By Bruce J. Schryver, Ph.D., CSP
Now I don’t want
anyone to think I am becoming condescending in any way. But I never cease to be
amazed at the lack of common sense in summoning Emergency Medical Response when
an employee is injured.
I have worked on
recent cases where an employee who has fallen was helped into the front seat of
another employee’s car, and driven to the hospital. Upon arrival, he was placed
on a backboard, cervical collar affixed, stabilized and immediately taken for
X-Rays. The Radiologist discovered a cracked vertebra. Had the employee been
twisted or moved in certain ways, there is a distinct possibility he would have
been paralyzed. That would have been a tragedy, one that could have been
avoided with a little thought.
What are the
rules for calling in emergency medical personnel? Do you call for a minor first
aid case? Of course not. But let’s look at some scenarios, and you decide
whether the 911 call is appropriate.
First, this
warning: If you are not sure you do not have to call for emergency medical aid,
make the call. It’s far better to have them respond and not be needed, than to
need them and not have them available. Unless you’re a medical professional,
and have the training to accurately assess the condition of the injured, always
err on the safe side!
Joe is a welder.
He has been working all day in the heat of the summer, which combined with the
heat of welding operations has sapped his strength. Joe starts to walk over and
suddenly collapses, his eyes rolling back. You run over to him and his skin is cool
and clammy, and he looks pale. Now what?
Joe is likely
suffering from heat exhaustion. His body temperature is likely over 102 degrees
Fahrenheit. If he can be quickly taken to a cool, shady area, bathed in cool
water, cool rags placed on various areas of his body, and he can drink
electrolyte replacement fluids (sports drinks), you may not need to call the
paramedics. However, if his body temperature remains elevated even after
treatment, it’s best to call emergency medical aid immediately.
Joe’s co-worker
Kay walks into the cafeteria. As hot as it is you notice she’s not sweating.
Her skin is red and flushed. She complains of a severe headache and then
collapses. Her body temperature seems very warm. Should you make the call?
Absolutely! Call
911 immediately! Kay is likely suffering from heat stroke, with her body
temperature at 106 degrees or above and a rapid pulse. There is a significant
possibility she will go into convulsions. She needs immediate emergency care.
While waiting for the paramedics, use the same cooling techniques that were
used on Joe. Regardless of whether she regains consciousness, she needs to
receive prompt medical attention to lower her body temperature.
Lisa cuts her
wrist on a sharp piece of metal. She is bleeding profusely, and placing
pressure on the wound does not appear to be slowing the blood flow much. You
notice the blood is dark red and seems to spurt out. Should you make the call
to 911?
YES! What you are
seeing is arterial blood flow, spurting because it is being pumped with every
beat of the heart. Lisa obviously has a deep laceration that has severed or
punctured an artery and needs immediate medical attention. Keep pressure on the
wound, have Lisa lie down and hold the arm up. This will frequently reduce the
blood flow. Trying to take Lisa to the hospital in an car would likely require
her to exert herself and the blood will only flow faster. The only time to try
transporting her yourself would be if there is no nearby emergency medical
response available, such as on an agricultural site many miles distant from a
town or medical aid. Make every effort to stem the flow of blood first, since
that’s the most important issue.
Bill walks into a
protruding piece of reinforcing rod (rebar) at the construction site. The metal
has pierced his skin, leaving a laceration that may need stitches. Bill has
controlled the bleeding with a cloth, and it appears he is not bleeding
heavily. What now?
Take Bill to the
clinic or to the Emergency Room at the nearest hospital, or as directed. Bill
does not appear to have a life threatening injury, but should be seen by
medical professionals promptly. If Bill should faint or otherwise exhibit
symptoms that are not in line with this type injury, make the call to 911.
Again, better to call if you are not sure of the entire problem.
Tom gets hit in
the head with a brick that falls off a scaffold above. He had just removed his
hard hat to wipe his brow of perspiration when the brick hit him. You notice no
blood that would signal a laceration. Tom is walking around, but seems
incoherent, uncoordinated and confused. He staggers and starts to say
something, but can’t get the sentence together. What should you do?
Call 911! Tom
likely has a concussion, or worse. Simply because there is no external blood
does not mean that damage has not been done. Tom could be developing a subdural
hematoma, a life threatening situation. Get him to lie down, keep him quiet and
comfortable until emergency medical help arrives.
Having worked in
the law enforcement and emergency medical fields, I know the importance of
immediate medical care in an emergency. The urgency and degree of that care are
directly related to the injury and the patient. I have witnessed auto accident
victims’ crawl free of mangled cars and never have the need for anything other
than minor medical treatment. And I have also seen people who appear not to
have a scratch die before the rescue unit or paramedics arrive. The human body
is a marvelous mechanism. It can take a lot of hits and still keep functioning.
But sometimes one hit is too many.
Use good judgment
when handling any injury. When you are first on a scene, with no qualified
emergency medical personnel immediately available, it is imperative for you to
make the right judgment call. You may be the bridge between life and death for
a fellow worker. I urge all to take an American Red Cross or other quality
First Aid Course, along with a CPR course. This gives you a much needed
advantage when dealing with accident victims. You could be the next victim who
depends on a fellow worker for help!
About the
author: Bruce J. Schryver, Ph.D.,
CSP, CHCM, CHMM, CPSM, CHSP, has been in the safety and health field for over
30 years. He started out as a first responder with a rescue unit, was with the
Coast Guard, and law enforcement before embarking on a career in occupational
safety and health. He has been employed as director of safety for a 1700
employee steel fabricator, and as a loss control consultant, regional loss
control manager and national loss control coordinator for a group of insurance
companies.
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