911 for Dummies

Safety Doc’s Safety Smarts offers safety managers and professionals information they can use as a safety toolbox talk or can include in written safety communications for employees.

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.