BLET: 20H TITLE: FIRST RESPONDER Lesson Purpose: Training Objectives: This block of instruction is designed to prepare the law enforcement officer to safely and effectively respond to lifesaving and other medical emergencies. At the end of this block of instruction, the student will be able to achieve the following objectives (the page number corresponds to the seventh edition of the Brady text) in accordance with information received during the instructional period: 1. Define the components of the Emergency Medical Services (EMS) systems. (Page 2) 2. Describe the difference between expressed consent and informed consent. (Page 22) 3. Define negligence, duty to act and how they relate to the Good Samaritan Law, and discuss the Health Insurance Portability and Accountability Act (HIPAA). (Page 25) 4. Define abandonment. (Page 27) 5. Give examples of situations that put First Responders at risk of contracting infectious diseases. (Page 42) 6. Explain why body substance isolation is important. (Page 44) 7. Identify the four (4) infectious diseases of most concern to First Responders. (Page 45) 8. List the steps to be taken and equipment to be used to protect First Responders from blood borne and airborne pathogens. (Page 46) 9. List the steps used to determine if the crime scene is safe to enter and why this is necessary. (Page 48) 10. Demonstrate the ability to perform adult, child and infant CPR, and clear adult, child, and infant airway obstructions by successfully completing CPR certification Basic Law Enforcement Training 1
taught in accordance with a national standard curriculum that included cognitive and skills testing. 11. Name and demonstrate the most common emergency moves to be used by First Responders. (Page 70) 12. Name and demonstrate the most common non-emergency moves used by First Responders. (Page 71) 13. Define focused history and physical exam in terms of when it is done, why it is done, and what types of problems are searched for during the procedure. (Page 158) 14. Define sign, vital signs, and symptoms. (Page 159) 15. Define interview and examination. (Page 163) 16. List some of the questions you should ask bystanders and patients. Also, if your EMS system requires it, define SAMPLE history. (Page 163) 17. List and demonstrate in correct order the steps of the head-to-toe examination. (Page 173) 18. List the signs and symptoms for a respiratory emergency difficulty and describe First Responder care for these patients. (Page 240) 19. Define hyperventilation, listing the signs and symptoms of this condition. State how a First Responder cares for patients who are hyperventilating. (Page 241) 20. List the signs and symptoms associated with altered mental states and describe First Responder care for possible stroke patients. (Page 243) 21. List the signs and symptoms of a seizure and describe First Responder care for seizure patients. (Page 246) 22. List the signs and symptoms of hyperglycemia (high blood sugar) and describe First Responder care for diabetic coma patients. (Page 248) Basic Law Enforcement Training 2
23. List the signs and symptoms of hypoglycemia (low blood sugar) and describe First Responder care for insulin shock patients. State the main differences between this list and the list for diabetic coma. (Page 250) 24. State what a First Responder should do if it is unclear if the patient is in diabetic coma or insulin shock. (Page 250) 25. List the signs and symptoms of ingested poisoning and describe First Responder care for patients who have ingested a poison. Are there any exceptions to these procedures? (Page 255) 26. Describe allergy shock (anaphylactic shock) in terms of what it is, how serious it is, what causes it and what its signs are. (Page 261) 27. List the signs and symptoms of hyperthermia and First Responder emergency care procedures. (Page 263) 28. List the signs and symptoms of hypothermia and First Responder emergency care procedures. (Page 267) 29. List signs that may indicate a patient is under the influence of alcohol. (Page 273) 30. Define uppers, downers, and hallucinogens. (Page 274) 31. Describe the steps for assessing and caring for substance abuse and patients in withdrawal. (Page 277) 32. List and define the three major types of blood vessels. (Page 286) 33. Define and describe arterial, venous, and capillary bleeding. (Page 287) 34. Relate profuse bleeding to First Responder actions during the initial assessment. (Page 289) 35. List the four (4) methods used to control external bleeding, stating which method is most commonly used by First Responders. (Page 289) Basic Law Enforcement Training 3
36. Describe and demonstrate how to apply a pressure dressing. (Page 291) 37. Describe and demonstrate the use of elevation in controlling external bleeding, including the situations when elevation should not be used. (Page 292) 38. Define arterial pressure point and name the two major pressure point sites used by First Responders. (Page 293) 39. Describe and demonstrate, step by step, the pressure point procedures used to control bleeding from the arm. (Page 293) 40. Describe and demonstrate, step by step, the pressure point procedures used to control bleeding from the leg. (Page 294) 41. State why tourniquets are used as a last resort, only after other methods to control bleeding have failed. (Page 295) 42. Describe and demonstrate, step by step, the procedure for applying a tourniquet, including all precautions for the procedure. (Page 295) 43. Define dressing, bulky dressing, occlusive dressing, and bandage. (Page 297) 44. State the four (4) basic rules for dressing wounds. (Page 299) 45. State the five (5) basic rules applying to bandaging. (Page 300) 46. List ten (10) signs associated with internal bleeding. (Page 303) 47. Describe and demonstrate the ten (10) steps used to control internal bleeding. (Page 305) 48. List the signs and symptoms of shock. (Page 309) Basic Law Enforcement Training 4
49. Describe and demonstrate, step by step, the procedure used to care for shock. (Page 312) 50. Describe how to reduce a patient s chances of fainting. (Page 314) 51. Classify open wounds by using the definitions for: (Page 316) a) Scratches and scrapes (abrasions), b) Incisions and lacerations, c) Punctures (penetrating & perforating), d) Avulsions, e) Amputations, and f) Crush injuries. 52. Cite and demonstrate the basic procedures used in caring for a closed wound. (Page 319) 53. Cite and demonstrate the basic procedures used in caring for open wounds. (Page 319) 54. List the six (6) steps used in caring for wounds with impaled objects. (Page 320) 55. Cite the basic procedures used in caring for avulsions and amputations. (Page 322) 56. Cite the procedures when caring for wounds to the scalp and face. (Page 323) 57. List how to care for eye injuries, including an impaled object. (Page 326) 58. Describe the basic care for injuries to the ear. (Page 330) 59. Describe the basic care for nosebleeds and other nonfracture injuries to the nose. (Page 330) 60. Describe the basic care for injuries to the mouth. (Page 331) 61. State and demonstrate the procedures for controlling arterial bleeding and venous bleeding from the neck. (Page 333) Basic Law Enforcement Training 5
62. State the procedures used when caring for abdominal injuries. (Page 337) 63. Describe the basic care for injuries to the genitalia. (Page 338) 64. Define superficial, partial thickness, and full thickness burns (first, second and third degree burns). (Page 341) 65. Demonstrate how to care for both minor and major burns. (Page 342) 66. Describe proper care for thermal, chemical, and electrical burns. (Page 343) 67. Define open and closed injuries. (Page 359) 68. Define fracture and compare and contrast this type of injury to dislocation, sprain, and strain. (Page 360) 69. Define painful, swollen and deformed extremities. (Page 360) 70. State the primary reasons for splinting. (Page 365) 71. State the rules for splinting. (Page 367) 72. List objects that can be used as splints when commercial splints are not available. (Page 374) 73. List the signs and symptoms of a head injury. (Page 397) 74. List the signs and symptoms of a brain injury. (Page 398) 75. List the signs and symptoms of facial injuries. (Page 398) 76. Describe and demonstrate how to care for head injuries. (Page 399) 77. List the signs and symptoms of a spine injury. (Page 401) Basic Law Enforcement Training 6
78. Describe the importance of care for patients with injuries to the head, spine, and chest. (Page 401) 79. Describe the possible patient problems that may result from improper care to head, spine, and chest injuries. (Page 401) 80. Describe the steps of checking for spine injuries in a responsive and an unresponsive patient. (Page 402) 81. Describe and demonstrate how to stabilize a possible head and spine injury. (Page 403) 82. List the signs and symptoms of a flail chest injury. (Page 413) 83. Describe how to care for flail chest injuries. (Page 414) 84. Name and locate the anatomical structures involved in pregnancy. (Page 422) 85. List and describe the three stages of labor. (Page 423) 86. List and explain the use of the materials needed for preparation and delivery. (Page 424) 87. Describe how to evaluate the mother before delivery. (Page 426) 88. Describe how to prepare the mother and the scene for delivery. (Page 427) 89. Describe step by step what you should do during each stage of labor. (Page 428) 90. Describe the care given to both mother and newborn after delivery. (Page 432) 91. Describe how to assess the newborn and determine the need for resuscitation. (Page 432) 92. State the basic pre-delivery care procedures for vaginal bleeding and miscarriages. (Page 441) Basic Law Enforcement Training 7
93. List First Responder Emergency care procedures for the following abnormal deliveries: prolapsed cord, breech birth, multiple births, premature births and stillborn births. (Page 443) 94. Describe the care and considerations for pregnant patients who have been victims of trauma and sexual assault. (Page 446) 95. Describe the changes in the approach to care when dealing with infants and children. (Page 456) 96. State the special problems faced when caring for the child patient. (Page 461) 97. Describe how assessments and care for the infant and child is different from the adult based on their physical and emotional development. (Page 462) 98. Describe the steps for performing a scene size-up, initial assessments, focused history and physical exam, detailed physical exam, and ongoing assessment for infant and child patients. (Page 466) 99. List the signs and symptoms of respiratory stress for infants and children. (Page 473) 100. List the signs and symptoms of shock, and describe emergency care. (Page 476) 101. Describe the steps to take with the infant and the parents when managing a sudden infant death syndrome (SIDS) incident. (Page 477) 102. List other concerns when assessing and caring for the ill or injured child patient including fever, hypothermia, vomiting, diarrhea, and poisoning. (Page 478) 103. List the signs of child abuse. (Page 490) 104. List the environmental indications and interaction implications that may lead you to suspect child abuse, and state your responsibilities in reporting it. (Page 493) Basic Law Enforcement Training 8
105. Define triage. (Page 528) 106. Classify given injuries in terms of their triage priority in accordance with the initial and standard systems of triage used in your locality. (Page 531) Hours: Instructional Method: Materials Required: References: Forty (40) hours Discussion/Practical Exercise First Responder Manual and Student Workbook HIPAA and Law Enforcement Handout CPR Equipment Medical Supplies Bergeron, David and Gloria Bizjak. First Responder, Seventh Edition. Upper Saddle River, NJ: Brady Prentice-Hall, Inc., 2005. 45 C.F.R. 160-164 (1996). Prepared By: Gary Rector NC Department of Justice Criminal Justice Training and Standards Division Date Prepared: September 1997 Jon Blum /Coordinator North Carolina Justice Academy Date Revised: April 1999 April 2001 November 2001 October 2002 Peggy Schaefer Training Manager North Carolina Justice Academy Date Revised: February 2003 Eric Pope /Coordinator North Carolina Justice Academy Basic Law Enforcement Training 9
Date Revised: July 2003 Robert B. Yow BLET Curriculum Coordinator North Carolina Justice Academy Date Revised: January 2005 Tandy O. Dunn East Carolina University Date Revised: July 2005 Robert B. Yow Date Revised: January 2006 Basic Law Enforcement Training 10
TITLE: FIRST RESPONDER - INSTRUCTOR NOTES 1. This lesson must be taught by a Commission-certified First Responder or Commission-certified Professional Lecturer. 2. Course objective materials are located within Brady s First Responder text (7 th edition). s will be responsible for locating objective materials within the text. As an aid, the page numbers next to the objectives guide the student to the beginning of the text relating to the objective. 3. School directors must provide students with the textbook and student workbook. 4. There is not a hypermedia slide presentation for this lesson. However, Brady does produce a CD Rom that includes a multi-media presentation. s are encouraged to use this CD Rom during delivery. The CD Rom can be purchased from Prentice Hall and is available on-line at http://vig.prenhall.com/catalog, ISBN: 0130158755 5. School directors/instructors should consider purchasing the First Responder instructor notebook. 6. In addition to the end of block examination, students are required to complete CPR certification in accordance with a national standard curriculum that includes both cognitive and skills testing. 7. s should discuss the HIPAA and Law Enforcement handout. 8. To promote and facilitate law enforcement professionalism, three (3) ethical dilemmas are listed below for classroom discussion. At their discretion, instructors must provide students with each ethical dilemma listed below. Sometime during the lecture instructors should Aset the stage@ for the dilemma prior to taking a break. s are encouraged to develop additional dilemmas as needed. a) Upon arriving at the scene of a traffic collision, you observe a young man lying in the road bleeding. A passenger in the car advises you that the young man is HIV positive. What will you do? b) After conducting a traffic stop, you observe the driver of the car appearing very drunk and disoriented. With a sweet smell on his breath, your partner accuses him of DWI but the suspect says, I have diabetes, and pulls away from your partner s grasp. Your partner slams the suspect to the ground for resisting, and arrests him. What will you do? c) You are assaulted by a defendant. You spray him with OC spray. He begins to have difficulty breathing. What will you do? Basic Law Enforcement Training 11