pick one of the boxes and answer the following questions in complete se

When the Injured or III Person Is a Child

· If the child's parent or guardian is present, remember to get the parent's or guardian's consent to give care.

· Be aware that children often take emotional cues from the adults around them. If the child sees that adults are upset, the child's anxiety and panic may increase. Stay calm and encourage the child's parent or guardian to do the same.

· The child's parent or guardian can be a valuable source of information if the child is not able to speak for themself.

However, if the child is old enough to understand and answer your questions, speak directly to the child using age-appropriate language, rather than addressing your questions to the parent or guardian.

· Think about "not being a monster" when talking to children.

· Don't be loud.

· Don't tower over them; get on their eye level.

· Don't be rough; handle them gently.

· Don't scare them; tell them what you are going to do.

· If the care you need to provide will cause discomfort or pain, describe what the child can expect to feel in terms the child can understand. Never make promises or statements that you cannot support (e.g., do not say that something will not hurt if it will).

When the Injured or III Person Is an Older Adult

· Pay attention to how the person introduces themself. If the person gives a last name, consider addressing the person more formally (e.g., "Mr. Johnson" rather than "Bill") as a sign of respect.

· A family member, caregiver or other person who knows the older adult well can be a valuable source of information if the older adult is not able to speak for themself. However, if the older adult is able to understand and answer your questions, speak directly to them, rather than addressing your questions to others who might be present.

· Speak clearly and loudly enough for the person to hear you, but do not shout. If the person does not seem to understand what you are saying, change your words, not the volume of your voice, unless you spoke too softly.

· When interviewing the person, avoid rushing. Allow the person enough time to process your questions and respond.

· Be aware that in older people, the signs and symptoms of a medical emergency may be very general and nonspecific,and they may not even be noticeable to someone who does not know the person well. General signs and symptoms that could indicate a medical emergency in an older adult include headache, a change in the persons usual level of activity, a change in mental status (such as agitation, the new onselt of confusion, or increased confusion in a person who is already confused), lethargy (extreme drowsiness or sleepiness) and difficulty sleeping.

· Many older adults have impaired hearing, vision or both. If the person seems confused, make sure the "confusion" is not just the result of being unable to hear you or see you clearly. If the person normally wears a hearing aid, make sure it is in place and turned on. If the personusually wears glasses, make sure they have them on.

When the Injured or ILL Person Has a Disability

· Remember, the presence of a physical disability does not mean the person has a cognitive disability. If the person is able to understand and answer your questions, speak directly to them, rather than addressing your questions to others who might be present. However, if they can't speak for themself, a family member, caregiver or other person who knows the injured or ill person well can be a valuable source of information.

· A person with a disability may use a service animal. Be aware that service animals are trained to protect their owners, and both the service animal and the person may become anxious if they are separated. Allow the service animal to stay with the person if possible.

· If the person wears an assistive device (e.g. a leg brace), do not remove the device when you are examining the person unless you have to provide care such as controlling bleeding.

· If the person has an intellectual disability:

· Address the person as you would any other person in their age group. If the person does not seem to understand you, rephrase your statement or question in simpler terms.

· Be aware that being injured or becoming suddenly ill may make the person very upset, anxious or fearful. Take time to explain who you are and what you intend to do and reassure the person.

· If the person has impaired hearing:

· Approach the person from the front.

· Hearing-impaired people who know how to read lips rely on watching your mouth move. Position yourself so that the person can see your mouth and facial expressions. Pronounce your words slowly and clearly and speak in short sentences.

· If the person does not seem to understand what you are saying, change your words, not the volume of your voice, unless you spoke too softly. Shouting sometimes causes the person more distress and they still may not understand what you are trying to say.

· If the person can't hear you and does not seem to be able to read your lips, you can often communicate by using gestures and writing comments and letting them speak or write their responses.

· If the person has impaired vision:

· Speak in a normal voice. It is not necessary to shout.

· As the person may not be able to see what you are doing as you provide care, be sure to describe what you are doing.

When the Injured or III Person Speaks a Different Language

· Speak in a normal voice. It is not necessary to shout.

· Find out if any bystanders speak the person's language and can assist by translating.

· Do your best to communicate nonverbally, using gestures and facial expressions.

· When you call 9-1-1 or the designated emergency number, explain that you are having difficulty communicating with the person, and tell the dispatcher which language you believe the person speaks. The dispatcher may have someone available who can help with communication.

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BOX 1-8 ABUSE

Abuse is the willful infliction of injury or harm on another.

People who depend on others for care, such as children and the elderly, are at the highest risk for being abused. Abuse can take many forms, including physical abuse (deliberately hurting another person's body), emotional abuse (degrading, belittling or threatening another person), sexual abuse (forcing a person to take part in sexual activities of any kind) and neglect (failing to provide for a dependent person's basic needs).

Signs and symptoms of abuse could include:

· An injury whose cause does not fit its explanation.

· Unexplained fractures or dislocations

· Unexplained lacerations or abrasions, especially to the mouth, lips and eyes.

· Injuries in various stages of healing, especially bruises and burns.

· Bruises and burns in unusual shapes, such as bruises shaped like belt buckles or handprints, or burns the size of a cigarette tip.

· Bruises, scratches or cuts around the breasts, buttocks or genitals.

· A withdrawn or fearful demeanor, especially in the presence of the person who is causing the abuse.

Signs and symptoms of neglect could include:

· Lack of appropriate supervision.

· Signs of poor personal hygiene.

· Signs of dehydration and malnutrition. An unsafe living environment.

· Untreated chronic illness.

In a first aid situation, you may have reason to suspect that the person is a victim of abuse. Your priority is to give first aid care for the person's injury or illness, according to the conditions that you find and your level of training. If you suspect abuse, share your concerns with the responding emergency medical services (EMS) personnel, if possible. You can also report your suspicions to a community or state agency, such as the Department of Social Services, the Department of Child and Family Services, Child Protective Services, or Adult Protective Services.

You may be hesitant to report suspected abuse because you do not wish to get involved or are concerned about legal action. In most states, when you make a report in good faith, you are protected from any civil or criminal liability or penalty, even if the report was made in error. In this instance, good faith means that you honestly believe that abuse has occurred or the potential for abuse exists and that a prudent and reasonable person in the same position would also honestly believe that abuse has occurred or the potential for abuse exists. You may have to identify yourself when you report abuse. In some professions, employees are legally obligated to report suspicions of abuse of a person in their care to their supervisor (or to another person in the organization, per their employer's policy). This does not take the place of any mandatory reporting as required by law or regulation and cannot be used as gatekeeper for mandatory reporting.

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BOX 1-9 WHEN TO ACTIVATE THE EMS SYSTEM

Call 9-1-1 or the designated emergency number, or tell someone to do so, for any of the following emergency situations and conditions.

Emergency Situations

· An injured or ill person who needs medical attention and cannot be moved

· Fire or explosion

· Downed electrical wires

· Swiftly moving or rapidly rising flood waters

· Drowning

· Presence of poisonous gas

· Serious motor vehicle collision

· Spilled chemicals

Emergency Conditions

· Unresponsiveness or an altered level of consciousness (LOC), such as drowsiness or confusion

· Cardiac arrest (unresponsive; no breathing or only gasping)

· Choking (cannot cough, cry, speak or breathe; universal sign of choking)

· Anaphylaxis (signs of allergic reaction; history of allergy; swelling of the face, neck, tongue or lips; trouble breathing; shock; change in responsiveness)

· Breathing problems (trouble breathing or no breathing; asthma attack)

· Chest pain, discomfort or pressure lasting more than a few minutes or that radiates to the shoulder, arm, neck, jaw, stomach or back

· Persistent abdominal pain or pressure

· Life-threatening external bleeding (bleeding that spurts or flows continuously from a wound, pools on surfaces, is enough to fill half of a soda can or even less for small children and infants)

· Vomiting blood or passing blood

· Burns

· Suspected poison exposure

· Seizures

· Signs or symptoms of stroke (e.g., drooping of the face on one side; sudden weakness on one side of the body; sudden slurred speech or difficulty speaking; sudden, severe headache)

· Signs or symptoms of shock (e.g., changes in level of responsiveness; rapid breathing; rapid, weak heartbeat; nausea or vomiting; pale, ashen [grayish], cool, moist skin; restlessness or irritability; excessive thirst)

· Opioid overdose (decreased breathing effort and rate;

· unresponsiveness; bluish or greyish colored skin; small pupils)

· Diabetic emergency (trouble breathing; fast or deep breathing; feeling weak or different; sweating; fast heartbeat)

· Hypothermia (shivering; pale; cold to the touch; disoriented)

· Heat stroke (moist, pale or flushed skin; absence of sweating or some degree of sweating; unresponsive or confused; seizure; headache; nausea; dizziness; weakness; exhaustion)

· Suspected or obvious injuries to the head, neck or spine

· Suspected or obvious broken bone

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BOX 1-10 SHOULD YOU EVER CARE FIRST?

Most of the time, you will call first and then give care. But if you are alone, you may have to care first in some situations.

If you are alone and do not have a cell phone, you will usually follow the normal steps of check, call and care. However, for a few conditions you will need to give immediate care, then go to call 9-1-1 or the designated emergency number. These conditions include:

· An unresponsive infant or child younger than about 12 years whom you did not see collapse.

· A person who is choking.

· A person who is experiencing a severe allergic reaction (anaphylaxis) and has an epinephrine auto-injector.

· A person who has life-threatening bleeding.

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