Emergency Scene Management

Emergency scene management means to manage the scene of an incident requiring first aid. This could involve leading others, or may just be you managing the scene. The person who takes charge is known as the first aider.

The first aider will undertake a scene survey followed by a primary then secondary survey and ultimately ongoing care until the medical/professional help arrives.

Scene Survey - Four H's

• Hazards - check the scene for hazards such as live electricity, blood, glass, road traffic or wild animals.
• Hands - ensure you wear gloves to protect yourself from infectious diseases.
• Hello - Establish contact with the patient(s) and ask consent before you assist them. If they are unconscious or unable to respond, consent is implied.
• Help - call for professional help (ambulance).

Emergency phone numbers

For South Africa only.

• Emergency (cellphone) - 112
  • The number 112 can be called from any cell phone in South Africa. It will transfer your line to a call centre and they will route you to the emergency service closest to you.
  • When this number is dialled, it is followed by an automated menu. But remain calm, because the menu exists as a form of triage (priority of treatment) control and filters out abuse of the medical and emergency system.
  • A call to 112 on a cell phone is free and is even possible on a cell phone that does not have airtime.
• Emergency - Ambulance and Fire - 10177
  • The 10177 number can be used in the case of a medical emergency and can be called in conjunction with both the fire and police department respectively, depending on whether or not there are casualties.
• Emergency - Police - 10111
  • The telephone number 10111 is for any emergency that requires police response and can be dialled from anywhere in South Africa.
• General emergency (land-line Cape Town only) - 107

Calling for help

When you are speaking to an emergency centre contact number, ensure that you remain calm. Do the following:

• Listen to the call centre agents instructions and questions.
• State your name, location (including city and province).
• State what the emergency is, and how serious.
• Explain what you have done so far. Did you witness the incident?
• Let them know your level of first aid experience.
• Stay on the call until the agent tells you to hang up.

Primary survey

Do not move the injured person(casualty) to do your primary survey unless you really have to to make them safe. Provide first aid to life threatening conditions as you find them in conjunction with performing your vital signs ABC method. First check to see if you are dealing with a responsive or and unresponsive casualty.

Responsive

• A = Check the airway (asking what happenned? allows you to quickly find out if there is an obstruction)
• B = Assess the quality of breathing (rate, ryhtym and depth)
• C = Check for circulation (check shock via skin condition, colour and temp and check for severe bleeding)

Unresponsive

Check for vital signs by looking for rise and fall of the chest.

• if breathing is present continue with ABC method.
• If no breathing/gasping begin CPR.

Secondary survey

After providing first aid for life threatening injuries (primary first aid), do a secondary survey if:

• medical help is delayed or
• you have to transport the casualty or
• if the casualty has multiple injuries.

Create a history using the SAMPLE method

• S = Symptoms
• A = Allergies
• M = Medications
• P = Past/present medical history
• L = Last meal (when and what)
• E = Events leading up to incident

Assess vital signs

Quickly reassess the vital signs using ABC

• A = Check the airway
• B = Assess the quality of breathing (rate, ryhtym and depth)
• C = Check for circulation (check shock via skin condition)

Full head to toe examination

first aid head to toe examination

Take Charge

The scene of an accident can be scary. An injured person may be crying or screaming. The sight of blood might frighten you. Other people may be too stunned to help. The most important thing you can do is stay calm. Focus your attention on the job of making people safe. Act with confidence, using the first aid skills you know. Cheerfulness will help the victim and the people around you lose their fear.

Approach Carefully. Keep your own safety and the safety of other rescuers in mind. At the scene of a car accident, watch for cars on the road. In the outdoors, be aware of slippery footing, steep slopes, and other hazards.

Do First Things First

Here are five vital steps for treating accident victims. Perform them in the order they are given.

1. Treat "hurry cases" immediately. A hurry case is any condition that threatens a victim's life. The most serious are:
   • stopped breathing
   • no heart beat
   • severe bleeding
   • choking
   • poisoning by mouth.
2. Send someone to a phone to call for help. Give full information about your location and the extent of the injuries.
3. Treat every accident victim for shock.
4. Examine the victim for other injuries that may require first aid.
5. Plan what to do next. If help is on the way, keep the victim comfortable and watch for any changes in his condition. Where there are no phones, decide on a clear course of action. A victim who can walk alone or with some help may be able to hike to a road. When injuries are serious, though, it is usually best to send two Scouts for help.

See also

• First Aid
• First Aid Scout Interest Badge
• First Aid Scoutcraft Badge