General procedures for injury or sudden illness on the land

1. Size up the scene-is safe for you, put on the gloves, determine the mechanism of injury, number of victims and if additional help is needed

2. Perform an initial assessment-identify any life-threatening conditions:

   1. Check for consciousness and obtain consent if the victim is conscious: (Tap the shoulder or flick the foot:”ARE YOU OK? CAN YOU HEARE ME?”)

   2. Check for sign of life (movement and breathing)

   3. Check for a pulse

   4. Check for severe bleeding

3. Summon emergency medical services (EMS) by calling 9-1-1for following conditions:

Unconsciousness, breathing problems, chest discomfort, no pulse, severe bleeding, suspected head, neck or back injuries, stroke, seizures, severe burns,…..

4. Perform a secondary assessment to identify additional conditions only if lifeguard is sure that the victim does not have any life-threatening conditions.

If lifeguard recognizes that somebody needs immediate help:

Activate the EAP-emergency action plan (blow the whistle 3 times) → approach the victim → check the victim for consciousness → If the victim does not respond summon EMS personnel ”Please call 911” →check for signs of life ( movement and breathing), tilt the head back and lift chin to open the airway, look for movement, look, listen and feel for breathing for not more than 10 seconds(1-one thousand…10-one thousand)

If the victim is not moving or breathing:

Give 2 rescue breaths: position the resuscitation mask, tilt the head back and lift chin to open the airway, watch the chest clearly rise with each rescue breath.

• If the chest clearly rises: check for a pulse for no more than 10 seconds(1-one thousand….10-one thousand)-for adult and child-at the carotid artery: for infant: brachial pulse on the side of the upper arm, between the infant’s elbow and shoulder.

• If the first 2 rescue breaths do not make the chest clearly rise: reposition the airway by tilting the victim’s head farther back and try 2 rescue breaths again.

• If the additional two rescue breaths still do not make chest clearly rise - provide care for an unconscious choking victim

Unconscious choking victim

For adult and child: give 5 chest thrusts: place the heel of one hand on the center of the chest, place the other hand on top of the first hand and compress the chest 5 times (for adult, compress the chest about 1½-2 inches, for a child 1-1½ inches), look inside the victim’s mouth, if an object is seen, take it out: for an adult-remove the object with the index finger .For the child with little finger. Replace the mask and give 2 rescue breaths.

For infant: give 5 chest thrusts: keep one hand on the victim’s forehead, put two or three fingers on the center of the chest, just below the nipple line, compress the chest ½-1 inch, look into the infant mouth, if an object is seen take it out with little finger, replace the mask and give two rescue breaths.

If the rescue breaths still do not make the chest clearly rise: repeat again

If the chest clearly rise: remove the mask and look for movement, breathing and pulse for no more than 10 seconds(1-one thousand….10-one thousand)

If there is a pulse, but no breathing- perform the rescue breathing

If there is no movement, breathing and pulse- start CPR

If there is movement, breathing and pulse – place the victim in recovery position