HOW TO GET OUT OF A BURNING BUILDING

1. Step 1

   React quickly. As soon as you become aware that the building is on fire, begin to plan your escape and work quickly to get to safety.

2. Step 2

   Cover your mouth with a shirt or towel. This will help filter your air a little better than directly inhaling smoky air.

3. Step 3

   Stay low- this will prevent you from becoming intoxicated by smoke. Crawl calmly on your hands and knees.

4. Step 4

   Always feel doors with the back of your hand before you open them. This way, if you do happen to get burned, you can still grab things because the palm of your hand can still function. The back of your hand is also more sensitive than your palm.

5. Step 5

   If worst comes to worst, know you can always break a window and escape that way. If you are under 3 stories high, you can usually survive a jump from a window. If you can, try jumping into something soft (a bush, etc). Injury is always better than death!

Maintaining Hygiene during a Medical Emergency

Maintenance of proper hygiene is critical even under makeshift conditions.
Some steps that individuals can take to maintain proper hygiene are:

1. Wash hands frequently using soap and water.
   
2. Wear latex gloves at all times. You should change gloves after each patient, or use bleach and water solution to sterilize (1 part bleach to 10 parts water.)
3. Wear a mask and goggles. If possible, wear a mask that is rated "N95."
4. Keep dressings sterile.
5. Avoid contact with body fluids.

POOR SANITATION IS A MAJOR CAUSE OF ILLNESS, DISEASE, AND DEATH.

TRIAGE FLOWCHART

Follow this flowchart when performing triage!!

IMPORTANT INFORMATION ON FIRE

Should you fight the fire?

Before you begin to fight a small fire:

	Make sure everyone has left, or is leaving, the building.
	Make sure the Fire Department has been called.

Never fight a fire if even one of the following is true:

	The fire is spreading fast or is already a large fire.
	The fire could block your escape route.
	You are untrained in the proper operation of the extinguisher.
	You don't know whether the extinguisher is designed for the type of fire at hand or is large enough to fight the fire.

To fight a fire with an extinguisher in any one of these cases is reckless. Instead, leave immediately, close off the area, and leave the fire to the fire fighters.

Fire Extinguisher Ratings

Old Icon Label | New Label		Classification
		Class A Extinguisherswill put out fires in ordinary combustibles, such as wood and paper. The numerical rating for this class of fire extinguisher refers to the amount of water or dry chemical the fire extinguisher holds and the amount of fire it will extinguish.
		Class B Extinguishersshould be used on fires involving flammable liquids, such as kitchen grease, gasoline, kerosene, paint, oil, etc. The numerical rating for this class of fire extinguisher states the approximate number of square feet of a flammable liquid fire that a non-expert person can expect to extinguish. NEVER USE WATER
		Class C Extinguishersare suitable for use on fires involving electrical equipment or wires. This class of fire extinguishers does not have a numerical rating. The presence of the letter “C” indicates that the extinguishing agent is non-conductive. NEVER USE WATER
		Multi-Class Ratings Many extinguishers available today can be used on different types of fires and will be labelled with more than one designator, e.g. A-B, B-C, or A-B-C. Make sure that if you have a multi-purpose extinguisher it is properly labelled.

Types of Fire Extinguishers

Multi-purpose – Dry Chemical These extinguishers are usually rated for multiple-purpose use. They contain an extinguishing agent and use a compressed, non-flammable gas as a propellant. Dry chemical extinguishers are usually rated for class B and C fires and may be marked multiple purpose for use in A, B, and C fires. Dry chemical extinguishers put out fires by coating the fuel with a thin layer of fire retardant powder, separating the fuel from the oxygen. The fire retardant powder works by suffocating the fire, inhibiting the release of combustible vapours and interrupting the combustion chain reaction, which makes these extinguishers extremely effective. ABC fire extinguishers are red in colour, and range in size from 2.27 kg to 9 kg (5 to 20 pounds). Dry Chemical extinguishers will have a label indicating they may be used on class A, B, and/or C fires.

Water – Air-pressurized Water (APW) These extinguishers contain water and compressed air and should only be used on Class A (ordinary combustibles) fires. Water is one of the most commonly used extinguishing agents for type A fires. You can recognize an APW by its large silver container. They are filled about two-thirds of the way with ordinary water, then pressurized with air. In some cases, detergents are added to the water to produce a foam. They stand about .6 to 1 metre tall (2 to3 feet) and weigh approximately 11.5 kg (25 pounds) when full. APWs extinguish fire by cooling the surface of the fuel to remove the "heat" element of the fire triangle. APWs are designed for Class A (wood, paper, cloth, upholstery, rubber, and certain plastics) fires only. Important: Never use water to extinguish flammable liquid fires (Class B). Water is extremely ineffective at extinguishing this type of fire and will make matters worse by the spreading the fire. Never use water to extinguish an electrical fire (Class C). Water is a good conductor and may lead to electrocution if used to extinguish an electrical fire. Electrical equipment must be unplugged and/or de-energized before using a water extinguisher on an electrical fire.

Carbon Dioxide (CO2) These extinguishers are most effective on Class B and C (liquids and electrical) fires. This type of extinguisher is filled with Carbon Dioxide (CO2) gas, a non-flammable gas under extreme pressure. These extinguishers put out fires by displacing oxygen, or taking away the oxygen element of the fire triangle. Because of its high pressure, when you use this extinguisher pieces of dry ice shoot from the horn, which also has a cooling effect on the fire. Since the gas disperses quickly, these extinguishers are only effective from 1 to 2-1/2 metres (3 to 8 feet). Since the fire could re-ignite, continue to apply the agent even after the fire appears to be out. You can recognize this type of extinguisher by its hard horn and lack of pressure gauge. CO2 cylinders are red and range in size from 2.27 kg to 45.36 kg (5 to 100 pounds) or larger. CO2 extinguishers are designed for Class B and C (flammable liquid and electrical) fires only. Important: CO2 is not recommended for Class A fires because they may continue to smoulder and re-ignite after the CO2 dissipates. Never use CO2 extinguishers in a confined space while people are present without proper respiratory protection.

TRIAGE

Triage is a French term meaning "to sort."

This will be part of your mission during the first aid rodeo in January with multiple victims.

During triage, victims are evaluated, sorted by the urgency of the treatment needed, and set up for immediate and delayed treatment. Typical time is about 20 seconds per patient. This is extremely important the more victims are present. Car crash with multiple vehicles and multiple passengers per car.

During triage, victims' conditions are evaluated and the victims are prioritized and labeled (tagged) into three categories:

• (I) immediate: the victim has one of the three killers and needs help now.
• (D) delayed: the victims injuries do not at this time jeopardize their life.
• (M) morgue: the victim is already beyond your capability to help.
  

If more help has arrived you can have them transport the "tagged" victims to staging areas where they will receive additional treatment. You will need an area for all three types of tags. Evaluate your surroundings and look for places that would make sense. Immediate staging area will need to be were Emergency Medical people have the best access. Keep it simple but there are a lot of things to think about. It all goes back to situational awareness.

SHOCK

Shock is a disorder resulting from ineffective circulation of the blood throughout the body. Remaining in shock will lead to the death of cells, tissues, and organs.

The body will initially compensate for this type of reduced blood flow and the condition will be hard to spot. Because of this most victims must be continually evaluated for shock.

Look for;

• Rapid and shallow breathing
• Capillary refill greater than 2 seconds (blanch test) press on the nail beds and see how long it takes for the white color to turn back to normal.
  
• Failure to follow simple commands, such as, "squeeze my hand."
• Changes in skin color.
  

* People who are in shock should never eat or drink until after their condition is under control.

Procedures for Controlling Shock:

1. Lay the victim on his or her back, and elevate the feet 6-10 inches above the level of the heart. Be sure that you maintain an open airway.
2. Control obvious bleeding.
3. Maintain body temperature (e.g., cover the ground and the victim with a blanket if necessary).
4. Avoid rough or excessive handling unless the rescuer and victim are in immediate danger.
   

IMAGES

PROCEDURES FOR CONTROLLING BLEEDING

Direct Pressure is usually the first method of controlling bleeding.

• Place direct pressure over the wound by putting a clean dressing (sterile gauze) over the wound and press firmly.
  
• Maintain pressure on the dressing over the wound by wrapping the wound firmly with a pressure bandage.

Elevation

• Simply elevate the wound above the level of the heart in the body.
  

Pressure Points

• Put pressure on the nearest pressure point to slow the flow of blood to the wound.
  
• Brachial point for bleeding in the arm.
• Femoral point for bleeding in the leg.
  

This could easily take 5 to 7 minutes to stop the bleeding completely. The use of a dressing with a pressure bandage will allow the rescuer to move on the the next victim.

A pressure bandage should be tied with a bow or square not so that it can me easily untied and the wound examined without cutting and wasting supplies.

CONTROLLING BLEEDING

If bleeding is not controlled, the victim will go into shock within a short period of time, and finally die. An average adult has 5 liters of blood. The loss of only one liter can be fatal.

The Three Types of Bleeding:

1. Arterial - bleeding from an artery is spurting bleeding.
2. Venous - bleeding from a vein is flowing bleeding.
3. Capillary - bleeding from capillaries is oozing bleeding.

The Three main methods for controlling bleeding:

1. Direct pressure
2. Elevation above the heart
3. Pressure points