EMT

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EMTs and Injury Prevention

• Advocates for Children
• and
• Safety

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EMT-BASIC SUPPLEMENT

• OSDH APPROVED 10/98
• ALL EMT-BASIC COURSES
• EMT-BASIC REFRESHER
• WITHIN WELL BEING OF EMT

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Learning Objectives

• Describe how EMTs can be effective community
  activists.
• Describe the Problem.
• Leading causes of death and injury to kids.
• Describe the Haddon Matrix and how to use it.

• Discuss specific strategies for prevention.
• Identify Resource Agencies.
• List sources for Injury Data.
• Describe methods for evaluating prevention
  programs.

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What is an ACCIDENT ?

• The term accident suggests
• something unpredictable,random and
• therefore not preventable.
• How many injuries have you responded to
• that were truly from an accident and
• not from a preventable incident ?

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Injury Prevention in EMS
A change of focus from

• Secondary Prevention Primary
  Prevention
• Prevention of Death
  Prevention of
• and Disability from
  Injury
• Injury

This is called a Paradigm Shift
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Kids and Injury Prevention

• Children are truly our future and our
• legacy! Yet we fail to care for our children
• by providing them safe environments to
• grow up in. For the last forty years Injuries
• have been the leading cause of death in
• children. Accounting for over 20,000 deaths
• per year.

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Why Do Kids Get Hurt?

• Its Age and Development Related

• Physical Attributes are varied.
• Motorskills havent fully developed.
• Cognitive and Behavioral development isnt
  complete either.
• Anatomic Physiologic differences alter injury
  patterns and severity in comparison to adults.

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Infants

• Injury Risks
• Falls
• Suffocation aspiration from FBAO.
• Child Abuse
• Burns

• Behaviors
• Unable to communicate verbally.
• Explores by mouth.
• Rapid changes in motor abilities and mobility.
• Completely dependent on the care giver to meet
  needs.

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Toddlers Preschoolers

• Injury Risks
• Falls
• Scald Burns
• Drowning
• Poisonings
• Child Abuse

• Behaviors
• Curious, exploratory, unaware of dangers
• Increased mobility
• Higher center of gravity

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Elementary School Age

• Injury Risks
• Bicycle Injuries
• Pedestrian Injuries
• Playground Injuries

• Behaviors
• Improved Motor Skills
• Recognizes danger
• Lacks experience and judgement
• Increased mobility independence

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Adolescents

• Behaviors
• Risk Takers
• Strong Peer Influence
• Increased Independence
• Impulsive
• Increased Experimentation Behaviors

• Injury Risks
• Auto/Motorcycle Crashes
• Sports injuries
• Violence Related Injuries
• Substance Abuse
• Suicide

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Anatomic Physiologic Differences

• General surface to volume ratio? , slow
  developing coordination and motor skills.
• Airway smaller, flexible, easily obstructed.
  Tongue is larger.
• Head larger in proportion to body. Higher center
  of gravity increased falls.
• Trunk chest wall is less rigid allowing for
  greater compression, abdominal organs are less
  protected also.

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What can EMS do to Help?
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What EMS Already Does

• Bystander Care
• CPR
• Seat Belt Safety
• First-Aid
• Calling EMS - 911

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What Else Can We Do?

• Identifying Risks
• Seat-belt Use, Bicycle Helmet Use, Drunk
  Drivers, Injuries from Airbags, etc.
• DOCUMENT! DOCUMENT! DOCUMENT!
• Speaking UP, Speaking OUT
• Traffic Control Issues, Public Access Defib,
  Water Safety
• YOU ARE AN EXPERT!!

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Public Education

• Make the Right Call
• Bystander Care
• CPR - Early Defib
• Public Service Announcements
• Newspaper Articles
• Public Speaking

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BREAK TIME
Next Principles of Injury Control
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Principles of Injury Control
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Scope of the Problem

• Nationally Injuries are the leading cause of
  death in ages1-44, and the third leading cause of
  death in all age groups.
• Most at risk are Children, minorities, those
  living in rural areas with low income.
• Dollars lost Lifetime costs per death caused by
  injuries are almost 4 times greater than deaths
  from Cancer and 6 times greater than those from
  Cardiovascular Diseases. Estimates of cost are
  45 billion per year.

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Scope of the Problem

• In Oklahoma
• Death Rates are HIGHER (92 vs. 64 per 100,00)
• Motor Vehicle Crashes are the 1 cause of death
  in kids aged15-19 in Oklahoma and the third
  leading cause of death in the 0-1 age group.

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Scope of the Problem
Injuries that result in death

• Death is only the tip
• of the iceberg,
• injuries that require
• treatment at a
• medical facility are
• 400 times greater.

Injuries requiring treatment at a Medical
Facility
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Who Pays for all of this?

• WE DO!!!

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The 4 Es of Injury Prevention

• Education
• Enforcement
• Engineering
• Environmental Modification

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Education

• Changing behaviors through education is a slow
  process and can take several years to occur.
• Identify a Target group.
• Education is used to increase the publics
  awareness.

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Enforcement

• A Great Behavior Modifier
• Examples
• Seatbelt Compliance Laws
• Manufacturers Compliance in Product Safety
• Product Liability Accountability

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Engineering

• Technological Advancements
• Design Changes (Airbags)
• User Protection

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Environmental Modifications

• Elimination or Reduction of Risk
• Community based changes in behaviors

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Synergy

• When you combine all four of the Es, their total
  impact is greater than the sums of each one .
  4410

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The Haddon Matrix
Factors
P h a s e s
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The Haddon MatrixPhases

• Pre-event Actions that can be taken prior to an
  events occurrence to prevent it from occurring.
• Event The injury causing incident and controls
  that are already in place to lessen the severity
  of the injury.
• Post-event What EMS does currently, as well as
  other measures designed to stop or lessen the
  injury process.

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The Haddon MatrixFactors

• Host Whos involved in the injury. Who gets
  hurt.
• Agent What objects or persons are involved with
  the injuries occurrence. May be contributors to
  the injury process or protective mechanisms.
• Environment Things within the community that
  have an influence good or bad on the injury
  process.

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Practice Session

• Break into workgroups and solve an injury
  prevention problem

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Project Development
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Getting Started

• Identify the injury problem, its size and
  severity. Data Sources ?????
• What is your target population and what do you
  know about them?
• Are there existing programs in place for this
  problem or its target population?
• Dont reinvent the wheel- look for existing
  programs that have been successful.

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The Planning Stage

• Gather together stakes holders - people with an
  interest in the issue.
• Include community leaders - shakers and movers.
  They can get things done.
• Convene a meeting on neutral turf for everyone.
  Let it be a brain storming session.
• Set goals both short and long range with specific
  timelines for each.
• Anticipate opposition and plan to overcome.
• Stay Focused!!!

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Implementation

• Convene the Grassroots network.
• Now involve the power brokers of the community.
• Plan for and create early successes - this breeds
  future success.
• Pick your fights carefully, if at all.
• Involve the media and keep them updated on your
  activities.
• Continually seek to improve the program.
• Tweak! Tweak! Tweak!

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A Primer on Presentations
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A Primer for Presentations

• Keep the presentation age appropriate
• Plan around the audiences ability to understand
  and reason.
• Use age appropriate words and examples.
• KISS!!!!
• Modify the length of the presentation to fit the
  audiences attention span.
• Each of us learn in different ways, impact all of
  them with your message.

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Presentation Methods

• R review
• O overview
• P present
• E exercise
• S summarize

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Visual Aids

• A picture is worth a thousand words

Head Injury
Bike Safety
CRASH
Bike Safety
CRASH
Helmets
Skull Fracture
Helmets
Death
Head Injury
Head Injury
Death
Death
Skull Fracture
CRASH
Helmets
Bike Safety
Head Injury
Bike Safety
CRASH
Skull Fracture
Helmets
Brain Injury
Bike Safety
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Scene Size UpReading the Audience

• SMILE, be friendly
• Move around, dont hide behind a podium.
• Make and maintain EYE contact
• Facilitate Group Participation
• Remember ATTITUDE is everything
• Be Professional

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Remember the Boy Scout Motto

• BE PREPARED

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The End