Encyclopedia of Health and Medicine

First Response 359
site and situation assessment The first action a
responder should take when arriving at a situation
that requires emergency assistance or first aid. The
assessment must be brief but thorough enough to
determine potential hazards for the responder as
well as the condition of the person who needs
assistance. Site and situation assessment should
consider, at minimum
Nature of the emergency
• How many people are involved?
• Is anyone bleeding?
• Is anyone not BREATHING?
• Is the cause of the emergency still an active
hazard?
• Are those who need aid safe from further
harm?
Risk of fire
• Are flames visible?
• Is there a smell of smoke?
• Is there a smell of gasoline, diesel, oil, or natural
gas?
• Are the engines of any vehicles still running
after involvement in a collision or accident?
• Are there downed power lines?
Risk of ELECTROCUTION
• Are or were there power tools in use?
• Are there downed trees, power poles, or power
lines?
Risk of drowning
• Is the person in water?
• Does the responder have training in water rescues?
Multiple hazards are often present, such as traffic
attempting to pass through the scene of a
motor vehicle accident or water on the surface
when power lines are down. Less obvious hazards
may include dogs in the home or at the scene of a
motor vehicle accident whose behaviors to protect
their owners threaten responders, power tools
that have caused injury and remain plugged in, or
gasoline leaking from a vehicle involved in an
accident. Often the most appropriate response for
the person first on the site is to summon emergency
personnel and follow their instructions after
they arrive for providing further assistance.
See also ACCIDENTAL INJURIES; MOTOR VEHICLE ACCI-
DENTS; RESPONDER SAFETY AND PERSONAL PROTECTION;
SYMPTOM ASSESSMENT AND CARE TRIAGE.
symptom assessment and care triage A
methodic approach to quickly determining the
nature and severity of injuries so as to provide
appropriate FIRST RESPONSE. A responder’s ability to
provide symptom assessment depends on the
responder’s level of knowledge and training.
Medical emergency personnel use various systems
to triage patients—that is, determine the
severity of injuries, type of care the injuries need,
and likelihood for survival within the context of
the medical resources immediately available.
Emergency personnel will conduct such an assessment
when they arrive at the site. In the meantime,
the person who is first on the scene of a
medical emergency that involves more than one
person, or one person with multiple injuries,
needs to determine how to provide the most
appropriate attention to those who need care until
medical emergency personnel arrive.
The most important and fundamental assessment
is whether the person’s life is in imminent
danger. These four basic steps help make a rapid
determination; the findings direct the responder’s
subsequent actions. Because time is crucial when
the injuries or circumstances (such as HEART
ATTACK) are life threatening, the basic assessment
should take no more than 30 seconds.
1. Is the person conscious? If so ask, “Where do
you hurt?” CONSCIOUSNESS, especially right after
an injury or medical crisis such as heart attack,
is not of itself an indication of whether the situation
is life threatening.
2. Is the person BREATHING? Look for bluish gray
discoloration of the lips, fingers, and SKIN overall.
Watch to see if the person’s chest rises and
falls. Feel for air coming out of the NOSE or
MOUTH.